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3.
Br J Nurs ; 28(15): 985-992, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393775

RESUMO

Leukaemia is the most common cancer in children. The presenting manifestations can be wide-ranging, from a relatively well child to life-threatening complications. Symptoms can be manifested in any of the bodily systems. Undertaking a thorough clinical assessment of the child, in addition to recognising and addressing parental concerns, is vital. Furthermore, recognising that children can commonly present with musculoskeletal or abdominal symptoms increases the diagnostic yield, thereby preventing missed or late diagnoses. Childhood cancer has a huge impact on the child and their family, both at diagnosis and in the long term; providing advice and signposting families to appropriate support groups is an important aspect of their management. Nurses play a vital role in managing children with cancers, starting from raising suspicion and identifying the child with leukaemia, ensuring that high-quality care is delivered throughout their treatment, managing complications, and providing support and information to children and their families. An illustrative case study is included to highlight some of the challenges that health professionals may encounter in their clinical practice.


Assuntos
Leucemia/enfermagem , Diagnóstico de Enfermagem , Enfermagem Pediátrica , Criança , Diagnóstico Diferencial , Humanos , Leucemia/classificação , Leucemia/epidemiologia , Fatores de Risco
5.
Indian J Gastroenterol ; 38(3): 203-210, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31183842

RESUMO

BACKGROUND: Celiac disease (CD) is a lifelong condition with significant morbidity and requires an accurate diagnosis. Guidelines for pediatric CD were revised by the European and British Societies of Paediatric Gastroenterology Hepatology and Nutrition in 2012 and 2013, respectively. New recommendations introduced non-biopsy pathway (NBP) of diagnosis for a selective group of symptomatic children whose anti-tissue transglutaminase (anti-tTG) antibody titer is greater than ten times upper limit of normal. A clear understanding of the guidelines amongst consultant pediatricians will ensure all children with suspected CD receive a prompt and secure diagnosis. The aim of this study was to establish the interpretation and implementation of the revised guideline for CD amongst consultant general pediatricians in Southwest England (SWE) during the study period. METHODS: Telephone/email survey was conducted amongst consultant general pediatricians (n ≈ 140) working in 12 secondary care hospitals across SWE. The survey included eight questions incorporating three main themes: understanding of diagnostic pathway particularly for non-biopsy diagnosis, awareness of laboratory tests involved, and variations in practice in relation to the revised guidelines. RESULTS: Responses were available from 101/140 (72%). One hundred respondents were aware of the revised guidelines for diagnosing CD. However, only 17 respondents stated all the criteria of the guideline required for diagnosis by NBP, with further 17 seeking immediate advice from a specialist. Forty-four listed both the criteria for HLA-DQ2/DQ8 testing applicable to pediatricians. Forty-nine out of 100 pediatricians would commence gluten-free diet only after all the results were available. Thirty-three pediatricians also considered asymptomatic children with high anti-tTG titer eligible for diagnosis of CD by NBP. CONCLUSIONS: There is a need for improved understanding of revised CD guidelines amongst consultant general pediatricians especially while using the NBP and requesting HLA-DQ2/DQ8 testing.

6.
Br J Nurs ; 28(9): 560-564, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31070976

RESUMO

Cases of children presenting with limb or joint pain are relatively common and are due mainly to benign conditions. Early diagnosis will help reduce unnecessary invasive investigations so, although a relatively rare condition, benign acute childhood myositis (BACM), which presents with acute lower limb pain and an isolated rise in creatine kinase, should be considered. BACM is characterised by an infiltration of viruses into calf muscle fibres, which may cause a subsequent inflammatory response leading to calf-muscle pain. Symptomatic and supportive management, along with explanation and reassurance, is all that is required in managing this condition. This article discusses the management of a 10-year-old boy with a classical presentation of BACM, alongside differentials and management for clinician consideration.


Assuntos
Miosite/enfermagem , Diagnóstico de Enfermagem , Profissionais de Enfermagem Pediátrica , Doença Aguda , Criança , Diagnóstico Precoce , Humanos , Masculino
8.
Nurs Child Young People ; 30(6): 30-37, 2018 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-30394701

RESUMO

Chest X-ray (CXR) is one of the most common radiological investigations undertaken in practice with children. CXRs are requested for a number of suspected diagnoses, including pneumonia, pneumothorax and foreign body aspiration or ingestion. They may also be requested as part of a skeletal survey or to confirm the position of central and umbilical lines, as well as nasogastric tubes. Nurses play a vital role in ensuring that X-rays are performed in a safe and timely manner, and to ensure children are supported and positioned appropriately to obtain the best quality images. It is useful for nurses working with children to understand the underlying mechanism and rationale for requesting X-rays because this helps them to communicate the relevance of the procedure to other team members. This article provides an overview of the fundamental principles of obtaining a CXR and interpreting the images.

