Treatment Resources

Heart failure (HF) remains one of the most common reasons for hospital admissions and is predicted to rise substantially in the next decade. As many of these patients have other comorbidities, general practice nurses (GPNs) are in the ideal position to assess and identify any possible deterioration before it results in admission. Having a good understanding of HF, terminology and treatment will assist with this, and standardising care and reviews in line with current guidelines will improve care.

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.

When patients present with red lower legs, the cause is often assumed to be cellulitis or erysipelas. There are, however, several alternative conditions which mimic the clinical signs of cellulitis or erysipelas, which can lead to misdiagnosis. It is important that the cause is correctly diagnosed to prevent inappropriate prescribing of antibiotics. This article discusses the different potential causes of ‘red legs’, in addition to cellulitis and erysipelas, together with clinical signs and symptoms to enable general practice nurses (GPNs) to differentiate between them and implement appropriate treatments

There are many different causes of liver disease and current estimates suggest that as many as one in 10 people have problems with their liver at some time in their life (Foundation for Liver Research, 2020). Perhaps most worrying is the fact that incidence of liver disease is increasing, with the number of deaths reported to have increased by 400% since 1970 (British Liver Trust, 2020). Most liver diseases are asymptomatic early on, frequently resulting in late diagnosis, potentially leading to a higher risk of poor outcomes. Many of the well-known liver diseases are preventable and this article, which covers fatty liver disease, hepatitis A, B and C and liver cancer, hopes to raise awareness of risk factors, recognition, causes and treatment of these conditions, and give general practice nurses (GPNs) and non-medical prescribers more confidence when caring for patients with these illnesses.

Hay fever and allergic rhinitis are common conditions seen in primary care which can have a huge effect on the quality of life of sufferers The most important step in diagnosing hay fever or allergic rhinitis is to take an allergy focused clinical history. There are many treatment options available, including allergen avoidance, antihistamines and nasal corticosteroids. Many medications are now available over the counter; patients need to know how to take their medication correctly. Asthma frequently co-exists with allergic rhinitis and can make asthma symptoms much worse. General practice nurses (GPNs) are ideally placed to offer advice and support to these patients. If initial treatments fail, patients should return to primary care as there are a wide range of therapeutic interventions which may help. For those whose symptoms are very severe or not responding, immunotherapy may be an option, and the patient should be referred.

The terms sexually transmitted diseases and sexually transmitted infections (STIs) are used to cover a number of individual conditions that vary in their presentation, treatment, management and risk, and severity of complications. Statistics indicate that the prevalence of some diseases is rising, while others are falling. Yet, in spite of these findings, in 2017 there were 422,147 new diagnoses of STIs made in England alone (Public Health England [PHE], 2018). Current data shows that young people experience the highest diagnosis rates, thought to be likely due to more frequent rates of partner change among younger adults, with females more likely to be diagnosed than males (PHE, 2018). Early detection and treatment is key if complications and avoidance of spread are to be achieved. Given the incidence of some STIs, it is likely that general practice nurses (GPNs) and GPs will be approached by patients asking for help and advice. This article gives an overview of some of the more common STIs, with the aim of improving knowledge and confidence in this area of clinical practice.

Perinatal mental health is a critically important part of understanding the journey of life. Pregnancy and childbirth are a time of great excitement and change, which impacts both personally and professionally on the vast majority of the population. For at least 20% of pregnant women, this life event will also bring emotional disturbances and for some it will have an effect on their mental wellbeing for years after the birth. Consequently, it is vital that healthcare professionals recognise the diversity of mental illness that can impact on the childbearing population, including the need to commission effective services and be aware of how best to support women, fathers and their families during this time. This is particularly relevant for general practice nurses (GPNs) and those working in community settings, as well as nurses and midwives working with women who are pregnant, planning a pregnancy, or who have recently given birth. 

Around 12 million people in the UK have been diagnosed with hypertension (i.e. blood pressure [BP] greater than or
equal to 140/90mmHg) and over five million people have undiagnosed hypertension, which, if left untreated, can lead to premature ill health and death (Blood Pressure Association, 2008).

The risks associated with increasing BP are continuous — with each 2mmHg rise in systolic BP there is a 7% increased risk of mortality from ischaemic heart disease and a 10% increased risk of mortality from stroke (Lewington et al, 2002). However, although BP-lowering strategies have been shown to significantly reduce the risk, population-based studies consistently demonstrate that patients are unaware of the causes and effects of hypertension, and around two-thirds of those diagnosed remain untreated or inadequately controlled (Falaschetti et al, 2009; Antikainen, 2010). This article re-examines the evidence and guidelines to see how we can improve practice within this important area of  cardiovascular disease prevention.
 

Colorectal cancer is the third most common cancer in the UK, affecting 40,000 people (Patnick and Atkin, 2011). It is likely therefore that general practice nurses (GPNs) will encounter patients at risk of, or with the disease during everyday practice. This article gives GPNs a brief understanding of colorectal cancer, including identifying patients who may be at risk of developing the disease and who may benefit from screening and health promotion. GPNs can play an active role in managing patients with colorectal cancer, providing clinical interventions, while also offering advice and support.