Search

Beverley Bostocklooks at how nurses can use their communication skills to support patients

Beverley Bostock, chair of the Association of Respiratory Nurses' respiratory diseases committee, summarises key considerations for services treating patients with chronic obstructive pulmonary disease, including optimisation of diagnostics, involvement of the multidisciplinary team and a focus on comorbidities.

It is crucial for practice nurses to understand how to determine the severity of symptoms of allergic rhinitis. In this article, Beverley Bostock discusses how nurses can identify the relationship between asthma and allergic rhinitis.Allergic rhinitis (AR) is a condition which presents with symptoms such as a runny, itchy or blocked nose. It is also associated with ocular symptoms such as watering and itchy eyes. The symptoms of AR can significantly affect quality of life and the ability to take part in day-to-day activities. The impact can be felt from the condition alone or through the effect it can have on other conditions, most notably asthma.

Every year, the Global Initiative for Obstructive Lung Disease publishes its update on COPD. Beverley Bostockprovides an overview of what the latest publication means for general practice nursesThe latest guidance from the Global Initiative for Obstructive Lung Disease (GOLD) on chronic obstructive pulmonary disease (COPD) will have an impact on the management of patients in general practice. The definition of COPD has been updated as well as the recommended approach to diagnosis. Updated treatment recommendations act as an important reminder for primary care clinicians to implement interventions that are relevant in the community setting and to refer on for more specialised interventions in secondary care as appropriate. The replacement of the ABCD assessment tool with the ABE approach underlines the significant impact that exacerbations can have in the management of COPD, independent of the symptom burden. Updated sections on exacerbations remind clinicians of the importance of considering comorbid or new diagnoses as the cause of any symptoms.

Triggers for asthma symptoms can alter during the course of the year. Beverley Bostockevaluates the management of seasonal asthmaAsthma is an inflammatory condition, which is usually associated with an allergic trigger and response. Seasonal changes can influence asthma morbidity and mortality. The aim of asthma management is to optimise symptom control by impacting on the inflammatory cascade and, where possible, avoidance of known allergens. Triggers for asthma symptoms can alter during the course of the year as weather and airborne allergens change with the seasons. People living with seasonal allergic asthma should be taught to recognise their own triggers for their asthma symptoms and should be offered personalised, tailored advice, medication and action plans to proactively manage their asthma, optimise symptom control and prevent exacerbations.

Exacerbations of COPD require additional acute treatment. Beverley Bostockdiscusses the rationale for offering rescue packs as part of patient self-managementFor many people who have been diagnosed with COPD, there is a risk of experiencing an exacerbation of their symptoms which will require additional acute treatment to supplement their usual therapy. Exacerbations of COPD are associated with reduced quality of life, loss of lung function and a higher risk of dying. People living with COPD may be advised to keep a ‘rescue pack’ of oral corticosteroids and antibiotics to start if they develop symptoms of an exacerbation. Patient education should include advice on how to recognise exacerbations and when and how to treat them, with information about the effects and side-effects of any medication.

It is estimated that there may be as many as 2 million people in the UK who have undiagnosed chronic obstructive pulmonary disease (COPD). Undiagnosed COPD results in an increased symptom burden, reduced quality of life, risk of exacerbations and the potential to develop comorbid conditions. General practice nurses have a key role to play in identifying those who may have COPD and ensuring patients get timely treatment to reduce unnecessary suffering and risk to health.

Cardiovascular disease causes significant morbidity and mortality across the UK. Beverley Bostocklooks at the role practice nurses can play in the primary prevention of this conditionNurses working in general practice play an important role in identifying those at risk of developing cardiovascular disease (CVD) and implementing person-focused risk reduction strategies. The NHS Health Check programme was designed to identify people between the age of 40 and 74 years with risk factors for CVD. Nurses in general practice have a key role to play in encouraging people to attend Health Checks and helping people to understand the potential benefits of CVD risk assessment and reduction strategies. Lifestyle interventions and pharmacological management allow modifiable risk factors to be managed in an evidence-based and person-focused way.

Greater consideration of gender influence may be important not only in diagnosis of respiratory disease, but also for education, engagement and support of men.

Cardiovascular disease is often thought of as a condition that mainly affects men. Beverley Bostockanalyses the role practice nurses can play in recognising and managing cardiovascular disease in womenAlthough cardiovascular disease (CVD) is recognised to be a condition that affects men more than women overall, this risks underplaying the significant challenges relating to the diagnosis and management of CVD in women. Women are adversely affected compared to men in terms of diagnosis, acute management and implementation of secondary prevention, and the evidence base for treating women is lacking, due to the low numbers of women included in trials. Hormonal fluctuations throughout a woman's lifetime can also affect CVD risk. GPNs are ideally placed to consider the challenges of recognising and addressing CVD risk in women and to support them with engaging in reducing their lifetime risk.

With evidence supporting the link between cardiovascular disease and myriad risk factors, Beverley Bostock considers how best to identify and support at-risk individuals through long-term, multidisciplinary management.

Beverley Bostocklooks at how the changing weather may impact respiratory conditions

Beverley Bostockdetails the risks of malnutrition in the treatment of COPD, and how to treat it

How to take care of patients with respiratory conditions during the pandemic. By Beverley Bostock

Beverly Bostockexplains how variations in this common cardiovascular condition can be managed

Beverley Bostocklooks at how nurses can help patients with this common and painful condition

Beverley Bostocklooks at managing this new condition in primary care settings

Beverley Bostockexplains how missing a routine kidney test could harm diabetes patients

A healthy blood pressure is vital to life and both low and high blood pressure can be life-threatening. This article looks at how the body regulates blood pressure, what a healthy blood pressure is, how it should be measured and what happens when blood pressure rises or falls. Paramedics may see patients who have a previous diagnosis of hypertension or who have suffered the devastating consequences of undiagnosed and uncontrolled hypertension such as myocardial infarction and stroke (Law et al, 2003). Hypotension may be a presenting sign in conditions such as haemorrhage, both obvious as in the case of trauma and concealed as in the case of a slow gastro-intestinal bleed (Dutton et al, 2002) and may also be a sign of chronic disease such as neurological or endocrine disease (NHS Direct Wales, 2013). It is therefore important to understand how to recognise possible causes of blood pressure changes, understand how these fluctuations occur and how to measure blood pressure accurately in order to accurately assess the patient's condition.