Diagnósticos de enfermagem em pacientes submetidos à cirurgia cardíaca

Abstract

RESUMOPesquisa exploratória e transversal realizada com pacientes no pós-operatório de cirurgia para revascularização do miocárdio. Objetivou-se identificar diagnósticos de enfermagem segundo a Taxonomia II da NANDA e intervenções de enfermagem segundo a Nursing Interventions Classification, associando-os aos resultados de enfermagem segundo a Nursing Outcomes Classification. Os dados foram colhidos de 22 pacientes por um formulário e exame físico. As informações possibilitaram a identificação de quinze diagnósticos de enfermagem, segundo a Taxonomia II NANDA, dentre eles destacam-se: Risco para infecção; Risco para constipação; Déficit no autocuidado para higiene íntima e Integridade de pele prejudicada. O estudo revelou ser fundamental desenvolver estudos sobre diagnósticos de enfermagem, para direcionar análises de problemas nos pacientes demandadoras de ações específicas de enfermagem, que contribuam para o desenvolvimento da Enfermagem. Descritores: Cirurgia torácica; Diagnóstico de enfermagem; Cuidados de enfermagem; Enfermagem perioperatória. ABSTRACT Exploratory and transversal research accomplished with postoperative patients outgoing coronary bypass. It was aimed at identifying nursing diagnoses according to

Diagnósticos de enfermagem em pacientes no período pós-operatório de cirurgias cardíacas

“…A study with myocardial revascularization cardiac surgery postoperative patients that aimed to identify possible nursing diagnoses, according to NANDA-I Taxonomy II, identified 19 diagnoses, among them: Risk of Infection; Impaired Skin Integrity; Impaired Physical Mobility; Insomnia; Anxiety; Ineffective Airway Clearance; Acute Pain; Impaired Gas Exchange; and Impaired Verbal Communication (4) . In another research with cardiac surgery postoperative patients, 14 diagnoses related to immediate postoperative patients were identified, namely: Risk of Infection; Impaired Physical Mobility; Impaired Skin Integrity; Risk for Imbalanced Fluid Volume; Impaired Verbal Communication; Risk for Altered Body Temperature; Ineffective Airway Clearance; Impaired Gas Exchange and Pain (3) .…”

“…The defining characteristics include altered respiratory frequency and rhythm and adventitious respiratory sounds. Besides, the endotrachial intubation disables patients' verbal communication, and is related to the Impaired Verbal Communication, evidenced by patients' verbal expression inability, which can be observed in all patients who undergo cardiac surgeries, due to the anesthetic coma induction and the artificial airway needs during the transoperative (3)(4) . The Impaired Bed Mobility diagnosis, defined as "Limitation of movement in bed from one side to another" (13) , may be related to the restrictions due to the surgical procedure, the drains presence, restraining the body movements, and the pain sensation when moving.…”

“…Surgery is indicated when the survival probability is higher by means of the surgical treatment than the clinical treatment. Cardiac surgeries can be classified as corrective, when related to correcting ductus arteriosus, artrial or ventricular septum defects; reconstructive, with the purpose of myocardial revascularization, or cardiac valve repair; and substitutive, comprising the valve replacement and transplant procedures (2)(3)(4)(5) . The expressive cardiovascular disease incidence among the population and the technological advances for their treatment, as well as the complexity and details related to care required by patients who undergo cardiac surgeries, whose health conditions go through constant and abrupt changes, demand immediate and accurate nursing interventions, lacking of previous and scientifically based planning.…”

“…The expressive cardiovascular disease incidence among the population and the technological advances for their treatment, as well as the complexity and details related to care required by patients who undergo cardiac surgeries, whose health conditions go through constant and abrupt changes, demand immediate and accurate nursing interventions, lacking of previous and scientifically based planning. Several studies demonstrate a concern regarding the nursing diagnosis identification for specific groups, such as: inpatients of surgical practice (6) and medical practice (7) units; hospitalized elderly patients (8) ; medullary injury patients (9) , cardiac catheterization patients (10) , laparoscopic Cholecystectomy immediate postoperative patients (11) , patients during surgical preoperative, intraoperative, and postoperative (2)(3)(4)12) . Such studies emphasize the relevance of verifying clinical manifestations of common characteristic patient groups, enabling knowledge of the affected human needs, and thus contributing to the direct and individual nursing interventions development, resulting in the implementation of quick and effective actions to solve the identified problems.…”

Diagnósticos de enfermagem de pacientes internados em enfermaria de Moléstias Infecciosas

“…It is also relevant to the identification of specific diagnoses of a certain unit and because of that it will enhance the process of preparing diagnoses, improving their accuracy and, above all, contributing to the planning of more accurate and adequate interventions to the profile of the clientele cared for (11) .…”