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Clinical

Extreme pacemaker reel syndrome in an elderly patient with cognitive impairment

A wheelchair-bound 82-year-old female with documented dementia presented to the emergency department (ED) following syncopal episodes. Eight months earlier a single-chamber VVI pacemaker had been...

Managing conversations with patients about death and dying

‘At death you break up: the bits that were you Start speeding away from each other for ever With no one to see.’ .

Discharge planning in end-of-life care

Recognising that a patient may be nearing the end of their life is a key consideration. Early recognition of dying is vital to allow for discussions to be started about the patient's wishes, for...

Decreased level of consciousness in a child: recognition and management

Consciousness can refer to either the state of wakefulness, awareness, or alertness in which most humans function while not asleep. Decreased consciousness is considered to be present when there is a...

Using play as a distraction technique for children undergoing medical procedures

Play therapy is a communication tool used to alleviate chronic, mild and moderate psychological and emotional conditions in children (Play Therapy UK, 2017). The focus for this article is the role...

The diagnosis and management of a patient with acute pyelonephritis

Acute pyelonephritis, known in clinical practice as an upper urinary tract infection (UTI), is defined as a tubulointerstitial disorder characterised by inflammation of the renal parenchyma caused by...

Advance care planning

ACP is a process that supports patients at any stage of health, and is a means of extending autonomy by planning for future care in the event if someone becomes unable to make their decisions or...

Effective decision-making: applying the theories to nursing practice

Linda was a 71-year-old who had been admitted to the cardiac ward following an episode of unstable angina. She was on continuous cardiac monitoring as recommended by the National Institute for Health...

Monitoring respiratory rate in adults

Health professionals use several terms to describe irregular respiratory rates, including:.

Lower limb assessment

Venous insufficiency includes a broad spectrum of venous complaints which range from telangiectasias or ‘spider veins’ (named for their spider web appearance) and varicose veins, to chronic venous...

The diagnosis and management of pulmonary embolism

Risk factors for pulmonary embolism include pregnancy, cancer, obesity, previous deep vein thrombosis (DVT) or PE, varicose veins, recent surgery, hospitalisation and immobilisation or lower limb...

How to manage the care of the dehydrated child

The NHS defines dehydration as the body losing more fluid than it is taking in (NHS website, 2019). Dehydration in children is usually caused by diarrhoea and vomiting or systemic infection, but can...

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