http://www.bjpcn-cardiovascular.com/issue/current Volume 10,Number 2,Apr-May-Jun 2013 en-ukhttp://www.bjpcn-cardiovascular.com/download/3847http://www.bjpcn-cardiovascular.com/download/3847http://www.bjpcn-cardiovascular.com/download/3846Some patients with advanced kidney disease may prefer not to receive treatment with dialysis. Conservative management describes the care designed to relieve these patients’ symptoms and maximise their health during their remaining months or years. By working with local renal and palliative services, practice nurses and other primary healthcare professionals will play a major role in ensuring a good death for kidney patients opting for conservative management.http://www.bjpcn-cardiovascular.com/download/3846http://www.bjpcn-cardiovascular.com/download/3845Unplanned pregnancy with poor glycaemic control at conception is associated with major maternal and perinatal complications. However, contraception is used haphazardly by women with diabetes and is often not discussed by diabetes professionals. Practice nurses need to be able to give appropriate advice about contraception to the increasing numbers of women of childbearing age who have type 1 or type 2 diabetes.http://www.bjpcn-cardiovascular.com/download/3845http://www.bjpcn-cardiovascular.com/download/3844A12-lead electrocardiogram (ECG) is performed on thousands of patients every day in the NHS. This non-invasive investigation is a valuable diagnostic tool and can be of crucial importance in diagnosing cardiovascular problems—but only if it is performed accurately. However, with training and careful preparation, all practice nurses should be able to undertake an accurate ECG.http://www.bjpcn-cardiovascular.com/download/3844http://www.bjpcn-cardiovascular.com/download/3843http://www.bjpcn-cardiovascular.com/download/3843http://www.bjpcn-cardiovascular.com/download/3842NICE recommends that all patients with diabetes should be offered a structured educational programme at diagnosis, together with regular reviews and updates. Several programmes are available that meet NICE criteria, and there is evidence that they can help to improve patients’ quality of life, well-being and diabetic control.http://www.bjpcn-cardiovascular.com/download/3842http://www.bjpcn-cardiovascular.com/download/3841Falls are a relatively common occurrence in older people and can have serious consequences for their health and independence. Many falls are preventable, and the annual review provides an excellent opportunity for practice nurses to consider how long term conditions and medication may ‘push’ an elderly patient into a fall.http://www.bjpcn-cardiovascular.com/download/3841http://www.bjpcn-cardiovascular.com/download/3840Nearly two thirds of adults in England are overweight and one quarter are obese. Given the physical, social, psychological and economic consequences of overweight and obesity, it is understandable that patients are drawn to fad diets and quick fixes. Unfortunately, there is no easy route to sustained weight loss, but several options are now available that can help patients to lose weight and improve their health.http://www.bjpcn-cardiovascular.com/download/3840http://www.bjpcn-cardiovascular.com/download/3839Providing need-to-know information and recommended actions resulting from new clinical researchhttp://www.bjpcn-cardiovascular.com/download/3839http://www.bjpcn-cardiovascular.com/download/3838Sometimes I shock myself with what I do not know. But one of the fantastic things about working as a practice nurse is that there are so many chances to find out something new. We can all learn things from simply talking to patients. When I was starting out, it bothered me (‘the professional’) when a patient knew more than I did. But the patients were so nice—I think they felt sorry for me— that I soon stopped feeling overwhelmed and became interested.http://www.bjpcn-cardiovascular.com/download/3838