Treatment Resources

Despite advances in knowledge, understanding, risk factors and treatment, cervical cancer continues to be a cause of death in women around the world. The disease is the fourth most frequent cancer type in women, with an estimated 342,000 deaths in 2020, with the majority of these (approximately 90%) occurring in low and middle-income countries (World Health Organization [WHO], 2022).

When patients present with red lower legs, the cause is often assumed to be cellulitis or erysipelas. There are, however, several alternative conditions which mimic the clinical signs of cellulitis or erysipelas, which can lead to misdiagnosis. It is important that the
cause is correctly diagnosed to prevent inappropriate prescribing of antibiotics. This article discusses the different potential causes of ‘red legs’, in addition to cellulitis and erysipelas, together with clinical signs and symptoms to enable community nurses to differentiate
between them and implement appropriate treatments. Systemic antibiotics may not be the most appropriate management, and with the current focus on reducing antibiotic usage, community nurses need to be confident that they are prescribing them appropriately
and safely, and only when required.

The menopause affects every woman, but the age at which it occurs, the symptoms  experienced, and the later development of menopause-related problems varies widely. For some, the transition is relatively smooth, but for others it is not, and the later development of postmenopausal health problems can affect general health and
wellbeing, as well as quality of life as women age. This article gives an insight into some of the commonest postmenopausal problems with a view to increasing confidence in community nurses and nonmedical prescribers in recognition and management of the conditions discussed, so that they can offer advice and treatment where appropriate and if able to do so.

Pneumonia is defined as an infection of the lung tissue in which the air sacs become filled with microorganisms, fluid and inflammatory cells, affecting the function of the lungs (National Institute for Health and Care Excellence [NICE], 2021a). The disease can affect anyone at any age and is a cause of morbidity mortality around the world, and particularly likely to result in poor outcomes in the elderly, babies and young children, and those with additional health problems (Htun et al, 2019). This article focuses on community-acquired pneumonia (CAP) in adults, and hopes to give nurses and non-medical prescribers an insight into the recognition, treatment and management of this disease in the adult population, with the aim of reducing hospital admissions and improving outcomes for those patients affected.

Faecal incontinence (FI), always has an underlying cause (Harari, 2009). It is defined as any involuntary loss of faeces that is a social or hygiene problem (National Institute for Health and Care Excellence [NICE], 2007).

All too often patients subjected to radiotherapy (RT) will develop skin burns. These are accepted by many clinicians as being an unfortunate sequel of a lifesaving treatment; however, evidence is beginning to show that they need not be regarded as ‘inevitable’ (Bray et al, 2016). There are treatment options which can help avoid, or ameliorate them that merit consideration. After specialist RT centre treatment, skin burns become the responsibility of the community nurse to address. They can cause serious reduction in patient quality of life, or even delay further radiotherapy owing to pain and exudation (Singh et al, 2016).

The effect of drugs on mental and physical health are well documented. However, these consequences do not necessarily prevent people using them either recreationally or more regularly, with some becoming addicted to their drug or drugs of choice. It is estimated that in 2016/17, around one in 12 (8.5%) adults aged 16 to 59 in England and Wales had taken an illicit drug in the last year (NHS Digital, 2018). Ketamine has become increasingly popular, especially among younger users, as it is cheap and mistakenly seen as a ‘safe’, non-addictive drug. However, the reality is that even recreational use may have serious consequences. The effect on the urinary system can be devastating, with users experiencing anything from frequency and cystitis-like symptoms, to extreme debilitating pain from the inflamed and shrunken bladder, resulting in cystectomy and urinary diversion, and, if the kidneys are affected, renal failure and dialysis.

This third article in a seven-part series looking at the identification and treatment of psoriasis, explores the active ingredients and action of the main topical treatments for psoriasis. Community nurses are perfectly placed to help patients take control of their skin condition, particularly in advising them on the benefits of topical treatments, which as they can be applied directly to the skin, allow the area to be targeted, lowering the level of absorption into the bloodstream and reducing side-effects (Psoriasis and Psoriatic Arthritis Alliance (PAPAA, 2017a).

Psoriasis is a common skin problem that can cause significant distress to primary care patients, as well as representing a significant burden to healthcare resources. Often seen by communinity nurses, psoariasis is a condition that requires careful management as well as extensive knowledge of the different presentation. This article, the second in a series looking at the identification and treatment of psoriasis, examines the use of emollients in psoriasis treatment, focusing on the aims, benefits and efficacy of these topical treatments.

Judy Poole discusses leprosy, new treatments and protocols for dealing with the disease and warns community nurses to be on the lookout for this disfiguring condition.

Judy Poole, MPH, BSc (Hons), PGDAE, RGN, RM, RHV is a Lecturer,
School of Health & Social Welfare,
Open University, East Midlands and
Children Services Liaison Health Visitor
with Broxtowe & Hucknall
PCT, Nottingham
Article accepted for publication
May 2000.