Pub Date : 2021-02-01DOI: 10.1093/MED/9780198831815.003.0012
T. Robinson, J. Scullion
Lung cancer is the most common cancer in the UK. This chapter covers the epidemiology of the disease, the two main types of lung cancers (non-small cell lung cancer—NSCLC, and small cell lung cancers—SCLC), presenting symptoms, investigations, and diagnostic procedures. The role of the multidisciplinary team and techniques for breaking bad news are both covered. Treatment options, including surgery, systemic anticancer treatment, concurrent chemoradiation, and radiotherapy are all described for both NSCLC and SCLC. Interventions for pain, the analgesic ladder, and the role of the lung cancer specialist nurse are defined. Finally, the aspects of mesothelioma are covered.
{"title":"Lung cancer and mesothelioma","authors":"T. Robinson, J. Scullion","doi":"10.1093/MED/9780198831815.003.0012","DOIUrl":"https://doi.org/10.1093/MED/9780198831815.003.0012","url":null,"abstract":"Lung cancer is the most common cancer in the UK. This chapter covers the epidemiology of the disease, the two main types of lung cancers (non-small cell lung cancer—NSCLC, and small cell lung cancers—SCLC), presenting symptoms, investigations, and diagnostic procedures. The role of the multidisciplinary team and techniques for breaking bad news are both covered. Treatment options, including surgery, systemic anticancer treatment, concurrent chemoradiation, and radiotherapy are all described for both NSCLC and SCLC. Interventions for pain, the analgesic ladder, and the role of the lung cancer specialist nurse are defined. Finally, the aspects of mesothelioma are covered.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128245114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/med/9780198831815.003.0020
T. Robinson, Jane Scullion
Pulmonary arterial hypertension (PH) is an often-misdiagnosed lung disorder occurring as a primary idiopathic disease or as a complication of a large number of respiratory and cardiac diseases. It was previously thought to be a rare condition with a relentlessly progressive course and few treatment options. However, it is increasingly recognized in association with other conditions and recent advances have resulted in the development of effective therapies. This has focused attention on making an early and accurate diagnosis. Despite these recent advances, it is important to consider that it remains an alarming, incurable disease with a poor prognosis. PH describes a number of devastating diseases causing breathlessness, loss of exercise capacity, and death due to right-sided heart failure. This chapter begins by defining the condition, including the ESC and ERS guidelines, then goes on to give help with diagnosis and functional classification. Clinical features and investigations are outlined, as well as further assessment and key respiratory, cardiac, and haematological investigations. Specific targeted therapies, general treatment, and nursing care and advice are covered too.
{"title":"Pulmonary hypertension","authors":"T. Robinson, Jane Scullion","doi":"10.1093/med/9780198831815.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780198831815.003.0020","url":null,"abstract":"Pulmonary arterial hypertension (PH) is an often-misdiagnosed lung disorder occurring as a primary idiopathic disease or as a complication of a large number of respiratory and cardiac diseases. It was previously thought to be a rare condition with a relentlessly progressive course and few treatment options. However, it is increasingly recognized in association with other conditions and recent advances have resulted in the development of effective therapies. This has focused attention on making an early and accurate diagnosis. Despite these recent advances, it is important to consider that it remains an alarming, incurable disease with a poor prognosis. PH describes a number of devastating diseases causing breathlessness, loss of exercise capacity, and death due to right-sided heart failure. This chapter begins by defining the condition, including the ESC and ERS guidelines, then goes on to give help with diagnosis and functional classification. Clinical features and investigations are outlined, as well as further assessment and key respiratory, cardiac, and haematological investigations. Specific targeted therapies, general treatment, and nursing care and advice are covered too.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117194913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/med/9780198831815.003.0023
T. Robinson, Jane Scullion
Although there are respiratory diseases that are acute and respond well to treatments, many end in what could be viewed as an essentially palliative or terminal phase. Many respiratory disease processes are essentially chronic in nature and some patients should be considered palliative from diagnosis. There is increasing evidence that patients with end-stage lung disease experience declining heath, anxiety, depression, fatigue, coping difficulties, and somatic preoccupation, and if this is unrecognized then there is a potential for basic needs to remain unmet. This chapter describes the management of breathlessness, chest clearance, and relaxation during the palliative phase of care, methods for managing anxiety, depression, and pain, and the nurse’s role in care during end-of-life care.
