I. Setting the scene: an introduction

I. Setting the scene: an introduction

SOCIAL AND POLITICAL INFLUENCES UPON COMMUNITY NURSING            The economic crisis of the 1970s led to the first real major reforms in the National Health Service (NHS). The centralisation of administrative power led to dissatisfaction amongst NHS employees. In 1976 the Resource Allocation Working Party reviewed the allocation of funds and began the move away […]

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III: Nursing in a community environment

III: Nursing in a community environment

FACTORS INFLUENCING THE DELIVERY OF COMMUNITY HEALTH CARE SERVICES       Community nurses face many challenges within their evolving roles. The transition from working in an institutional setting to working in the community can be quite demanding at first. As a student on community placement or a newly employed staff nurse, it soon becomes apparent that […]

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New ways of working

New ways of working

Rapid changes have occurred within the NHS since the return of the Labour government to power in 1997. This commenced with The New NHS: Modern, Dependable (DOH 1997) and has  been consolidated in The NHS Plan (DOH 2000a). Health and social policy have provided the driver for change and health care professionals have been required […]

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Setting the scene: an introduction

Setting the scene: an introduction

These are exciting and challenging times for community nurses. Liberating the Talents (DOH 2002) provides a framework for the expansion ofclinical roles and calls for greater freedom to encourage creativity. This book has been designed to support staff who may be new to working in acommunity setting and is an essential guide to practice. We […]

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DISSEMINATED INTRAVASCULAR DISEASE

DISSEMINATED INTRAVASCULAR DISEASE

Disseminated intravascular coagulation, formerly termed as disseminated intravascular coagulopathy, is not a disease but a sign of an underlying condition. DIC may be triggered by sepsis, trauma, cancer, shock, abruptio placenta, toxins or allergic reactions. The severity of DIC is variable, but it is potentially life-threatening. PATHOPHYSIOLOGY  Normal homeostatic mechanism are altered in DIC so […]

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BUERGER’S DISEASE

BUERGER’S DISEASE

Buerger’s disease is characterized by recurring inflammation of the intermediate and small arteries and veins of the lower and (in rare case) upper extremities. It results in thrombus formation and occlusion of the vessels. It is differentiated from other vessel diseases by it microscopic appearance. In contrast to atherosclerosis, Buerger’s disease is believed to be […]

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Pulmonary Emphysema

Pulmonary Emphysema

Pulmonary emphysema is defined as a nonuniform pattern of abnormal, permanent distention of the air spaces  with destruction of the alveolar walls and eventually a reduced pulmonary capillary bed. It appears to be the end stage of a process that has progressed slowly for many years. Smoking is the major cause. In a few patients, […]

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Anemia, Megaloblastic (Vitamin B12 and Folic Acid Deficiency)

Anemia, Megaloblastic (Vitamin B12 and Folic Acid Deficiency)

The anemias caused by deficiencies of the vitamins B12 and folic acid show identical bone marrow and peripheral blood changes. Both vitamins are essential for DNA synthesis. Pathophysiology The two main vitamin deficiencies may coexist. In each case, hyperplasia of the bone marrow occurs, and the precursor erythroid and myeloid cells are large and bizarre […]

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Diabetes Insipidus

Diabetes Insipidus

    Diabetes insipidus is a disorder of the posterior lobe of the pituitary gland due to a deficiency of vasopressin, the antidiuretic hormone (ADH). it is characterized by polydipsia and polyuria. Diabetes insipidus may be (1) secondary, related to head trauma, brain tumor, or surgical ablation or irradiation of the pituitary gland or infection […]

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Diabetes Mellitus

Diabetes Mellitus

Diabetes mellitus is a group of mtabolic disorders characterized by elevated levels of blood glucose (hyperglycemia) resulting from defects in insulin production and secretion, decreased cellular response to insulin, or both. Hyperglycemia may lead to metabolic complications, such as diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Long-term hyperglycemia may contribute to chronic microvascular […]

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