Lisa Carroll RGN, MSc, Consultant Nurse Acute Medicine. University Hospital of North Staffordshire, UK.

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• Preface xiIntroduction xiii1 Patient Assessment 1Communication 1History taking 3The functional enquiry 6The physical assessment 8General inspection 11Respiratory examination 12Cardiovascular examination 14Gastrointestinal examination 17Neurological examination 18Musculoskeletal examination 24Post examination 25Conclusion 252 Emergencies 27Anaphylaxis 27Cardio-respiratory arrest 29Ethical Issues 363 Acute Poisoning and Drug Overdose 41Deliberate self-harm 41Paracetamol overdose 45Aspirin overdose 48Tricyclic antidepressant overdose 51Heroin overdose 53Alcohol overdose 54The National Institute for Clinical Excellence (NICE) self-harm guideline 56Alcohol withdrawal 58Drug withdrawal 604 Infection 65Sepsis and septic shock 65Meningitis 67Infective endocarditis 71Gastroenteritis 75Urinary tract infection (UTI) 77Fever in the returning traveller 79Hot swollen joints 83Antimicrobial resistance 865 Respiratory Conditions 89Asthma 89Chronic obstructive pulmonary disease (COPD) 93Pulmonary embolism 96Community and hospital acquired pneumonia 100Pneumothorax 104Type I respiratory failure 106Type II respiratory failure 1086 Cardiovascular Conditions 113Acute coronary syndromes (ACS) 113Stable angina 113Unstable angina 114Non-ST elevation myocardial infarction 116ST elevation myocardial infarction 117DIGAMI 121Arrhythmias 121Bradycardia 123Tachycardia 126Atrial fibrillation (AF) 129Cardiac failure 132Deep vein thrombosis (DVT) 134Aortic dissection 136Cardiac tamponade 1387 Gatrointestinal Conditions 143Upper gastrointestinal bleeding (GI bleed) 143Variceal bleeding 145Acute liver failure with encephalopathy 147Acute ulcerative colitis and crohn’s disease 1498 Metabolic Conditions 153Diabetic ketoacidosis (DKA) 153Hyperosmolar non-ketotic state (HONK) 155Hypoglycaemia 157Hyperglycaemia in the critically ill patient 159Hypercalcaemia 162Hyponatraemia 164Hypernatraemia 166Hypokalaemia 168Hyperkalaemia 170Addisonian crisis 172Thyroid crisis (thyroid storm) 174Myxedema crisis 1779 Neurological Conditions 181Status epilepticus 181Stroke 184Transient ischaemic attacks (TIA) 186Isolated seizure and unexplained loss of consciousness 188Headache 190Subarachnoid haemorrhage (SAH) 192Spinal cord compression 19510 Renovascular Conditions 197Acute renal failure (ARF) 197Accelerated (malignant) hypertension 19911 Elderly Care 203Hypothermia 203Confusion 20512 Haematological Conditions 209Severe anaemia 209Sickle cell crisis 212Neutropenic sepsis 215Blood transfusion guidance 21713 Advanced Practice 223An overview of advanced practice 223The challenges of advanced practice 225Legal perspective 225Ethical principles 226Informed consent 228Assessment of capacity 229Prescribing 231Patient group directions 233Conclusion 234AppendicesAppendix I Examples of Clinical Management Plans 237Appendix II Examples of Patient Group Directions 245Glossary 255Index 259