Diagnosis Resources

Healthy ageing has become a global priority to add quality to our later years and reduce the morbidity associated with ageing. Entering older adulthood, however, increases the risk of frailty and sarcopenia — key factors driving age-related morbidity. Frailty is a multi-system impairment associated with increased vulnerability to stressors. Sarcopenia is the loss of muscle mass and function and is a major component of frailty. Skeletal muscle has a reduced response to stimuli such as protein intake and exercise with advancing age, driving the gradual loss in muscle mass seen in older adults. High protein diets, especially when paired with resistance exercise, can help to overcome this anabolic resistance and restore or maintain physical robustness. The commonly cited protein requirements for adults published by the Department of Health (DH) underestimate the needs of older adults. Other nutritional factors, such as weight loss and vitamin D status, also play important modulating roles in frailty and sarcopenia.

Diagnosis of low back pain can be intriguing and complex. Careful history-taking and physical examination are essential to ensure red flags (serious issues) are not missed, that treatment is appropriate, evidence-based and timely, and that follow-up and review are well documented and understood by the patient. This article covers some of the more common causes of back pain in primary and urgent care.

Laryngeal cancer falls under the umbrella term of head and neck cancers and is the second commonest cancer type within this group. The condition often presents with symptoms shared with those of other less serious diseases, making diagnosis challenging.
This article hopes to give nurses and non-medical prescribers an overview of symptoms, diagnosis, treatment, and prognosis with the aim of raising awareness and helping to get an earlier diagnosis of this devastating disease.

Necrotising fasciitis (NF) is a life-threatening condition, consisting of a soft-tissue infection with rapidly progressive, widespread fascial necrosis and sepsis. Prompt diagnosis and  treatment are essential, but in the early stages, it is difficult to differentiate from other skin conditions such as cellulitis. A high level of suspicion and a low threshold for surgical referral are essential to avoid significant mortality. Following often lengthy hospital treatment, patients will be discharged for management in the community — usually with extensive wound care needs. As part of recovery, supported self-care is an option for some patients and the benefits may help improve outcomes.

For many nurses working in primary care, chronic obstructive pulmonary disease (COPD) is a familiar condition. From carrying out annual reviews to supporting people living with the symptoms of cough, phlegm, breathlessness and managing their effect on day-to- 
day living, most community nurses will have some experience of supporting people living with COPD. Increasingly, though, community nurses are having to consider comorbidities as part of the review, as for many people living with COPD, this will be just one of the long-term conditions they have already been diagnosed with or of which they will be at risk. In this article, the relationship between COPD and other long-term conditions will be highlighted, along with recommendations about how to identify and manage comorbidities in order to holistically optimise outcomes.

Coughs are extremely common and vary in duration and degree of severity. Coughs of any duration are a frequent reason for seeking medical advice and unresolved coughs lasting beyond eight weeks are a cause of patient anxiety and reduced quality of life. Chronic coughs are those lasting for more than eight weeks. There are many causes, some more common than others. This article hopes to give nurses and non-medical prescribers who are approached by patients asking for advice some insight into diagnosing and resolving the problem, with the aim of improving quality of life for those affected.

Diagnosing and managing lower urinary tract infections (UTIs) in women aged 65 years and over is important to ensure their health and wellbeing. This article explores how to diagnose lower UTI, considering alternative diagnoses especially in older adults, as their symptoms may mimic UTI but may indicate other underlying conditions. It also looks at how to manage and treat uncomplicated lower UTI and provides guidance on recurrent UTI, usually  defined as three or more episodes in a year.

Hidradenitis suppurativa (HS) is a devastating, progressive disease of the skin which is poorly understood and often misdiagnosed (British Dermatological Nursing Group [BDNG], 2022; Moloney et al, 2022). It affects the hair follicles and is characterised by recurring inflammatory nodules, abscesses, draining lesions and tunnels (World Union of Wound Healing Societies [WUWHS], 2016; Moloney et al, 2022)

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.