September - APNA

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FEATURE Nutrition and chronic disease The Australian Institute of Health and Welfare report Australia’s Health 2010 shows deaths from stroke and heart attack have decreased by 76 per cent since the 1960s — and cancer deaths have also fallen 1 . The report, however, reveals a worrying upwards trend in rates of diabetes and obesity. In 2007–2008 one in four children aged five to 17 and 61 per cent of adults in Australia were deemed overweight or obese. The rates of type 2 diabetes have increased in parallel with rates of overweight and obesity in Australia 2 . More than 800 000 Australians have been diagnosed with diabetes, making the disease three times more common than it was two decades ago. We have all heard the phrase ‘You are what you eat’. Poor nutrition and physical inactivity are known risk factors for lifestyle-related chronic diseases, such as type 2 diabetes, cardiovascular disease and cancer. Nutrition intervention can help prevent and better manage some chronic health conditions and can greatly improve quality of life in both the short and long term. An Accredited Practising Dietitian (APD) is best-placed to provide tailored, evidence-based nutrition advice to patients. But practice nurses are now more often carrying out health assessments to detect chronic diseases and are increasingly at the forefront of delivering health information to patients. This presents an opportunity for practice nurses to discuss general nutrition principles and basic healthy eating guidelines with patients, and to refer them to an APD for further advice. Ten ways to help improve patients’ health 1. Encourage patients to start a food diary. This will help them see what they are eating and drinking, and where there may be any problem areas. A food diary is also useful to take to any appointment with an APD. 2. Encourage patients who are overweight or obese to lose weight. No one likes to be told they need to lose weight, but there are many benefits — such as improved blood lipids, reduced blood pressure and decreased insulin resistance. Modest weight loss of 5–10% of starting weight can be beneficial to health. And focussing on ‘waist loss’ must be a priority. Ideally, women should have a waist circumference of under 80 cm and men less than 94 cm. 3. Recommend patients eat more fruit and vegetables. For many people, adding one more piece of fruit and one more serve of vegetables to their day is a good goal. Encourage patients to build up to the recommended two pieces of fruit and five serves of vegetables (around three cups) every day. Visit www.gofor2and5. com.au for patient resources and fact sheets on improving fruit and vegetable intake. 4. Eat less energy-dense foods and drinks. Foods rich in fat and added sugar provide ‘empty calories’ and often not many nutrients. Cakes, biscuits, pastries and chocolates fall into this category. One small square of chocolate provides 120 kJ — the same as 10 strawberries, but 24 Primary Times <strong>September</strong> 2010
Important to demonstrate, easy to use. 1,2 SIMPLE TWO STEP OPERATION Practice nurses play a critical role in making certain EpiPens are used correctly in life-threatening allergic reactions. By ensuring your patients regularly re-familiarise themselves with EpiPen encourages correct use in an emergency situation. 3 Encourage your patients to join EpiClub. EpiClub is an online educational resource that also offers a FREE reminder service which reminds people that their EpiPen is about to expire and needs to be replaced. ‘How to use EpiPen’ videos are also available to download. PBS Information: Authority Required. Refer to PBS Schedule for full authority information. † After administration of EpiPen ® always seek medical attention References: 1. EpiPen ® Approved Product Information. 2008. 2. Kemp SF, et al. Allergy. 2008;63:1061-1070. 3. NPS RADAR. Adrenaline (EpiPen) auto injector for acute allergic anaphylaxis. www.npsradar.com.au Accessed June 2009. Before prescribing, please review approved Product Information. Product Information is available on request from Alphapharm. MINIMUM PRODUCT INFORMATION EpiPen ® . Adrenaline Auto-Injector 300mcg / 0.3mL EpiPen ® Jr. Adrenaline Auto-Injector 150mcg / 0.3mL. The following are not a complete listing: Indication: For the emergency treatment of anaphylaxis (acute severe allergic reactions) due to insect stings, drugs or other allergens. Contraindications: Contraindications are relative, as this product is intended for use in life-threatening emergencies. Cardiac dilation, certain arrhythmias, cerebral arteriosclerosis, vasopressor drug contraindication, maternal blood pressure > 130/80, shock (except anaphylactic shock), organic brain damage, general anaesthesia. Precautions: sulfite allergy, intravenous administration, ventricular fibrillation, prefibrillatory rhythm, tachycardia, myocardial infarction, phenothiazine-induced circulatory collapse, prostatic hypertrophy, anginal pain in coronary insufficiency, elderly, individuals with diabetes, cardiovascular disease, hypertension, narrow angle glaucoma, hyperthyroidism, psychoneurosis, Parkinsonism. Injection into hands, feet, ears, nose, buttocks, genitalia. Pregnancy Category A. Excreted in breast milk. Adverse Effects: anxiety, restlessness, tachycardia, respiratory difficulty, tremor, weakness, dizziness, headache, dyspnoea, cold extremities, pallor, sweating, nausea, vomiting, sleeplessness, hallucinations, flushing of face and skin. Psychomotor agitation, disorientation, impaired memory, potentially fatal ventricular arrhythmias, severe hypertension which may lead to cerebral haemorrhage and pulmonary oedema. Dosage: Single intramuscular injection into anterolateral aspect of thigh, repeat every 5 to 15 minutes if symptoms recur or have not subsided. Adults > 30kg: EpiPen ® auto-injector (300mcg Adrenaline) Children 15 – 30kg: EpiPen ® Jr auto-injector (150mcg Adrenaline). PBS Dispensed Price: EpiPen & EpiPen Jr $106. EpiPen ® is a registered trademark of Mylan, Inc. EpiPen ® and EpiPen ® Jr. are distributed in Australia by Alphapharm Pty. Limited. ABN 93 002 359 739, Cnr Wentworth Park Road & Bay Street, Glebe NSW 2037, Australia, Phone (02) 9298 3999, Medical Information Phone: 1800 028 365, www.alphapharm.com.au ALPH2456/PT EPI038 8/09
Page 1 and 2: Supporting nurses in PRIMARY HEALTH
Page 3 and 4: CONTENTS EDITORIAL BOARD APNA NEWS
Page 5 and 6: PROFESSIONAL ISSUES Member question
Page 7 and 8: APNA NATIONAL CONFERENCE 2011 Great
Page 9 and 10: PROFESSIONAL ISSUES All practice nu
Page 11 and 12: Secure your FLUVAX ® 2011 season o
Page 13 and 14: PRACTICE MATTERS standards or guide
Page 16 and 17: CLINICAL CARE Helping patients thro
Page 18 and 19: PRACTICE NURSE PROFILE Practice nur
Page 20 and 21: CLINICAL CARE Gastroenteritis in ch
Page 22 and 23: CLINICAL CARE Identifying common nu
Page 24 and 25: SPECIALIST INTERVENTION Practice nu
Page 28 and 29: FEATURE without the nutrients. Pati
Page 30 and 31: NEWS Role of codeine questioned The
Page 32: CoaguChek ® XS systems - the smart

September - APNA

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