Description
Book SynopsisThis book provides Nurse Practitioners working in the field of Acute Medicine with an up to date, practical, and comprehensive guide to the management of acute medical patients. It serves as a text from which the busy highly skilled nurse can obtain information on assessment, diagnosis, and management of acute medical conditions.
Table of ContentsPreface xi
Introduction xiii
1 Patient Assessment 1
Communication 1
History taking 3
The functional enquiry 6
The physical assessment 8
General inspection 11
Respiratory examination 12
Cardiovascular examination 14
Gastrointestinal examination 17
Neurological examination 18
Musculoskeletal examination 24
Post examination 25
Conclusion 25
2 Emergencies 27
Anaphylaxis 27
Cardio-respiratory arrest 29
Ethical Issues 36
3 Acute Poisoning and Drug Overdose 41
Deliberate self-harm 41
Paracetamol overdose 45
Aspirin overdose 48
Tricyclic antidepressant overdose 51
Heroin overdose 53
Alcohol overdose 54
The National Institute for Clinical Excellence (NICE) self-harm guideline 56
Alcohol withdrawal 58
Drug withdrawal 60
4 Infection 65
Sepsis and septic shock 65
Meningitis 67
Infective endocarditis 71
Gastroenteritis 75
Urinary tract infection (UTI) 77
Fever in the returning traveller 79
Hot swollen joints 83
Antimicrobial resistance 86
5 Respiratory Conditions 89
Asthma 89
Chronic obstructive pulmonary disease (COPD) 93
Pulmonary embolism 96
Community and hospital acquired pneumonia 100
Pneumothorax 104
Type I respiratory failure 106
Type II respiratory failure 108
6 Cardiovascular Conditions 113
Acute coronary syndromes (ACS) 113
Stable angina 113
Unstable angina 114
Non-ST elevation myocardial infarction 116
ST elevation myocardial infarction 117
DIGAMI 121
Arrhythmias 121
Bradycardia 123
Tachycardia 126
Atrial fibrillation (AF) 129
Cardiac failure 132
Deep vein thrombosis (DVT) 134
Aortic dissection 136
Cardiac tamponade 138
7 Gatrointestinal Conditions 143
Upper gastrointestinal bleeding (GI bleed) 143
Variceal bleeding 145
Acute liver failure with encephalopathy 147
Acute ulcerative colitis and crohn’s disease 149
8 Metabolic Conditions 153
Diabetic ketoacidosis (DKA) 153
Hyperosmolar non-ketotic state (HONK) 155
Hypoglycaemia 157
Hyperglycaemia in the critically ill patient 159
Hypercalcaemia 162
Hyponatraemia 164
Hypernatraemia 166
Hypokalaemia 168
Hyperkalaemia 170
Addisonian crisis 172
Thyroid crisis (thyroid storm) 174
Myxedema crisis 177
9 Neurological Conditions 181
Status epilepticus 181
Stroke 184
Transient ischaemic attacks (TIA) 186
Isolated seizure and unexplained loss of consciousness 188
Headache 190
Subarachnoid haemorrhage (SAH) 192
Spinal cord compression 195
10 Renovascular Conditions 197
Acute renal failure (ARF) 197
Accelerated (malignant) hypertension 199
11 Elderly Care 203
Hypothermia 203
Confusion 205
12 Haematological Conditions 209
Severe anaemia 209
Sickle cell crisis 212
Neutropenic sepsis 215
Blood transfusion guidance 217
13 Advanced Practice 223
An overview of advanced practice 223
The challenges of advanced practice 225
Legal perspective 225
Ethical principles 226
Informed consent 228
Assessment of capacity 229
Prescribing 231
Patient group directions 233
Conclusion 234
Appendices
Appendix I Examples of Clinical Management Plans 237
Appendix II Examples of Patient Group Directions 245
Glossary 255
Index 259
