RESUMO
Arterial punctures for arterial blood gases (ABGs) analysis are described as the most painful laboratory procedure and are performed without the benefit of pain management. This study originated from one nurse's concern about the level of pain her hospitalized patients endured when she drew their ABGs. A review of the literature found that ABG pain relief has not been studied in hospitalized patients. Therefore, this study explored the question "Can the pain of arterial blood gas draws be reduced through the use of infiltration with a local anesthetic agent?" This study compared the pain scores of 40 hospitalized patients who received either no intervention or one of three analgesic interventions (infiltration of 0.7 ml 1% lidocaine, 0.7 ml buffered 1% lidocaine, or 0.7 ml of bacteriostatic saline at the arterial puncture site). Results showed that, although lidocaine and buffered lidocaine are effective in reducing the pain associated with the arterial puncture, plain lidocaine was the only intervention in which the pain rating score for the overall experience was significantly diminished. This study is limited by partial randomization, small sample size, and patient duress; however, it provides a foundation for further nursing research that explores methods to reduce the pain associated with this very painful procedure. Future studies should be directed at larger, diverse populations, multiple operators, and comparison of interventions to topical analgesics and nonpharmacological measures.
Assuntos
Anestésicos Locais/administração & dosagem , Gasometria/enfermagem , Lidocaína/administração & dosagem , Dor/enfermagem , Dor/prevenção & controle , Flebotomia/enfermagem , Gasometria/métodos , Feminino , Humanos , Masculino , Dor/tratamento farmacológico , Medição da Dor/enfermagemRESUMO
Coarctation is a constriction or narrowing of the aorta and presents most commonly within the first two weeks of life. This article reviews a case study of an infant diagnosed with coarctation of the aorta on day 8 of life. It includes an overview of the etiology, clinical presentation, and management plus an account of the infant's transport to a regional pediatric intensive care unit (PICU).
Assuntos
Coartação Aórtica/enfermagem , Coartação Aórtica/diagnóstico , Coartação Aórtica/cirurgia , Gasometria/enfermagem , Determinação da Pressão Arterial/enfermagem , Diagnóstico Diferencial , Dinoprostona/administração & dosagem , Permeabilidade do Canal Arterial/diagnóstico , Permeabilidade do Canal Arterial/enfermagem , Ecocardiografia/enfermagem , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Testes de Função Hepática/enfermagem , Masculino , Diagnóstico de EnfermagemRESUMO
This is the second of a two-part unit discussing arterial blood gas (ABG) analysis. Part 1 outlined background information on ABG reports and focused on a systematic approach to ABG analysis. This part examines the physiology of the various lines of defence in the body and explores the concept of compensation. A step-by-step guide to interpretation and examples of uncomplicated ABGs are available in the Portfolio Pages for this unit at nursingtimes.net, as well as further practice examples relevant to this part of the unit.
Assuntos
Acidose/sangue , Alcalose/sangue , Gasometria/métodos , Avaliação em Enfermagem/métodos , Acidose/diagnóstico , Alcalose/diagnóstico , Bicarbonatos/sangue , Gasometria/enfermagem , Ácido Carbônico/sangue , Homeostase , Humanos , Concentração de Íons de HidrogênioRESUMO
Following the introduction of new guidelines in February 2006, assessments for long-term oxygen therapy are now being undertaken by respiratory nurse specialists. The key skill required is arterial blood gas sampling. This has traditionally been the role of the doctor, however by using an education and training package along with a competency-based assessment, nurses can now perform this extended role. Sarah Dodds and Graham Williamson describe a competency-based education and training programme for nurses to carry out this procedure.
Assuntos
Gasometria/enfermagem , Educação Continuada em Enfermagem , Gasometria/normas , Humanos , Guias de Prática Clínica como AssuntoRESUMO
Liz Allibone and Nicola Nation describe how arterial blood gas results can be analysed and how this assists in the diagnosis and management of illness.
Assuntos
Desequilíbrio Ácido-Base/diagnóstico , Gasometria/métodos , Gasometria/enfermagem , Humanos , Valores de ReferênciaRESUMO
In vitro diagnostic point-of-care testing (IVDPCT) can improve patient care but improvements can only be properly realised by adequate management in order to ensure high-quality test results. Nurses perform IVDPCT in all areas of clinical practice, from intensive care units to GP surgeries, using a wide variety of devices ranging from urinalysis strips to blood gas analysers.