{"title":"Palliative care","authors":"T. Robinson, Jane Scullion","doi":"10.1093/med/9780198831815.003.0023","DOIUrl":"https://doi.org/10.1093/med/9780198831815.003.0023","url":null,"abstract":"Although there are respiratory diseases that are acute and respond well to treatments, many end in what could be viewed as an essentially palliative or terminal phase. Many respiratory disease processes are essentially chronic in nature and some patients should be considered palliative from diagnosis. There is increasing evidence that patients with end-stage lung disease experience declining heath, anxiety, depression, fatigue, coping difficulties, and somatic preoccupation, and if this is unrecognized then there is a potential for basic needs to remain unmet. This chapter describes the management of breathlessness, chest clearance, and relaxation during the palliative phase of care, methods for managing anxiety, depression, and pain, and the nurse’s role in care during end-of-life care.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130469726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/med/9780198831815.003.0014
T. Robinson, J. Scullion
Oxygen therapy is the administration of supplementary oxygen to achieve a higher inspiration of oxygen than is achieved when breathing air. Oxygen therapy aims to correct hypoxaemia. This chapter covers the clinical indicators of hypoxaemia, the use of acute oxygen therapy, the choice of high-flow or low-flow devices, and examples of different types of each. Humidification of acute oxygen therapy is also covered, and the points to consider such as the risk of encouraging bacterial growth. The evidence base for long-term oxygen therapy (LTOT) is outlined, as well as assessment by the respiratory team for prescribing the treatment. Intermittent oxygen therapy, ambulatory oxygen, and oxygen containers are all covered. Home oxygen and follow-up care are both covered.
{"title":"Oxygen therapy","authors":"T. Robinson, J. Scullion","doi":"10.1093/med/9780198831815.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780198831815.003.0014","url":null,"abstract":"Oxygen therapy is the administration of supplementary oxygen to achieve a higher inspiration of oxygen than is achieved when breathing air. Oxygen therapy aims to correct hypoxaemia. This chapter covers the clinical indicators of hypoxaemia, the use of acute oxygen therapy, the choice of high-flow or low-flow devices, and examples of different types of each. Humidification of acute oxygen therapy is also covered, and the points to consider such as the risk of encouraging bacterial growth. The evidence base for long-term oxygen therapy (LTOT) is outlined, as well as assessment by the respiratory team for prescribing the treatment. Intermittent oxygen therapy, ambulatory oxygen, and oxygen containers are all covered. Home oxygen and follow-up care are both covered.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124035958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/MED/9780198831815.003.0027
T. Robinson, J. Scullion
Respiratory services should be delivered in an integrated way, taking into account the overlap in patient population and in the personnel providing care. The majority of patients with respiratory disease are cared for by a team of health professionals from both primary and secondary care. Respiratory nurses work as part of the multidisciplinary team. This team includes doctors, ward-based, and outpatient nurses, physiotherapists, occupational therapists, lung-function technicians, community pharmacists, social services and, of course, the patient, and their family and carers. This chapter outlines the responsibilities and contributions of each member of the multidisciplinary team in providing respiratory services.
{"title":"The multidisciplinary team","authors":"T. Robinson, J. Scullion","doi":"10.1093/MED/9780198831815.003.0027","DOIUrl":"https://doi.org/10.1093/MED/9780198831815.003.0027","url":null,"abstract":"Respiratory services should be delivered in an integrated way, taking into account the overlap in patient population and in the personnel providing care. The majority of patients with respiratory disease are cared for by a team of health professionals from both primary and secondary care. Respiratory nurses work as part of the multidisciplinary team. This team includes doctors, ward-based, and outpatient nurses, physiotherapists, occupational therapists, lung-function technicians, community pharmacists, social services and, of course, the patient, and their family and carers. This chapter outlines the responsibilities and contributions of each member of the multidisciplinary team in providing respiratory services.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131936557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/med/9780198831815.003.0004
T. Robinson, Jane Scullion
Many nurses in both primary and secondary care are working as respiratory nurse specialists and nurse practitioners. These roles involve assessing and diagnosing many conditions, including common respiratory disorders. This chapter covers the undertaking of a respiratory assessment. It shows how making a diagnosis can be difficult because the principal symptoms of respiratory disease are common to many different conditions. The respiratory assessment also determines which investigations may be required to reach a diagnosis. Respiratory assessments involve skilled communication with patients and carers and other medical professionals, along with an understanding of informed consent and the ethical implications of gaining consent.
{"title":"Respiratory assessment","authors":"T. Robinson, Jane Scullion","doi":"10.1093/med/9780198831815.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780198831815.003.0004","url":null,"abstract":"Many nurses in both primary and secondary care are working as respiratory nurse specialists and nurse practitioners. These roles involve assessing and diagnosing many conditions, including common respiratory disorders. This chapter covers the undertaking of a respiratory assessment. It shows how making a diagnosis can be difficult because the principal symptoms of respiratory disease are common to many different conditions. The respiratory assessment also determines which investigations may be required to reach a diagnosis. Respiratory assessments involve skilled communication with patients and carers and other medical professionals, along with an understanding of informed consent and the ethical implications of gaining consent.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129222064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/MED/9780198831815.003.0007
T. Robinson, J. Scullion
Asthma is a significant problem in the UK reported to affect approximately 5.2 million people; and occurring in 21% of children and 15% of adults. Allergy is an important component of asthma, and most people with asthma are sensitive to one or more common aeroallergens. Approximately 80% of people with asthma also have rhinitis (essentially a runny, blocked nose), which is associated with a significant impact on quality of life. This chapter covers asthma and its assessment and management, patient education, and an introduction to allergy. This also includes the allergic response, diagnosis, anaphylaxis, immunology, and care algorithms as other important aspects.
