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Clinical

Urinary tract infection in an older patient: a case study and review

Mrs M, an 87-year-old lady living in a nursing home, was referred to the community ANP by the senior carer. The presenting complaint was reported as dark, cloudy, foul-smelling urine, with new...

COPD: what GPNs need to know from the latest GOLD update

An updated definition of COPD is included in the guidelines, reflecting the symptoms (productive cough and breathlessness) that are linked to persistent, often progressive and non-fully reversible...

Vaccine-preventable food- and water-borne diseases

Poliomyelitis (Polio) is a viral infection that is potentially paralysing and mostly affects the under 5's. This disease is spread via the faecal-oral route and humans are the only natural known host...

Managing chronic kidney disease, diabetes and coronary artery disease

Whatever the cause of an individual’s CKD, there is a universal emphasis on HT control (Pugh et al, 2019); HT being both a cause and symptom of CKD. NICE (2021) guidance for blood pressure control is...

Scabies: an update for nurses

Scabies is one of the most common dermatological conditions and affects more than 200 million people at any given time. While scabies occurs worldwide, it is most common in hot, tropical countries and...

Chronic kidney disease: the canary in the coal mine

The guardian of cost-effective care in the UK (except Scotland) is NICE, which has recently been very active in this area, producing new and updated CKD (NICE, 2021a) and type 2 diabetes guidelines...

Allergic rhinitis: classification, diagnosis and treatment

Allergic rhinitis can be classified depending on the frequency and severity of symptoms as per the World Health Organisation Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. Intermittent...

Uncontrolled asthma in primary care: part 1

The British Guideline on the Management of Asthma (BTS/SIGN, 2019) defines the aim of asthma management as being to gain control of the disease, while the guideline from the National Institute for...

A brief guide to immunisation and the immunocompromised child or young person

During immunosuppression, the normal function of the immune system is inhibited. Treatments, such as chemotherapy, disrupt the normal function of the cell cycle, which consequently causes...

Breastfeeding and medication for long-term conditions

When prescribing to breastfeeding women we need to be aware that some of the drug which she takes is likely to pass to the baby via breastmilk. The British National Formulary (BNF) is not always a...

Consultation in out-of-hours practice: a clinical review of Lyme disease

Consultation models were originally developed as a means to explore and understand the psychological aspects of doctor-patient consultations, in addition to providing a structure to the process...

SGLT2 inhibitors in type 2 diabetes: time to flozinate?

SGLT2 inhibitors, sometimes also referred to as ‘gliflozins’ or ‘flozins’ are an established class of medications, which are licensed for the treatment of (Table 1):.

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