Assuntos
Técnicas e Procedimentos Diagnósticos/enfermagem , Sistemas Automatizados de Assistência Junto ao Leito/organização & administração , Gasometria/enfermagem , Automonitorização da Glicemia/enfermagem , Competência Clínica/normas , Tomada de Decisões Gerenciais , Monitoramento de Medicamentos/enfermagem , Humanos , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem Hospitalar/educação , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Urinálise/enfermagemAssuntos
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
Long-term oxygen therapy (LTOT) is becoming a mainstay of treatment for people with severe chronic obstructive pulmonary disease (COPD) in the community. This article provides an overview of the fundamental aspects of the therapy, measurement of blood gases and the equipment used in LTOT.
Assuntos
Enfermagem em Saúde Comunitária/métodos , Oxigenoterapia/enfermagem , Doença Pulmonar Obstrutiva Crônica/terapia , Gasometria/enfermagem , Desenho de Equipamento , Serviços de Assistência Domiciliar , Humanos , Máscaras , Oxigenoterapia/instrumentação , Oxigenoterapia/métodos , Seleção de Pacientes , Doença Pulmonar Obstrutiva Crônica/sangue , Fatores de TempoRESUMO
This article examines acid-base balance and the interpretation of arterial blood gases (ABG). The article begins with a brief revision of related physiology, followed by a description of the primary disorders associated with acid-base imbalance. The normal ranges and the significance of abnormal ABG results are explored. The article concludes by providing an easy to follow four-step guide to ABG interpretation with practice examples presented in the CPD task section.
Assuntos
Equilíbrio Ácido-Base/fisiologia , Gasometria/enfermagem , Homeostase/fisiologia , Monitorização Fisiológica/métodos , Recursos Humanos de Enfermagem/educação , Guias de Prática Clínica como Assunto , Competência Clínica , Educação Continuada em Enfermagem , Humanos , Concentração de Íons de HidrogênioRESUMO
Correlations of mixed venous and arterial oxygen saturation, heart rate, respiratory rate, and mean arterial pressure with arterial blood gas variables were computed for 57 sets of data obtained from 30 postoperative coronary artery bypass graft patients who were being weaned from mechanical ventilation. Arterial oxygen saturation and respiratory rate correlated significantly, although moderately, with blood gases.
Assuntos
Gasometria/métodos , Pressão Sanguínea , Ponte de Artéria Coronária , Frequência Cardíaca , Oxigênio/sangue , Cuidados Pós-Operatórios/métodos , Respiração , Desmame do Respirador , Artérias , Gasometria/enfermagem , Pesquisa em Enfermagem Clínica , Ponte de Artéria Coronária/enfermagem , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Monitorização Fisiológica/enfermagem , Avaliação em Enfermagem , Cuidados Pós-Operatórios/enfermagem , VeiasRESUMO
The Paratrend 7 sensor is a continuous intravascular blood gas sensor that consists of a miniaturized Clark-type PO2 electrode, fibreoptic pH and PCO2 optodes and a thermocouple, the monitor continuously displays the measured pH, PaO2 PaCO2 and temperature of the blood, and the calculated oxygen saturation, BE and SBC. After 7 years of caring for over 200 patients following insertion of the sensor, we describe our nursing experience with particular emphasis on the adequate fixation of the cannula, sensor system and connectors. The maintenance of the sensor through adequate flushing of the arterial line and care of the insertion site is described. Also outlined are the potential advantages to nursing practice of this new monitoring system, with particular reference to early warning of deterioration in respiratory function, closer control of mechanical ventilation and reduction in blood gas sampling and the errors inherent therein.
Assuntos
Gasometria/instrumentação , Gasometria/enfermagem , Cuidados Críticos/métodos , Gasometria/métodos , Falha de Equipamento , Humanos , Manutenção , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Monitorização Fisiológica/enfermagemRESUMO
Understanding acid-base disturbances is essential in the care of the critically ill patient. Through a systematic evaluation of patient symptoms and arterial blood gas values, patient care can be improved. These formulas can be effective tools for the nurse to use in the care of patients with acid-base imbalances.