{"title":"Asthma and allergies","authors":"T. Robinson, J. Scullion","doi":"10.1093/MED/9780198831815.003.0007","DOIUrl":"https://doi.org/10.1093/MED/9780198831815.003.0007","url":null,"abstract":"Asthma is a significant problem in the UK reported to affect approximately 5.2 million people; and occurring in 21% of children and 15% of adults. Allergy is an important component of asthma, and most people with asthma are sensitive to one or more common aeroallergens. Approximately 80% of people with asthma also have rhinitis (essentially a runny, blocked nose), which is associated with a significant impact on quality of life. This chapter covers asthma and its assessment and management, patient education, and an introduction to allergy. This also includes the allergic response, diagnosis, anaphylaxis, immunology, and care algorithms as other important aspects.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130688814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/med/9780198831815.003.0018
T. Robinson, Jane Scullion
A pneumothorax is defined as air in the pleural space. It can be spontaneous, occur as the result of trauma, or be iatrogenic. Patients with a pneumothorax commonly present with pleuritic chest pain on the affected side and/or breathlessness. Younger patients often have minimal breathlessness although in secondary pneumothorax breathlessness may be increased. A pneumothorax will reduce the compliance of the lungs and so the lungs will become stiffer. Because of reduced compliance in the affected lung greater pressure needs to be generated during inspiration to move the same volume of air into the lungs. As a result, breathing will become more of an effort and the sensation of breathlessness will be increased. The patient may also have pleuritic chest pain from inflammation of the pleura, generally due to bleeding, and heightened by attempts to inflate the affected lung. This chapter covers the incidence, risk factors, features, and investigations of the condition, different management options and prognosis, and different aspects of nursing care. Practical care of chest drains and management of the pregnant patient is also covered.
{"title":"Pneumothorax","authors":"T. Robinson, Jane Scullion","doi":"10.1093/med/9780198831815.003.0018","DOIUrl":"https://doi.org/10.1093/med/9780198831815.003.0018","url":null,"abstract":"A pneumothorax is defined as air in the pleural space. It can be spontaneous, occur as the result of trauma, or be iatrogenic. Patients with a pneumothorax commonly present with pleuritic chest pain on the affected side and/or breathlessness. Younger patients often have minimal breathlessness although in secondary pneumothorax breathlessness may be increased. A pneumothorax will reduce the compliance of the lungs and so the lungs will become stiffer. Because of reduced compliance in the affected lung greater pressure needs to be generated during inspiration to move the same volume of air into the lungs. As a result, breathing will become more of an effort and the sensation of breathlessness will be increased. The patient may also have pleuritic chest pain from inflammation of the pleura, generally due to bleeding, and heightened by attempts to inflate the affected lung. This chapter covers the incidence, risk factors, features, and investigations of the condition, different management options and prognosis, and different aspects of nursing care. Practical care of chest drains and management of the pregnant patient is also covered.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129374595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/med/9780198831815.003.0019
T. Robinson, Jane Scullion
A pulmonary embolism (PE) is a clinically significant obstruction occurring in part of or the entire pulmonary vascular tree. The most common cause is a thrombus from a distant site such as the leg. Most pulmonary emboli originate from detached portions of venous thrombi that have formed in the deep veins of the lower limbs. Other sites where they form include the right side of the heart and the pelvis. Non-thrombotic emboli, mainly fat, air, and amniotic fluid, may also occur but these are rarer. This chapter provides an overview of incidence and aetiology, and tabulates the risk factors for PE. The clinical features and assessment are covered, and six different investigations are explained. Management—anticoagulants, thrombolysis, and high-flow oxygen—are also included, along with nurse involvement at different points of PE.
{"title":"Pulmonary embolism","authors":"T. Robinson, Jane Scullion","doi":"10.1093/med/9780198831815.003.0019","DOIUrl":"https://doi.org/10.1093/med/9780198831815.003.0019","url":null,"abstract":"A pulmonary embolism (PE) is a clinically significant obstruction occurring in part of or the entire pulmonary vascular tree. The most common cause is a thrombus from a distant site such as the leg. Most pulmonary emboli originate from detached portions of venous thrombi that have formed in the deep veins of the lower limbs. Other sites where they form include the right side of the heart and the pelvis.\u0000 Non-thrombotic emboli, mainly fat, air, and amniotic fluid, may also occur but these are rarer. This chapter provides an overview of incidence and aetiology, and tabulates the risk factors for PE. The clinical features and assessment are covered, and six different investigations are explained. Management—anticoagulants, thrombolysis, and high-flow oxygen—are also included, along with nurse involvement at different points of PE.","PeriodicalId":356279,"journal":{"name":"Oxford Handbook of Respiratory Nursing","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128101203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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