RESUMO
Abnormal fluid or air between the pleura results in respiratory distress and can cause death, if untreated. Intrapleural chest drains are used to remove abnormal accumulations of fluid or air. Caring for patients with intrapleural chest drains requires knowledge and skill to ensure patient safety. This article describes the pathophysiology, treatment and nursing care of patients who require intrapleural chest drains.
Assuntos
Tubos Torácicos , Drenagem/enfermagem , Educação Continuada em Enfermagem/métodos , Derrame Pleural/enfermagem , Pneumotórax/terapia , Competência Clínica , HumanosRESUMO
This article describes how to interpret the single-lead electrocardiogram (ECG). The author also describes cardiac electrophysiology and how this is represented by ECG graphs. Part 2 of this article, to be published in the next issue, will describe 12-lead ECGs and acute coronary syndromes.
RESUMO
Twelve-lead electrocardiograms (ECGs) record 12 different views of cardiac electrical activity, or leads. They therefore provide more information than bedside monitors, which usually record one or sometimes two leads. Many acutely ill patients have 12-lead ECGs recorded either on admission to hospital, before undergoing operations or when specific cardiac concerns have arisen. Traditionally, ECGs have aided clinical diagnoses and, by learning how to understand and interpret them, nurses will know when they need to summon expert help. This article describes what each of the 12 leads represents, outlines the main indications for recording 12-lead ECGs and identifies likely causes of error in interpreting them.
Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia/métodos , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/enfermagem , Síndrome Coronariana Aguda/fisiopatologia , Arritmias Cardíacas/enfermagem , Arritmias Cardíacas/fisiopatologia , Artefatos , Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/enfermagem , Bloqueio de Ramo/fisiopatologia , Eletrocardiografia/instrumentação , Eletrocardiografia/enfermagem , Eletrodos , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/enfermagem , Infarto do Miocárdio/fisiopatologiaRESUMO
Twelve-lead electrocardiograms (ECGs) record 12 different views of cardiac electrical activity, thus providing more information than bedside monitors, which usually display one or sometimes two leads. Many acutely ill patients have 12-lead ECGs recorded on admission to hospital and at other times, such as pre-operatively or when there are specific cardiac concerns. ECGs have traditionally been an aid to medical diagnosis, but understanding and being able to interpret them enables nurses to summon help urgently if needed. This article describes what each of the 12 leads represents, outlines the main indications for recording 12-lead ECGs and identifies likely causes of error.
Assuntos
Síndrome Coronariana Aguda/diagnóstico , Eletrocardiografia/métodos , Síndrome Coronariana Aguda/enfermagem , Síndrome Coronariana Aguda/fisiopatologia , Angina Instável/diagnóstico , Angina Instável/enfermagem , Angina Instável/fisiopatologia , Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/enfermagem , Bloqueio de Ramo/fisiopatologia , Eletrocardiografia/instrumentação , Eletrocardiografia/enfermagem , Eletrodos , Falha de Equipamento , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/enfermagem , Infarto do Miocárdio/fisiopatologiaRESUMO
This article describes how to interpret the single-lead electrocardiogram (ECG). The author also describes cardiac electrophysiology and how this is represented by ECG graphs. Part 2 of this article, to be published next week, will describe 12-lead ECGs and acute coronary syndromes.
Assuntos
Eletrocardiografia , Arritmias Cardíacas/fisiopatologia , Fibrilação Atrial/fisiopatologia , Bloqueio Atrioventricular/fisiopatologia , Educação Continuada , HumanosRESUMO
Although respiratory disease can occur at any age, older people are more likely to suffer both acute and chronic respiratory disease. Without sufficient oxygen, cells fail and die, and extensive cell death causes body systems to fail. This article considers the principles of short-term oxygen therapy and offers guidance to nurses who may be required to administer such treatment in their work with older people.
Assuntos
Enfermagem Geriátrica , Oxigenoterapia/enfermagem , Idoso , Humanos , Máscaras , Oxigenoterapia/métodos , Insuficiência Respiratória/enfermagem , Insuficiência Respiratória/terapiaRESUMO
Healthcare assistants are valuable members of the multi-disciplinary team, using many skills outlined in previous articles in this series. But anyone exceeding the limits of their skills can cause harm and may be called to account. This article explains how everyone is accountable.
Assuntos
Papel do Profissional de Enfermagem , Assistentes de Enfermagem/legislação & jurisprudência , Autonomia Profissional , Direitos Civis/legislação & jurisprudência , Direito Penal/legislação & jurisprudência , Emprego/legislação & jurisprudência , Humanos , Responsabilidade Legal , Licenciamento em Enfermagem/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Equipe de Assistência ao Paciente/legislação & jurisprudência , Designação de Pessoal/organização & administração , Responsabilidade Social , Reino UnidoAssuntos
Gasometria/métodos , Cuidados Críticos/métodos , Avaliação em Enfermagem/métodos , Desequilíbrio Ácido-Base/sangue , Desequilíbrio Ácido-Base/diagnóstico , Bicarbonatos/sangue , Gasometria/enfermagem , Dióxido de Carbono/sangue , Eletrólitos/sangue , Homeostase/fisiologia , Humanos , Concentração de Íons de Hidrogênio , Oxigênio/sangue , Pressão Parcial , Valores de ReferênciaRESUMO
The first part of this article examined the development of the role of the lecturer practitioner within nursing. This article discusses the qualifications needed for the role, the conflicts that may arise as a result of the dual nature of the role, and the career structure.