Assuntos
Gasometria/enfermagem , Avaliação em Enfermagem/métodos , Feminino , Humanos , MatemáticaAssuntos
Acidose Respiratória/enfermagem , Alcalose Respiratória/enfermagem , Gasometria/enfermagem , Unidades de Terapia Intensiva Neonatal , Equilíbrio Ácido-Base/fisiologia , Acidose Respiratória/diagnóstico , Acidose Respiratória/fisiopatologia , Alcalose Respiratória/diagnóstico , Alcalose Respiratória/fisiopatologia , Bicarbonatos/sangue , Dióxido de Carbono/sangue , Humanos , Recém-Nascido , Diagnóstico de Enfermagem , Sistemas Automatizados de Assistência Junto ao Leito , Valores de ReferênciaRESUMO
This article presents three cases that demonstrate the clinical application of mixed venous oxygen saturation monitoring. These case studies reflect how the critical care nurse integrates the physiology of oxygen delivery and consumption as well as critical thinking in making decisions regarding the care of patients with cardiopulmonary instability. This information gives the clinician immediate data from which therapeutic decisions are made to achieve positive patient outcomes.
Assuntos
Gasometria/enfermagem , Monitorização Fisiológica/enfermagem , Consumo de Oxigênio , Oxigênio/sangue , Adolescente , Adulto , Gasometria/métodos , Cuidados Críticos , Feminino , Humanos , Masculino , Monitorização Fisiológica/métodosRESUMO
Cellular oxygenation is dependent on both tissue oxygenation and pulmonary oxygenation. The use of profiles can help to make the assessment of tissue and pulmonary oxygenation more thorough. Although oxygenation profiles have limitations, an understanding of them can provide useful information to the critical care nurse. Oxygenation profiles enable the nurse to trend a patient's progress and response to nursing and medical interventions. A sophisticated assessment relies not merely on physical assessment alone but incorporates continuous mixed venous oxygenation and oxygenation profiles to assess a patient's tissue and pulmonary oxygenation status.
Assuntos
Gasometria/métodos , Gasometria/enfermagem , Cuidados Críticos/métodos , Hipóxia/sangue , Hipóxia/diagnóstico , Monitorização Fisiológica/métodos , Monitorização Fisiológica/enfermagem , Avaliação em Enfermagem/métodos , Consumo de Oxigênio , Oxigênio/sangue , Hipóxia Celular , Humanos , Hipóxia/enfermagem , OxigenoterapiaRESUMO
Carbon dioxide (CO(2)) monitoring can yield substantial information about cardiac and pulmonary function. Because capnography is not complicated, it is relatively easy to apply in a wide variety of clinical settings. A new area of CO(2) measurement is sublingual CO(2). Although outcomes data are as yet unavailable for this technology, its ease of use makes it an attractive monitoring tool to assess severity of illness and predict patients' responses to therapy. This article describes the pathophysiology and clinical applications of the technologies and describes why they may well be "the newest vital signs."
Assuntos
Dióxido de Carbono , Cuidados Críticos/métodos , Hipercapnia , Hipocapnia , Monitorização Fisiológica/métodos , Adulto , Idoso , Gasometria/métodos , Gasometria/enfermagem , Testes Respiratórios/métodos , Capnografia/métodos , Capnografia/enfermagem , Dióxido de Carbono/análise , Dióxido de Carbono/sangue , Feminino , Humanos , Hipercapnia/sangue , Hipercapnia/diagnóstico , Hipocapnia/sangue , Hipocapnia/diagnóstico , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/enfermagem , Avaliação em Enfermagem/métodos , Valor Preditivo dos Testes , Fluxo Sanguíneo Regional , Índice de Gravidade de Doença , Língua/irrigação sanguíneaRESUMO
The arterial blood gas (ABG) analysis, one of the most common tests ordered, provides clinicians with valuable information on a patient's oxygenation and acid-base balance. Interpreting ABG analysis results can be challenging, even for the most experienced practitioners, because it requires knowledge of the physiology and cause-and-effect relationship of the disturbances. Applying the principles and the ABG algorithm described in this article will provide nurses with a systematic way to interpret uncomplicated arterial blood gas results, including primary, mixed, and compensated acidbase disturbances.