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Biological basis of child health 13: structure and functions of the skin, and common children’s skin conditions
This article, the 13th in a series on the biological basis of child health, focuses on the skin. The skin is the largest organ in the body and covers its whole outer surface, protecting it from external threats, assisting in retaining body fluids, eliminating waste products and regulating temperature. The skin also has a crucial role in wound healing and vitamin D synthesis. Skin conditions in children are often distressing for children and parents, and may significantly affect their everyday lives. This article explains how the skin develops in utero, describes the structure and functions of the skin, and explores the aetiology, manifestations and management of skin conditions commonly seen in children.
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Biological basis of child health 12: the endocrine system and common childhood endocrinopathies
This article, the 12th in a series on the biological basis of child health, focuses on the endocrine system. This system works alongside the nervous system to regulate the functioning of the human body using chemical mediators called hormones. It is composed of several glands secreting a wide range of hormones that act on target cells in organs and tissues. Various functions of the human body are controlled by the endocrine system, including growth, puberty, metabolism and bone health. This article explores the anatomy and pathophysiology of the endocrine system, the effects of hormonal excesses or deficiencies on the body, and the presentation and management of endocrinopathies commonly seen in children.
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Self-harm in young people: risk factors, assessment and treatment interventions
Self-harm, where an individual purposefully harms themselves with a non-fatal outcome, is common, especially among young people. A wide range of mental health issues are associated with self-harm and it increases the likelihood that the person will eventually die by suicide.This article explores the motivations for self-harming behaviours, risk and protective factors, the components of risk assessment and potential interventions. Self-harm can be associated with stigma and discrimination in society and in healthcare services. This article aims to support healthcare practitioners in providing non-judgemental, empathetic and respectful care to these young people and their families and carers.
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Focus on asthma 2: air pollution and its effects on children and young people
This article is the second in a series on asthma. The first article identified that the UK is experiencing an ‘epidemic’ of childhood asthma and one of the major culprits is air pollution. This article examines the main causes of air pollution and how they affect the lung health of children from before birth and onwards. It considers the contribution of indoor and outdoor air pollution, how these have changed over time and the unequal effect they may have on vulnerable populations. The nurse’s role is discussed, not only in terms of clinical care, but also as adviser to families and schools on what actions to take to limit their exposure and reduce their own emissions of pollutants.
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Biological basis of child health 4: an overview of the central nervous system and principles of neurological assessment
This article is the fourth in a series on the biological basis of child health. It explains the embryological development of the nervous system and describes some of the anatomical and physiological features of the central nervous system, which is comprised of the brain and spinal cord. It also outlines the principles of neurological assessment in infants and children, before detailing the presentation and management of three conditions that can affect the central nervous system in this patient population – seizures, meningitis and raised intracranial pressure.
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Dengue fever
Dengue fever is a viral infection transmitted by mosquitoes. It is endemic in tropical and subtropical regions of the world but is beginning to emerge in other regions, including Europe. Many dengue-endemic countries are popular tourist destinations, so nurses should be prepared to discuss the risks of dengue and strategies to avoid contracting it with patients who are preparing to travel.Rachael Fletcher, travel nurse adviser, National Travel Health Network and Centre, University College London Hospitals NHS Foundation Trust, London, England
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Effective management of adult patients with asthma
Asthma is a chronic respiratory condition that can affect people of all ages. Globally, asthma is one of the most common non-communicable diseases and is associated with significant personal, financial and societal costs. In some cases, asthma can be fatal, although many fatalities would have been preventable with appropriate management. People with asthma often underestimate the effects of their symptoms, and nurses should develop their knowledge and skills so that they can provide appropriate management advice. This article outlines the causes of asthma and its symptoms. It also explains the interventions used in the management of this condition, including medicines, patient education, appropriate lifestyle changes and referral to specialist services.
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Improving nursing students’ experience of clinical placements
Clinical placements can present a significant challenge for nursing students, since the learning environment differs from that of the classroom, involving potential risks and complicated interpersonal and interprofessional relationships. The array of decisions required on clinical placements can be confusing for nursing students, which can cause them to doubt their skills and knowledge. This article describes the challenges involved in clinical placements, and discusses the importance of person-centred care and techniques such as reasoning and reflection that can improve nursing students’ learning in practice. It uses two case studies to illustrate how clinical supervisors and mentors can design clinical placements that enable nursing students to develop their skills, knowledge and self-confidence.
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Prevention and management of hyperglycaemic crisis
Hyperglycaemia is a defining feature of diabetes mellitus. It involves an elevated level of glucose in the blood, which develops as a result of the body’s inability to produce insulin or process insulin effectively. If left unchecked and untreated, patients with diabetes are at risk of short-term, potentially life-threatening hyperglycaemic crises such as diabetic ketoacidosis or hyperosmolar hyperglycaemic state. Nurses frequently care for patients diagnosed with diabetes in various clinical settings; therefore, it is essential that they have an awareness of the prevention and management of hyperglycaemia and hyperglycaemic crises. This article explains the causes and clinical manifestations of hyperglycaemic crises, and details the management of patients with these conditions, in accordance with national guidelines.
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Using a structured clinical assessment to identify the cause of chest pain
Chest pain is a common reason for patient presentation to emergency departments and visits to primary care settings. While most causes of chest pain are not life-threatening, a small proportion require urgent intervention, particularly cardiac conditions such as acute coronary syndrome. Therefore, it is essential for healthcare practitioners, including nurses, to identify the cause of chest pain in a safe, timely and effective manner. This article outlines the main causes of chest pain and describes the aspects of chest pain assessment, including patient history-taking, physical examination and clinical investigations. Assessing chest pain requires healthcare practitioners to have knowledge of its causes and pathophysiology, the use of structured assessment tools and the latest evidence-based guidelines.
