Assuntos
Avaliação em Enfermagem/métodos , Cateterismo Urinário , Retenção Urinária , Análise Custo-Benefício , Documentação , Desenho de Equipamento , Humanos , Controle de Infecções , Palpação/enfermagem , Percussão/enfermagem , Sistemas Automatizados de Assistência Junto ao Leito , Ultrassonografia , Procedimentos Desnecessários , Cateterismo Urinário/enfermagem , Retenção Urinária/diagnóstico por imagem , Retenção Urinária/enfermagem , UrodinâmicaRESUMO
Physical assessment is a new responsibility for many nurses in the UK who are expanding their parameters of advanced clinical practice. A physical assessment framework can be used by both community and acute care nurses as a guide to the process of conducting a physical assessment. The framework presented here consists of the following sequence of steps: identifying the purpose of the assessment; taking a health history; choosing a comprehensive or focused approach; and examining the patient using the sequence of inspection, palpation, percussion and auscultation. The next step, interpretation of the clinical findings, which results in either the recognition of abnormality or identification of a differential diagnosis, then becomes the basis for clinical decision making. This paper describes a comprehensive, head-to-toe assessment as one example of the application of this physical assessment framework in clinical practice.
Assuntos
Anamnese/métodos , Avaliação em Enfermagem/métodos , Exame Físico , Auscultação/métodos , Auscultação/enfermagem , Ruídos Cardíacos , Humanos , Modelos de Enfermagem , Papel do Profissional de Enfermagem , Processo de Enfermagem , Palpação/métodos , Palpação/enfermagem , Percussão/métodos , Percussão/enfermagem , Exame Físico/métodos , Exame Físico/enfermagem , Autonomia Profissional , Sons Respiratórios , Reino UnidoRESUMO
Peripheral-inserted central catheters (PICCs) offer a successful alternative to peripheral venipuncture for long term medication therapy. When catheters become occluded, the nurse must intervene to avoid delayed or missed treatments. Pharmacological interventions are costly and not without risks. The purpose of this exploratory study was to test a mechanical percussive POP technique to restore patency. Thirty PICC catheters were clotted with human blood and incubated for 8 hours in a 35 degrees saline bath. Using the percussive POP technique, a 10-mL syringe with 1 mL of saline restored patency in 86% of the occluded catheters. The safety and effectiveness of the POP technique in vitro was established.