Dietary change, physical activity, weight management and self-management education are fundamental components of type 2 diabetes care. Medicines remain essential for many people, but outcomes are strengthened when pharmacological treatment is combined with person-centred support that reflects the individual's priorities, circumstances and readiness to change. This article outlines practical, evidence-informed approaches that practice nurses can use to explain insulin resistance, develop carbohydrate awareness, promote physical activity, support weight management and use glucose data appropriately. It also considers the psychological, social, cultural and economic barriers that may affect self-management. A case study illustrates how exploring the person's life context before escalating treatment can identify modifiable factors and support shared decision making.
The impact of breast cancer is multi-faceted and can extend far beyond the period of active cancer treatment, affecting the person physically, psychologically, socially, economically and spiritually. This article identifies ways in which practice nurses can support people with breast cancer throughout their journey, drawing both on the literature and on the personal experience of the author, who is a breast cancer survivor. The role of primary care nurses in providing holistic care at different stages of this process is discussed, alongside opportunities to improve access to primary care-based support for patients, particularly after they have been discharged from secondary care.
Chickenpox (varicella) is a highly infectious viral disease that is usually self-limiting in children but can cause serious complications in adults and vulnerable groups. This article reviews the clinical presentation, transmission, complications, prevention and management of chickenpox, with particular focus on the role of practice nurses. It describes the characteristic progression of the rash from macules and papules to vesicles and scabs, while highlighting how presentation may vary according to skin tone. Key red flag symptoms, including neurological and respiratory symptoms, persistent fever, dehydration and signs of bacterial infection, are discussed, alongside groups at increased risk of severe disease, such as pregnant women and people who are immunocompromised.
Chronic pruritus is common in primary care and can significantly affect sleep, wellbeing and quality of life, particularly in older adults. Persistent itch may result from dermatological disease, medication, dry skin or underlying systemic illness. This article outlines approaches to assessment and management, including skin examination, medication review, appropriate investigations and practical measures to relieve symptoms. It also highlights the role of practice nurses in recognising persistent or unexplained pruritus and identifying patients who require further assessment or referral.
