Indicadores clínicos para o diagnóstico de enfermagem Síndrome do equilíbrio fisiológico prejudicado para doadores de órgãos

Abstract

RESUMO Objetivo Selecionar indicadores clínicos para o diagnóstico de enfermagem em desenvolvimento Síndrome do equilíbrio fisiológico prejudicado para potenciais doadores de órgãos em morte encefálica. Método Estudo de consenso de especialistas, realizado através da técnica Delphi, dos indicadores clínicos de um diagnóstico de enfermagem em desenvolvimento. A amostra do estudo foi intencional mediante convite e constituída por 37 enfermeiros que atenderam a critérios de inclusão. Os indicadores que obtiveram um consenso igual ou maior que 70% foram considerados validados. Resultados Especialistas recomendaram 25 dos 44 indicadores avaliados, dos quais oito pertenciam ao grupo Alterações endócrino-metabólicas, sete ao grupo Alterações hemodinâmicas e/ou cardiovasculares, cinco ao grupo Alterações ventilatórias, dois ao grupo Alterações nutricionais e três ao grupo Alterações de coagulação, inflamatórias e/ou imunológicas. Conclusão e implicações para a prática Esse novo diagnóstico de enfermagem pode colaborar com o desenvolvimento de conhecimento da enfermagem na área de doação de órgãos, contribuindo para o ensino e pesquisa, além de acarretar implicações para a prática, proporcionando acurácia diagnóstica e embasando a implementação e a avaliação de intervenções que impactam na melhora da manutenção do potencial doador.

Sociodemographic profile, diagnoses and nursing care in post-COVID-19 patients in a Brazilian university hospital

“…A similar finding is evidenced in the study developed by the Nursing Process Research Network (RePPE -Rede de Pesquisa em Processo de Enfermagem) which identified the diagnoses Risk for Infection, Risk for Pressure Injury and Impaired Spontaneous Ventilation for hospitalized patients in critical condition (4) . Among these diagnoses, it should be noted that the ND "Impaired Physiological Balance Syndrome", which is in the process of being developed (18) , was It should be noted that the scored diagnosis would reduce the time taken to carry out the process stages and would include numerous diagnoses present for severe cases of COVID-19 (18) . Additionally, it is pointed out that the diagnoses recorded by nurses only once, in the sample of this study, stand out: Interrupted Breastfeeding; Deficient Knowledge; Hopelessness; Delivery Pain; Impaired Social Interaction; Impaired Memory; Impaired Oral Mucous; Impaired Sleep Pattern; Grief; Risk for Aggression; Risk for Ineffective Breastfeeding; Risk for Elopement Attempt; Risk for Adverse Reaction to Iodinated Contrast Media; and Risk for Trauma.…”

“…Among these diagnoses, it should be noted that the ND “Impaired Physiological Balance Syndrome”, which is in the process of being developed ( 18 ) , was identified in more than 70% of patients. It instigated, in this way, nurses to prescribe care in order to seek the physiological balance of the body of the individual being cared for.…”

“…It should also be noted that the diagnosis mentioned above has not yet been incorporated into the NANDA-I Classification so far, but during the pandemic nurses working at the HCPA requested inclusion in the medical record system electronic AGHUse, seeking, therefore, to follow the other steps of NP according to this diagnosis. It should be noted that the scored diagnosis would reduce the time taken to carry out the process stages and would include numerous diagnoses present for severe cases of COVID-19 ( 18 ) .…”

Nursing diagnosis prevalent in the care of organ donor patients in brain death / Diagnósticos de enfermagem prevalentes na assistência ao paciente doador de órgãos em morte encefálica

“…In endocrine-metabolic changes, endocrine regulatory dysfunctions prevail (>50%), electrolyte imbalance (43%) and hypothermia (32%), corroborating to hormonal deficiencies and subsequent central thermoregulatory dysfunction. 12,22 The nursing team controls all hemodynamic data of the potential donor; for this, it is necessary that professionals have knowledge about the physiopathological changes characteristic of brain death, as well as the hemodynamic repercussions resulting from volume replacement and administration of vasoactive drugs. 23 A highly complex procedure, conducted by actions that need to effect care, demonstrates the importance of nursing professionals in the Systematization of Nursing Care (SAE).…”

“…The authors also bring risk factors for unstable glycemia: use of glucose solution and fasting; for bleeding risk: disseminated intravascular coagulation and impaired liver function; for infection risk: the use of central and peripheral catheters. 12,[14][15]18…”