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Biological basis of child health 9: development of the liver and clinical features of childhood liver disease
This article is the ninth in a series on the biological basis of child health and follows on from the previous article, which discussed the gastrointestinal system. The liver is the largest solid organ in the body and has more than 500 functions. These functions include: producing bile, which serves as a vehicle for waste products and as an aid for the digestion of dietary fat; synthesising most coagulation factors, needed in the clotting cascade; and transforming glycogen into glucose for use as energy in cell metabolism. While most liver conditions seen in children are rare, it is important that children’s nurses can identify the clinical features of childhood liver disease. This article provides an overview of the embryological development of the liver, its anatomy and functions, liver function tests in children, and the clinical features and pathophysiology of childhood liver disease.
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How to give an intramuscular injection to an adult with an intellectual disability
People with intellectual disabilities can have various healthcare needs across their lifespan, which may be closely linked to genetic, biological and/or psychosocial factors. As a result, they may require medicines – some of which may be administered intramuscularly – for various clinical reasons, including as part of the treatment of a range of comorbid physical and mental health conditions. Additionally, this population may not fully understand why certain medicines are administered via the intramuscular (IM) route, nor the potential risks that are involved. Some people with intellectual disabilities may find it distressing to receive medicines via this route, and they may depend on others when making decisions in relation to IM injections. Therefore, it is important for nurses to establish a rapport with patients with intellectual disabilities and gain their consent for the procedure. Nurses also require knowledge of the preparation and administration of IM injections to ensure positive health outcomes.This article aims to enhance intellectual disability nurses’ knowledge of this procedure, and to explain how they can mitigate the potential physical and psychological effects that IM injections may have for people with intellectual disabilities.
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Understanding status epilepticus and its treatment in the community
Status epilepticus (SE) is a complication of epilepsy characterised by prolonged or repeated seizures. It is a life-threatening condition that requires the immediate administration of a rescue medicine. If given promptly, rescue medicines can reduce the duration of seizures and support SE cessation. Buccal midazolam is the recommended first-line treatment for SE in the community in people who have had a previous episode of prolonged or serial convulsive seizures. Therefore, it is crucial that all those who care for people with learning disabilities who have epilepsy in the community – including family members, friends and professional carers – receive support, training and guidance in the administration of buccal midazolam. This article provides an overview of the treatment of SE in the community, including the administration of buccal midazolam.
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Effective management of type 1 diabetes in children and young people
Type 1 diabetes is the most common type of diabetes among children and young people, and requires careful management to ensure that blood glucose levels stay as close as possible to the target range. Suboptimal management can lead to serious health consequences, including damage to various organs and body systems. Many children with type 1 diabetes are not diagnosed until they develop diabetic ketoacidosis, which is distressing and potentially life-threatening.This article provides an overview of the management of type 1 diabetes in children and young people, including the insulin replacement therapy and dietary management required. It also emphasises the importance of regular and ongoing monitoring of blood glucose levels, quarterly measurement of glycated haemoglobin, and the management of hyperglycaemia and hypoglycaemia.
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Supporting people with learning disabilities to receive subcutaneous injections
The average life expectancy of people with learning disabilities has increased and many of these individuals will experience long-term and potentially life-limiting conditions such as diabetes mellitus, cancer or arthritis. To manage these conditions and any associated complications medicine injections may be required, and many of these will be administered via the subcutaneous route.Learning disability nurses may sometimes need to administer subcutaneous injections as part of the care they provide and should therefore have the knowledge and skills required to undertake this procedure safely and effectively. In addition, learning disability nurses need to understand the principles of safe medicines administration, the equipment required for subcutaneous injections and the potential complications associated with the procedure.This article outlines the best practice for administering subcutaneous injections in people with learning disabilities and explains how nurses can support these individuals before, during and after this procedure.
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Biological basis of child health 8: development of the gastrointestinal system and associated childhood conditions
This article is the eighth in a series on the biological basis of child health. It describes the embryological development of the gastrointestinal (GI) system and some of the structural anomalies that may arise during that time and later affect GI functioning. The article also discusses the functions of the GI tract – including ingestion, digestion, absorption and defecation – and explains how these relate to GI conditions seen in infants and children. GI conditions are common in childhood and some of these will be medical emergencies, so it is important that children’s nurses have knowledge of the GI system and of the presentation and management of GI conditions in children.
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Oral health and supporting people with intellectual disabilities to get access to dental treatment
Oral health is an important aspect of a person’s overall health and well-being. People with intellectual disabilities have poorer oral health than the general population, so it is essential that service users and their carers are supported to address this. This article provides information for nurses and other healthcare professionals on how to provide evidence-based practice that supports people with intellectual disabilities with their oral healthcare and assists them to access dental services. The authors examine the latest evidence about optimal practice in oral healthcare for people with intellectual disabilities, emphasising the importance of a person-centred approach. The article also discusses the barriers that people with intellectual disabilities experience when accessing dental services and how these barriers can be addressed.
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Biological basis of child health 7: growth, development and the reproductive system
This article is the seventh in a series on the biological basis of child health. It describes early developmental milestones, stages of growth, puberty and the development of the reproductive system. It also outlines the methods used to assess growth and development, and describes conditions that affect growth and development in infants, children and young people. Understanding childhood growth and development is crucial for children’s nurses, who need to be able to identify potential deviations from the norm, since these often reveal underlying conditions that require treatment.
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Management of oxygen therapy for people with intellectual disabilities
People with intellectual disabilities may require oxygen therapy across the lifespan for various reasons. Some of them will require oxygen therapy frequently, such as those who experience recurrent respiratory conditions, while others may require oxygen therapy at times when they become acutely ill or, in certain circumstances, at the end of life. Healthcare professionals and family carers supporting people with intellectual disabilities who require this treatment must have the knowledge, skills and competence to administer it safely and effectively. Oxygen therapy may be administered at times when the individual is distressed and vulnerable, so a person-centred and respectful approach is essential. This article explores the rationale for administering oxygen therapy, outlines the types and equipment that can be used, and explains the measures that nurses can take to support people with intellectual disabilities who are receiving this treatment.
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Focus on asthma 1: the state of care for children and young people in the UK and globally
This is the first in a series of articles on asthma, the most prevalent long-term condition in children with a significant burden of disease. This first article presents an overview of the state of asthma and asthma care in the UK and globally, especially as it relates to children and young people. It considers prevalence, age and sex comparisons, causation, morbidity and mortality rates, cost and the quality of care. It also outlines what children and young people wish for their asthma care.
