Ineffective breathing pattern in cardiac postoperative patients: Diagnostic accuracy study.

PURPOSE: The aim of this study was to analyze the accuracy of the defining characteristics of ineffective breathing pattern (IBP) in postoperative cardiac patients. METHODS: A diagnostic accuracy study was performed with 98 patients. Measures of sensitivity, specificity, predictive values, likelihood ratios, diagnostic odds ratio, and area under the ROC curve were calculated. RESULTS: IBP was present in 23.5% of the patients. Alterations in depth of breathing (sensitivity 96%, negative likelihood ratio 0.11%) and pursed-lip breathing (sensitivity 99%, negative likelihood ratio 0.07%) were the most sensitive defining characteristics for IBP, while altered chest excursion (specificity 97%, positive likelihood ratio 11.41%) and prolonged expiration phase (specificity 99%, positive likelihood ratio 42.39%) were the most specific. CONCLUSION: Some clinical indicators were more related to the presence or absence of IBP than others. Knowledge of such measures can help nurses to assess patients more accurately.

Clinical Indicators of Impaired Gas Exchange in Cardiac Postoperative Patients.

PURPOSE: To analyze the accuracy of the defining characteristics of impaired gas exchange (IGE). METHODS: Cross-sectional study carried out in 93 cardiac postoperative adult patients. The 19 NANDA-I defining characteristics related to IGE were evaluated. FINDINGS: Ten defining characteristics were found in the sample. The best accuracy values, including specificity, diagnostic odds ratio, and likelihood ratios, inter alia, were found to decreased carbon dioxide, abnormal arterial blood gases, abnormal arterial pH, and abnormal breathing. CONCLUSION: Some clinical indicators predict the presence/absence of IGE more accurately than others. IMPLICATIONS FOR NURSING PRACTICE: Knowledge of the accuracy of defining characteristics allows an early identification of particular nursing diagnoses, which can prevent complications.

Clinical indicators of ineffective airway clearance for patients in the cardiac postoperative period.

BACKGROUND: The accuracy of an indicator determines the direct relationship between a defining characteristic and the presence or absence of a specific nursing diagnosis. AIMS: To analyse the accuracy of the clinical indicators of ineffective airway clearance in patients during the postoperative period of cardiac surgery. METHODS: A total of 98 patients recruited from a postoperative unit were included in the study. An analysis of sensitivity, specificity, predictive value, likelihood ratio, diagnostic odds ratio, accuracy, and area under the ROC curve was used to determine the accuracy of these clinical indicators. RESULTS: Four clinical indicators showed the highest levels of accuracy by statistical measure: dyspnoea, adventitious breath sounds, ineffective cough, and retained secretions. The indicators retained secretions and ineffective cough showed high diagnostic odds ratios (62.8 and 28.1, respectively). CONCLUSION: The results suggest that there are differences between the ineffective airway clearance indicators as accuracy measures.