RESUMO
With increasing use of arterial blood gas analysis in various ward and other hospital settings to aid medical diagnosis and management, nurses who can interpret results are often able to initiate earlier interventions and understand the reasons for medical interventions. This article enables nurses to interpret such results.
Assuntos
Gasometria/métodos , Gasometria/enfermagem , Equilíbrio Ácido-Base/fisiologia , Acidose/sangue , Bicarbonatos/sangue , Dióxido de Carbono/sangue , Humanos , Oxigênio/sangue , Insuficiência Respiratória/sangueRESUMO
BACKGROUND: This article examines the history of anthrax, the organism, the different forms of human anthrax, its symptoms and treatment. Set against fears of a bioterrorist attack, the article also examines the potential threat of anthrax as a weapon. CONCLUSION: Frontline staff such as nurses can contribute greatly to increasing survival by recognising symptoms, treating patients promptly and helping to allay public concern.
Assuntos
Antraz/diagnóstico , Antraz/terapia , Antraz/microbiologia , Antraz/transmissão , Antibacterianos/uso terapêutico , Bacillus anthracis/patogenicidade , Guerra Biológica/métodos , HumanosRESUMO
Non-invasive ventilation (NIV) is increasingly being used in domestic and acute health settings. Part one of this article identifies the benefits of NIV and describes the use of continuous positive airway pressure (CPAP). Part two, published in next week's Nursing Standard, discusses bilevel NIV, which has fewer complications and so is largely replacing CPAP. Part two also examines how to monitor and assess patients receiving NIV.
Assuntos
Respiração com Pressão Positiva/métodos , Insuficiência Respiratória/terapia , Doença Aguda , Desenho de Equipamento , Unidades Hospitalares , Humanos , Avaliação em Enfermagem , Oxigenoterapia/métodos , Respiração com Pressão Positiva/efeitos adversos , Respiração com Pressão Positiva/instrumentação , Respiração com Pressão Positiva/enfermagemRESUMO
Central venous catheters are increasingly being used in a variety of clinical areas outside critical care. Philip Woodrow examines the indications, measuring techniques and complications associated with central venous pressure monitoring.
Assuntos
Cateterismo Venoso Central/enfermagem , Pressão Venosa Central , Hidratação/enfermagem , Monitorização Fisiológica/enfermagem , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/métodos , Cuidados Críticos/métodos , Hidratação/efeitos adversos , Hidratação/instrumentação , Hidratação/métodos , Humanos , Controle de Infecções/métodos , Monitorização Fisiológica/efeitos adversos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Avaliação em Enfermagem , Seleção de Pacientes , Valores de Referência , Fatores de RiscoRESUMO
Most acute wards occasionally receive patients with tracheostomies, but relatively infrequent experience of caring for these patients means that nurses have limited opportunities to practise their knowledge and skills. This article examines the indications for using a tracheostomy and provides a problem-centred approach to patient care.
Assuntos
Obstrução das Vias Respiratórias/cirurgia , Traqueostomia/enfermagem , Doença Aguda , Bandagens , Comunicação , Humanos , Úlcera por Pressão/etiologia , Úlcera por Pressão/prevenção & controle , Traqueostomia/instrumentação , Traqueostomia/métodosRESUMO
The second part of this article on non-invasive ventilation (NIV) examines the use of bilevel non-invasive ventilation, discussing the differences between CPAP and bilevel NIV. It also focuses on how to assess and monitor patients receiving either CPAP or bilevel NIV, and patient outcomes.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas/instrumentação , Pressão Positiva Contínua nas Vias Aéreas/enfermagem , Cuidados Críticos/métodos , Desenho de Equipamento , Humanos , Unidades de Terapia Intensiva , Avaliação em Enfermagem , Oxigenoterapia/métodos , Respiração com Pressão Positiva , Insuficiência Respiratória/enfermagem , Insuficiência Respiratória/terapiaRESUMO
Nurses are often in the best position to detect any breathing problems in patients. This paper describes the mechanisms of respiration, the reasons why respiratory difficulties can develop and explains how problems can be detected and alleviated. It includes a series of reflective exercises that aim to enhance nurses' understanding of this life-threatening condition.
Assuntos
Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/enfermagem , Humanos , Papel do Profissional de Enfermagem , Insuficiência Respiratória/fisiopatologiaRESUMO
A government review has acknowledged that many critically ill patients are being cared for on acute wards. A lack of resources and intensive care beds, combined with low staffing levels, have led to increased demands being placed on wards that are already struggling to care for critically ill patients. Research shows that ward nurses are well placed to identify early indications of complications and initiate appropriate interventions, and that poor outcomes and some deaths are potentially avoidable. This article describes how one trust developed an in-house education programme to support nurses caring for acutely and critically ill patients on the wards.
Assuntos
Cuidados Críticos , Capacitação em Serviço , Recursos Humanos de Enfermagem Hospitalar/educação , Inglaterra , Medicina Baseada em Evidências , Humanos , Avaliação em EnfermagemRESUMO
As you are reading Nursing Older People, your answer to the question 'Should older people be admitted to intensive care?' is probably yes, perhaps qualified by 'when appropriate'. But as well as appropriateness (individual best interests), the quality of services is also affected by attitudes within society and health care. So why is this important for you?
RESUMO
The issue of nailbrushes seems to be unidentified by infection control literature, including the Infection Control Nurses' Association hand hygiene guidelines. The infection risk is, however, that they will be used as communal items, like a bar of soap, so may transmit micro-organisms. Therefore, in acute care their use should be discouraged. If used, they should be single use, and then disposed of.