9.
Br J Nurs ; 27(20): 1156-1162, 2018 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-30418862

RESUMO

Febrile convulsions (FCs) are characterised by convulsions associated with fever in children aged between 6 months and 6 years. FCs are relatively common and affect 3-4% of children in western countries. This is the most common seizure disorder seen in children. The cause of febrile illness in FC is usually benign and most frequently due to acute viral infection. Convulsions secondary to an intracranial infection (e.g. meningitis, encephalitis) or from acute electrolyte imbalance should not be labelled as FCs. The diagnosis is based mainly on clinical history, and further investigations are generally unnecessary; management is largely symptomatic. Prolonged FC may need anticonvulsant medication to stop the seizure. Referral to paediatric neurologists may be considered in cases of complex or recurrent FC or in children where there is a pre-existing neurological disorder. One third of children with a first FC will develop a further FC during subsequent febrile illness; the likelihood increases in presence of other risk factors. This article outlines the presentation, management, investigations and prognosis for FC, and highlights how nurses in different clinical settings can provide education, support and counselling to help families return to normality after the event. An illustrative case study is also included to highlight the challenges faced by health professionals while managing children with this condition.

10.
Emerg Nurse ; 26(4): 32-42, 2018 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-30362669

RESUMO

Childhood asthma is a complex disease which may be resistant to treatment and varies in its clinical presentation. The number of children admitted to emergency departments (EDs) with acute exacerbation of asthma is high and many are managed solely in the department. The correct assessment of the severity of an exacerbation can be achieved through competent history taking, examination and accurate recording of observations. Nurses working in EDs should be able to recognise the clinical signs and symptoms of acute asthma, assess severity and advise on appropriate management. Nurses should have some knowledge of first-line management and how and when to help deliver these therapies. They should also be able to guide patients in discharge and follow-up care, develop a rapport with families and educate them on topics such as trigger avoidance. The assessment and management of these patients as outlined in this article is based on the British Thoracic Society/Scottish Intercollegiate Guidelines Network ( 2016 ).

11.
Br J Nurs ; 27(17): 974, 2018 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-30235024
12.
Br J Nurs ; 27(15): 886-892, 2018 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-30089051

RESUMO

Reflex anoxic seizures (RAS) present with a transient loss of consciousness and are triggered by an unexpected stimuli. These are paroxysmal, short-lived episodes of pronounced bradycardia or transient asystole; the episodes are self-limiting, lasting between 15 seconds and 1 minute. RAS are an important differential diagnosis of transient loss of consciousness but they are commonly misdiagnosed as epileptic events. An accurate and focused history is key to the diagnosis. They are mostly managed by performing an ECG to rule out other causes of arrhythmia, with subsequent explanation of the condition and reassurance given to parents. Nurses play an important role in eliciting the history and providing support to parents following the diagnosis. This article addresses the epidemiology and pathophysiology of RAS, with suggestions for management. An illustrative case study is included to highlight some of the challenges that health professionals working in different clinical set-ups are likely to come across while managing a child with RAS.

13.
J Coll Physicians Surg Pak ; 28(8): 654-655, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30060802
16.
Br J Nurs ; 27(10): 532, 2018 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-29791218
17.
J Coll Physicians Surg Pak ; 28(4): 335-336, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29615185
18.
Emerg Nurse ; 25(10): 24-30, 2018 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-29521078

RESUMO

Children with acute onset non-traumatic limp often present to emergency departments (EDs). The limp can occasionally be associated with medical emergencies such as septic arthritis and slipped upper femoral epiphysis but is often due to less severe conditions. This article discusses the common and self-limiting causes of acute onset of non-traumatic limp in children, such as transient synovitis, reactive arthritis, and benign acute childhood myositis. It also discusses more severe conditions, including septic arthritis, osteomyelitis, slipped upper femoral epiphysis, Perthes disease, malignancies and non-accidental injury. Management and prognosis of these conditions are discussed in the context of guidance from the National Institute for Health and Care Excellence. The article includes two case studies that illustrate different presentations and the challenges that nurses who manage children in EDs are likely to come across in clinical practice.

20.
Br J Nurs ; 27(1): 51, 2018 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-29323979

RESUMO

Siba Prosad Paul, Alifa De Aguiar, Joanna Barnden, Anna Cannon and Megan Eaton discuss the implications of high levels of the inflammatory marker, drawing on local audit.

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