Management Resources

05 March 2024
Worldwide gout is the commonest type of inflammatory arthritis. It is often misdiagnosed and poorly managed (Dehlin et al, 2020). Gout can be diagnosed and treated in primary care and is amenable to nurse management (Doherty et al, 2018). This article will help readers to be able to diagnose and manage gout, as well as how to be aware of and treat
acute gout and prevent further episodes. Certain conditions increase the risk of gout and this article advocates a holistic approach to improve overall health.
Topics:  Management
05 March 2024
Due to its diverse manifestations, Lyme disease (caused by the bacterium Borrelia burgdorferi) can present as a diagnostic challenge. This article will help practitioners to recognise Lyme disease in all its formats, ensure that historytaking and assessment are appropriate, and to consider other differentials while considering Lyme disease as the most likely diagnosis. Additionally, clinicians need to be able to manage the presentation appropriately using up-to-date guidelines. There will also be some discussion about the sequelae of Lyme disease — treated or untreated — and the impact of global warming on arthropod disease generally, including Lyme disease.
Topics:  Sequelae
11 September 2023
Moisture-associated skin damage (MASD) is an umbrella term to describe the trauma that occurs when there is prolonged exposure to moisture. Incontinence-associated dermatitis (IAD) is an MASD condition caused by urinary and/or faecal incontinence. It often causes significant pain and has a negative impact on an individual’s quality of life. Prompt diagnosis of IAD is key to successful management, but the early symptoms of erythema and redness may not be obvious in those with a dark skin tone. Delays in assessment and treatment mean that maceration, infection and the development of pressure ulcers become more of a risk. This is compounded by the lack of education and awareness of the significance of skin tone in relation to wound care. This article is based on published research, together with the practical experience of healthcare professionals at the Complex Wound Clinic (CWC) in North West London. The aim is to highlight the importance of considering skin tone when managing IAD. This can be achieved by using a validated skin tone assessment tool which shows a range of six skin tones. The importance of skin tone is a critical subject as the latest 2021 Census data shows that in England and Wales, 18% belong to a black, Asian, mixed or other ethnic group (Gov.UK, 2021 Census data).
Topics:  Skin tone
11 September 2023
This article looks at amenorrhoea and oligomenorrhoea, both of which can be a cause of concern for those women affected. Such issues can be difficult for clinicians to diagnose and treat, because of variations in bleeding patterns, complicated history in some patients, and associated problems. Signs and symptoms, causes, diagnosis, treatment, and complications are covered here, in the hope that general practice nurses (GPNs) and non-medical prescribers will feel more confident in recognising concerns and can then get earlier investigations and treatment, thus reducing the risk of complications and improving quality of life for women affected.
Topics:  Prognosis
10 July 2023
Heart failure (HF) is a complex clinical syndrome which arises when the heart is unable to pump blood adequately around the body, leading to a range of symptoms from shortness of breath and fatigue to fluid retention. HF care is complex, multifaceted, and is often delivered in varied settings by a range of healthcare workers depending on
local resources and services. To this end, the British Society for Heart Failure (BSH), using Delphi methodology (Barrett and Heale, 2020), has collaborated with cardiologists, specialist nurses, pharmacists, leads from primary and secondary care, as well as those from the wider multidisciplinary team (MDT), to develop an online resource with the aim of supporting this complex management, clinician competence and confidence, and increasing guideline-directed care. This article encourages use of this pathway and raises the importance of HF management from detection to palliative care (Karauzum et al, 2018).
Topics:  Management
10 July 2023
Childhood eczema, also known as atopic dermatitis, is a chronic skin condition that affects millions of children worldwide. The condition is characterised by dry, itchy, and inflamed patches of skin that can appear anywhere on the body. While the physical symptoms of eczema are often the focus of treatment, the condition can also have
a significant impact on a child’s emotional wellbeing. Added to this, the strain that it can put on families in terms of loss of sleep, time off work, financial and time of managing a chronic condition, and sibling jealousy of attention given to the child with eczema can mean that the stresses of eczema are shared by the whole family, not just the affected child. This article examines these issues further with recommendations for how the emotional impact of eczema may be more effectively managed.
29 March 2023
Hidradenitis suppurativa (HS) is a chronic long-term condition that occurs mostly in intertriginous areas of the skin. Unfortunately, HS is often not recognised and is poorly managed in clinical practice. Early detection and referral to an appropriate service such as dermatology is essential to reduce the long-term impact of the disease. Treatment is
multifactorial and includes management of associated comorbidities and lifestyle factors, such as obesity and smoking, medication, surgical intervention and managing depression and anxiety. This article explores the assessment and management options for general practice nurses (GPNs) to consider when presented with a patient with HS.
Topics:  Management
29 March 2023
Tracheomalacia, bronchomalacia and laryngomalacia are conditions where there is a deficiency in the functioning of the cartilage in the airway walls, which causes them to be weaker or even absent in places. This leads to an exaggerated luminal narrowing within the affected airway during expiration. The malacia may be localised or generalised. There is limited literature and published research in this area. These three conditions are seen in both children and adults. However, because of the size of the airways in small children and the more marked clinical response to any narrowing of the airway, these malacias are usually diagnosed at an earlier stage than when the conditions occur in adults. In the fully mature airway, the symptoms may be less obvious, leading to the conditions
being under-recognised and under-diagnosed in adults. It is also important to understand that in the adult population malacia may coexist with more common conditions such as asthma or chronic obstructive pulmonary disease (COPD), where breathlessness, cough, dyspnoea and other symptoms may be misattributed to these more common diseases.
This article raises awareness of these three malacia conditions.
Topics:  Symptoms
29 March 2023
Pneumonia continues to cause mortality around the world, despite advances in treatment and prevention. The disease can affect any age and can present with variable degrees of severity ranging from mild to severe, with the worst cases resulting in admission to hospital. While vaccination in the UK has impacted on the severity and death rate of this potentially devastating disease, the condition continues to be the largest cause of mortality in children with the highest death rates seen in under developed countries. This article gives an overview of treatment, management and prevention, as well as a brief insight into the possible long-term effects following recovery from pneumonia in babies and children.
Topics:  Treatment
05 December 2022
Pilonidal sSinus disease (PSD) is a debilitating inflammatory disorder of the skin that is more common in young males. The cause of PSD is not fully understood but contributed to loose hair and debris driven deep into the skin within the natal cleft leading to prolonged inflammation and formation of ‘pits’ which fill with hair and debris. Symptoms range
from mild discomfort to severe sinus development, which may result in pain, infection and multiple surgical procedures and has a significant impact on an individual’s quality of life
Topics:  Management