RESUMO
BACKGROUND: Maintaining patient comfort and avoiding complications after coronary angiography are important both to the patient and the nurse. Strict bed rest with the head of bed (HOB) completely flat is standard care for postprocedure positioning to decrease pressure on the femoral artery. This position is not thought to be the most comfortable position for patients. OBJECTIVE: The purpose of this study was to determine if raising the HOB to 15° would impact patient comfort after cardiac angiography. METHODS: This study used a randomized, controlled crossover design to compare 3 groups with different HOB positions during the first hour after procedure. RESULTS: Data from 71 patients demonstrated that HOB position did not significantly impact difference in pain/discomfort rating. CONCLUSIONS: Of all the nursing interventions designed to improve patient comfort after angiography, slightly raising the HOB was not a factor in reducing pain/discomfort.
Assuntos
Repouso em Cama , Angiografia Coronária/efeitos adversos , Doença da Artéria Coronariana/diagnóstico por imagem , Dor Pós-Operatória/prevenção & controle , Posicionamento do Paciente , Cuidados Pós-Operatórios , Estudos Cross-Over , Feminino , Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Decúbito DorsalAssuntos
Injúria Renal Aguda/enfermagem , Enfermagem de Cuidados Críticos/métodos , Enfermagem de Cuidados Críticos/normas , Oxigenação por Membrana Extracorpórea/métodos , Oxigenação por Membrana Extracorpórea/normas , Terapia de Substituição Renal/métodos , Terapia de Substituição Renal/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Competência Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos RetrospectivosRESUMO
BACKGROUND: Measurement of mixed venous oxygen saturation helps determine whether cardiac output and oxygen delivery are sufficient for metabolic needs. As recommended by the American Association of Critical-Care Nurses guideline, blood samples for determining mixed venous oxygen saturation are obtained by slowly, in 1 to 2 minutes, withdrawing 1.5 mL of blood from the distal port of the pulmonary artery catheter. In theory, the negative force of rapid withdrawal could pull oxygenated blood from the pulmonary capillary bed, causing falsely elevated saturation values. OBJECTIVE: To determine if the speed of withdrawal affects oxygen content in blood samples used to measure mixed venous oxygen saturation. METHODS: The sample consisted of heart failure patients with pulmonary artery catheters admitted to a cardiac intensive care unit. A prospective, randomized, 2 × 2 crossover design was used to compare mixed venous oxygen saturation in blood samples obtained quickly or slowly. A total of 50 sets of saturation values were analyzed. Each set included 1 blood sample obtained slowly, in 1 to 2 minutes, and 1 obtained rapidly, in 5 seconds. RESULTS: The mean difference in saturation values between the fast and the slow groups was -0.3 (CI, -1.5 to 0.8; P = .55), indicating that no meaningful systematic bias is attributable to fast withdrawal of blood. CONCLUSIONS: Rapid blood sampling does not falsely elevate measurements of mixed venous oxygen saturation.