Adult Nursing Practice
Adult nursing is the largest field of nursing in the UK. Adult nurses care for patients from young adulthood to older age, in a variety of settings including hospitals, community clinics, and patients' homes.
Patient Assessment
Comprehensive assessment is the foundation of adult nursing. Use the ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) for acutely unwell patients. The National Early Warning Score (NEWS2) is used to detect deterioration early by scoring vital signs.
Common Adult Health Conditions
- Cardiovascular disease — Heart attacks, heart failure, hypertension, stroke
- Respiratory conditions — Asthma, COPD, pneumonia, pulmonary embolism
- Diabetes mellitus — Type 1 and Type 2, requiring blood glucose monitoring and insulin management
- Cancers — Various types requiring surgery, chemotherapy, radiotherapy
- Musculoskeletal conditions — Arthritis, fractures, falls in older adults
- Renal disease — Acute kidney injury, chronic kidney disease, dialysis
- Neurological conditions — Stroke, Parkinson's disease, multiple sclerosis
Nutrition and Hydration
The MUST (Malnutrition Universal Screening Tool) is used to identify patients at risk of malnutrition. Fluid balance charts record all input and output. Dehydration and malnutrition can lead to delayed recovery, pressure ulcers, and increased mortality.
Wound Care
Wound assessment includes size, depth, exudate, signs of infection, and surrounding skin. Wound care follows the principles of: cleaning, debriding, dressing selection, and monitoring. Pressure ulcers are assessed using the Waterlow scale and graded 1-4.
End of Life Care
The Liverpool Care Pathway has been replaced by individualised end of life care plans. Key principles include: symptom management (pain, breathlessness, nausea), psychological support, spiritual care, and involving the patient's family. The Mental Capacity Act applies to decisions about end of life treatment.