Two patients with duodenal obstruction resulting from erosion of a gallstone through the wall of the gallbladder and into the duodenum are described. Both cases were diagnosed endoscopically and successfully treated by a one-stage procedure to remove the obstruction and gallbladder and to close the fistula without complication.
Advanced physical assessment is a core component of the cardiac nursing role. This article focuses on the assessment of a patient referred with ‘typical’ symptoms of a stable angina. This care study highlights the significance of effective-nurse led physical assessment in the accurate identification of patients who require urgent cardiac attention. It demonstrates how a physical assessment and detailed history-taking during a nurse consultation identified that a patient needed a rapid, detailed evaluation by a consultant.
In response to an article in our February issue about typical stable angina in a nurse-led chest pain assessment unit, a reader wrote in with his comments and highlighted some inaccuracies
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