Diagnósticos de enfermagem, fatores relacionados e de risco no pós-operatório de cirurgia bariátrica

Abstract

RESUMOObje vou-se com esta pesquisa iden fi car os principais diagnós cos, fatores relacionados e de risco da classe resposta cardiovascular/pulmonar, propostos pela NAN-DA, versão 2009. Trata-se de estudo de série de caso, descri vo, realizado com vinte pacientes subme dos à cirurgia bariátrica em hospital público de Fortaleza-CE, Brasil. Duas enfermeiras especialistas em unidade de terapia intensiva coletaram os dados por meio de entrevista, exame sico e leitura do prontuário, que foram analisados a par r de esta s ca descri va e mapeamento cruzado. Os diagnós cos de enfermagem iden fi cados com frequência maior que 50% foram: débito cardíaco diminuído (75%), padrão respiratório inefi caz (65%), resposta disfuncional ao desmame ven latório (55%) e perfusão ssular periférica inefi caz (75%), dos quais 14 eram fatores relacionados e cinco, de risco. Reconhece-se a necessidade de outros estudos para melhor defi nir o perfi l diagnós co dessa clientela e, assim, direcionar a assistência de enfermagem para a detecção precoce de complicações. DESCRITORES Diagnós co de enfermagem Cirurgia bariátrica Enfermagem perioperatória Fatores de risco ABSTRACTThe objective was to identify the main diagnoses, related factors and risk factors regarding the cardiovascular/pulmonary responses class proposed by NANDA version 2009-2011. This case series descriptive study was performed with twenty patients who underwent bariatric surgery in a public hospital in Fortaleza-CE, Brazil. Data were collected by two intensive care unit nurse specialists through interviews, physical examinations and the reviewing of medical records, and analyzed through descriptive statistics and cross-mapping. The nursing diagnoses identified with a frequency greater than 50% were: decreased cardiac output (75%), ineffective breathing patterns (65%), dysfunctional ventilatory weaning response (55%) and ineffective peripheral tissue perfusion (75%); in addition, fourteen related factors and five risk factors were identified. We verified the need for further studies to better define the diagnostic profile of these patients in order to direct nursing care towards the early detection of complications. DESCRIPTORS Nursing diagnosis Bariatric surgery Periopera ve nursing Risk factors RESUMENSe obje vó iden fi car los principales diagnós cos, factores relacionados y de riesgo del po respuesta cardiovascular/pulmonar, propuestos por la NANDA, versión 2009-2011.Estudio de serie de casos, descrip vo, realizado con veinte pacientes some dos a cirugía bariátrica en hospital público de Fortaleza-CE, Brasil. Dos enfermeras especialistas en unidad de terapia intensiva recolectaron los datos mediante entrevista, examen sico y lectura de historia clínica, dichos datos fueron analizados mediante estadís ca descrip va y mapeo cruzado. Los diagnós cos de enfermería iden fi cados con frecuencia mayor al 50% fueron: gasto cardíaco disminuido (75%), patrón respiratorio inefi caz (65%), respuesta disfuncional al destete del respirador (55%) y perfusión sular periférica inefec va (...

Perfil clínico, diagnósticos e cuidados de enfermagem para pacientes em pós-operatório de cirurgia bariátrica

“…However, available studies showed results similar to those of the present study, especially investigations on the ND Acute pain, which is one of the most established for surgical patients (8,(15)(16) . The ND Acute pain (5) was established for 99.3% of patients in our study and have been investigated in several practice scenarios for nurses, who are responsible for diagnosing accurately, intervening appropriately and reassess the results obtained at a later time.…”

“…Hypertension was the most frequent comorbidity, followed by osteoarticular disorders. Brazilian studies with similar populations also found a predominance of young females with class III obesity and comorbidities, especially hypertension (8)(9) . It should be highlighted that, in the present study, 85 (59.4%) of patients had a BMI above 40Kg/m², with high levels of morbid obesity.…”

“…Risk for imbalanced nutrition: more than body requirements was the sixth more frequent ND, although it was not described in another investigation (8) with bariatric surgery patients. Nonetheless, this ND is considered accurate, because these patients remain vulnerable to the excess consumption of nutrients after surgery.…”

“…However, studies on nursing care to bariatric surgery patients remain little explored in our institution, since this surgical procedure is relatively recent. In addition, few publications have addressed this topic in the field of nursing (8)(9) , which reveals that there is a knowledge gap on NDs and appropriate care to these patients. Hence, the leading question of the present study was: who are the patients undergoing bariatric surgery and which NDs and nursing care are established in clinical practice?…”

The occurrence of the delayed surgical recovery nursing diagnosis among adults and the elderly

“…(1)(2)(3) On the other hand, the growth of the rates of surgical complications such as dehiscence of the sutures, atelectasis, deep vein thrombosis, or infection is noted. (2)(3)(4)(5)(6) This requires strategies directed towards patient safety, reduction of morbidity and mortality, readmissions and hospital costs.…”