Professional Nursing Today - latest Issue
Volume 21, Issue 1, 2017
Source: Professional Nursing Today 21, pp 2 –2 (2017)More Less
Source: Professional Nursing Today 21, pp 3 –15 (2017)More Less
A hundred years ago, Sir William Osler described the pneumococcus as the ‘Captain of the men of death’, referring to John Bunyuan’s phrase in his book ‘The life and death of Mr Badman’, written more than 200 years earlier: “Yet the captain of all these men of death that came against him to take him away was the consumption, for it was that that brought him down to the grave”. For Osler the captain of the men of death was not ‘consumption’ (tuberculosis) but pneumonia or the pneumococcus. During his time, acute pneumonia was responsible for more deaths than tuberculosis and the pneumococcus killed adolescents and young adults in the prime of their lives. Death followed a severe illness with high fever from 105°F to 107°F, fighting for air with rapid and shallow, often painful breathing. The condition escalated to a crisis, characterised by a sharp fall in temperature, and in many, death. Concerning those that recover Osler states, “Usually there is an abundant sweat and the patient sinks into a comfortable sleep” and “With the fall in the fever the respirations become reduced almost to normal, the pulse slows, and the patient passes from perhaps a state of extreme hazard and distress to one of safety and comfort”. Osler also called the pneumococcus the ‘friend of the aged’ as it kills them gently without severe symptoms (“Taken off by it in an acute, short, not often painful illness, the old escape those ‘cold gradations of decay’ that make the last stage of all so distressing”) and “one may say that to die of pneumonia is almost the natural end of old people”. The advent of antibiotics in the 1940s dealt a severe blow to the captain’s reign of terror and thanks to them the harshness of the escalating severity and crisis by death is now muted or rarely seen among young adults, at least in industrialised countries. It remains, however, a captain of the men of death among HIV-infected adults with limited access antiretroviral treatment and also among small children in the poorest countries without access to antibiotics. Small wonder the consternation then, when multiresistant strains emerged in South Africa in the 1970s.
Author Andre MaraisSource: Professional Nursing Today 21, pp 16 –21 (2017)More Less
Allergic conjunctivitis is a common condition encountered by the healthcare professional. Several factors have been implicated as possible causes and almost all involve an IgE mediated immune response. Symptoms may vary from mild to severe and if misdiagnosed, or incorrect treatment is given, the result could lead to permanent vision loss. It is important for the general practitioner to differentiate between allergic, bacterial and viral causes of conjunctivitis, and to treat and refer appropriately.
Source: Professional Nursing Today 21, pp 24 –31 (2017)More Less
Opioid use disorders have disappointing outcomes when treated via conventional methods, including detoxification and rehabilitation. This guideline is an update that is based on current available evidence and consensus of a panel of medical experts in the field of addiction medicine. It aims to provide an overview of the medical treatment of opioid use disorders.
Author W.G.J. KloeckSource: Professional Nursing Today 21, pp 33 –37 (2017)More Less
Manifestations of anaphylaxis may occur within seconds or minutes after exposure to a causative antigen. Almost any substance can be implicated as a potential precipitating agent. Reactions may be slow, progressive, or rapidly fatal within minutes. Any healthcare worker involved in the administration of medications or the care of patients, whether a doctor, dentist, nurse, paramedic or allied health professional, is ethically obliged to be able to appropriately manage the potential consequences of such an action – a life-threatening anaphylactic reaction.
Author J.A. KerSource: Professional Nursing Today 21, pp 40 –42 (2017)More Less
Heart failure is a global problem. It is estimated that approximately 38 million people worldwide experience heart failure, and this number is growing because of the ageing of nations’ populations, but also because patients are rescued from death during an acute myocardial infarction, and later develop heart failure. The prevalence of heart failure is roughly 2% of the population, and up to 10% in people aged 75 years and older. It is also estimated that the lifetime risk of heart failure at the age of 40 years is approximately 20% (one in five) for both men and women. Heart failure is also increasing in low- and medium-income countries, probably because of changes in lifestyle which favour the development of obesity, hypertension and diabetes mellitus. The mortality of heart failure is worse than that associated with most cancers. Average mortality is roughly 50% within five years. However, evidence-based treatment did reduce mortality significantly. About two thirds of the economic burden of heart failure is owing to hospital admissions and re-admissions. Therefore, heart failure is also an expensive disease.
Source: Professional Nursing Today 21, pp 43 –48 (2017)More Less
Corticosteroids act as potent anti-inflammatory drugs and have been used in various sport settings for the treatment of both acute and chronic injuries. Basic physiology and mechanisms of action for gluco- and mineralo-corticoids are discussed. Methods of administration, the action on the inflammatory response, and potential short and long-term side effects of corticosteroid use are also deliberated. More specifically, corticosteroid use in the treatment and management of sport-related injuries are discussed, elucidating on the ethical boundaries and anti-doping regulations pertaining to corticosteroid use in sports, as well as putting forth suggestions for the use of local steroid injections and their contraindications. In conclusion, it was found that, despite some controversy in the use of corticosteroid treatment in the sports environment, little empirical evidence exists that could conclusively rule for or against its use. It is however clear that, if clinically justified, there is a significant role for corticosteroid treatment in the realm of sports injury and notably with a relatively low risk profile, if administered correctly.
Author D. Den HollanderSource: Professional Nursing Today 21, pp 48 –49 (2017)More Less
Two toddlers with major burns are described who were seen in primary healthcare clinics and sent home. Both children drank large amounts of tap water and presented a few days later with severe hyponatraemia and seizures (‘water poisoning’). Indications for admission and early fluid management of burn patients are summarised.
Author Bridget AdamsSource: Professional Nursing Today 21, pp 50 –53 (2017)More Less
When planning a pregnancy, it is helpful for women and their partners to identify various factors that could increase the possibility of conception, then having a healthy pregnancy and healthy baby. The goal of preconception care is to provide health promotion, screening, and interventions for women of reproductive age to reduce risk factors that might affect future pregnancies.
Author Sithembile S. GwebuSource: Professional Nursing Today 21, pp 54 –56 (2017)More Less
All countries in the world are affected by diverse, multifactorial health challenges. In Africa, these challenges are characterised by a high burden of disease, poor governance, economic issues, poor distribution of resources, and political instability that make it extremely difficult to deliver high-quality health care to the population. Such challenges are a reflection of one of the major shortcomings that exist within the healthcare system, which is nursing leadership. Ezeh and the World Health Organization revealed that most researchers viewed the African health system as fragile and weak. This is evident from the African health leaders’ lack of autonomy and spontaneous response in resolving healthcare crises on the continent. Furthermore, it is argued that Africa has developed a dependency syndrome on the European Union healthcare leaders who are not afraid to take on health challenges in any setting. It is also claimed that these European health gurus implement care, which is not congruent with African values and ethics, and that the situation has robbed African healthcare leaders of their power to choose and exercise their authority. Conversely, the remodelling of the healthcare system calls for immediate interventions instigated by effective and aware leaders. While the African healthcare leaders struggle to regain their authority, their inadequate focus on promoting nursing leadership has limited their success in resolving dynamic healthcare issues. This paper, therefore, ascertains that nursing leadership is a looming crisis for Africa.
Source: Professional Nursing Today 21, pp 57 –62 (2017)More Less
Candida auris is an emerging fungal (yeast‐like) pathogen which has caused invasive infections and hospital outbreaks on several continents. The fungus is difficult to identify in the routine laboratory setting, is associated with a high in‐hospital mortality among patients with invasive infection and may be difficult to “eradicate” from the hospital environment.