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1.
J Perioper Pract ; 33(3): 56-61, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35787027

RESUMO

Although evidence-based practices exist for preventing hypothermia in patients during surgery, few studies have focused on this concern in postoperative patients. The aim of this qualitative study was to explore the most challenging issues experienced by surgical ward nurses while managing the body temperature of adult surgical patients. To address this research gap, this study used a qualitative descriptive design to document barriers to body temperature management as reported by a sample of 16 perioperative nurses. The semi-structured, face-to-face interviews were digitally recorded, transcribed verbatim and analysed using inductive content analysis. The main barriers fell into three categories: professional nursing ability limitations, unfavourable working conditions and management of human resources. The eight subcategories were disadvantageous professional views, professional knowledge limitations, low motivation to provide nursing care, non-standard treatment environment, inadequate equipment and care protocols, heavy nursing care loads, inadequate staff training and ineffective staff supervision. These findings highlighted the importance of adequate resources, proper education and evidence-based care protocols in the effective delivery of body temperature management to postoperative patients.


Assuntos
Hipotermia , Cuidados de Enfermagem , Enfermagem Perioperatória , Complicações Pós-Operatórias , Adulto , Humanos , Temperatura Corporal , Cuidados de Enfermagem/métodos , Cuidados de Enfermagem/normas , Pesquisa Qualitativa , Complicações Pós-Operatórias/enfermagem , Hipotermia/etiologia , Hipotermia/enfermagem , Condições de Trabalho/normas , Protocolos Clínicos , Competência Clínica , Enfermagem Perioperatória/educação , Enfermagem Perioperatória/métodos , Enfermagem Perioperatória/normas
2.
Comput Math Methods Med ; 2022: 5400479, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35936363

RESUMO

Objective: To explore the effect of continuous psychological nursing based on the grey clustering algorithm on erectile function, bad psychological emotion, and complications in patients after transurethral resection of prostate (TURP). Methods: 98 patients who underwent TURP were randomly divided into observation and control groups (routine nursing). The observation group first used the grey clustering algorithm to evaluate the psychological intelligence, found patients with abnormal psychological behavior, and then implemented continuous psychological nursing combined with pelvic floor muscle exercise. The patients were followed up for 4 months. The International Index of Erectile Function-5 (IIEF-5), the incidence of complications, the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA) scores, and the nursing satisfaction were analyzed and compared between these two groups. Results: The grey clustering algorithm can accurately reflect the characteristics of patients' psychological changes. After targeted nursing, compared with the control group, the IIEF-5 in the observation group was higher [(24.87 ± 1.85) vs. (22.24 ± 1.47), P < 0.05], the incidence of total complications was lower (10.20% vs. 26.53%, P < 0.05), the score of HAMA was lower [(6.11 ± 2.57) vs. (10.98 ± 2.29), P < 0.05], the score of HAMD was lower [(6.97 ± 2.85) vs. (11.35 ± 2.19), P < 0.05], and the nursing satisfaction was higher (100% vs. 85.71%, P < 0.05). Conclusion: Mental intelligence evaluation based on the grey clustering algorithm combined with pelvic floor muscle exercise can significantly improve the rehabilitation effect of erectile function in patients after TURP, reduce the incidence of postoperative complications, and alleviate patients' anxiety and depression.


Assuntos
Algoritmos , Disfunção Erétil/psicologia , Complicações Pós-Operatórias/enfermagem , Hiperplasia Prostática/cirurgia , Enfermagem Psiquiátrica/métodos , Ressecção Transuretral da Próstata/psicologia , Ansiedade/etiologia , Ansiedade/enfermagem , Ansiedade/terapia , Análise por Conglomerados , Depressão/etiologia , Depressão/enfermagem , Depressão/terapia , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Disfunção Erétil/reabilitação , Humanos , Masculino , Diafragma da Pelve/fisiologia , Complicações Pós-Operatórias/psicologia , Complicações Pós-Operatórias/terapia , Hiperplasia Prostática/psicologia , Ressecção Transuretral da Próstata/efeitos adversos , Ressecção Transuretral da Próstata/reabilitação
3.
Comput Math Methods Med ; 2022: 6940715, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35136418

RESUMO

OBJECTIVE: To systematically evaluate the effect of collaborative nursing on self-care ability of postcolostomy patients with colorectal cancer (CRC). METHODS: PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases were searched to collect relevant literatures on randomized controlled trials of postcolostomy patients with CRC. The search period was started from 2010 to 2021. Statistical analysis was performed on the data extracted from the comprehensive meta-analysis with STATA 16.0 analysis software. RESULTS: As a result, it was found that the incidence of adverse reactions in the control group was higher than that in the treatment group. Seven studies included the preintervention self-care concept and preintervention self-care skills. Six studies included preintervention self-care responsibility and preintervention exercise of self-care agency (ESCA) scale. In the comparison among the concept of self-care after intervention, self-care skills, self-care responsibility, and ESCA scale, all of them had higher scores in the treatment group than in the control group (P < 0.05). It fully explains that collaborative nursing can significantly improve the evaluation indicators of patients' self-care ability and reduce patient complications. CONCLUSION: The application of collaborative nursing in the nursing work of patients with CRC after colostomy can significantly reduce the incidence of adverse nursing reactions.


Assuntos
Neoplasias Colorretais/enfermagem , Neoplasias Colorretais/cirurgia , Colostomia/enfermagem , Cuidados Pós-Operatórios/enfermagem , China , Colostomia/efeitos adversos , Biologia Computacional , Humanos , Processo de Enfermagem , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Autocuidado
4.
Comput Math Methods Med ; 2021: 9581568, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34956400

RESUMO

Based on the ultrasonic imaging and endoscopic resection of the intelligent segmentation algorithm, this study is aimed at exploring whether nursing intervention can promote the good recovery of patients with colon polyps, hoping to find a new method for clinical treatment of the colon polyps. Patients with colon polyps were divided into an experimental group (fine nursing) and a control group (general nursing). The colonoscopy polyp ultrasound image was preprocessing to select the seed points and background points. The random walk decomposition algorithm was applied to calculate the probability of each marked point, and then, the marked image was outputted. The accuracy of the intelligent segmentation algorithm was 81%. The incidence of complications in the experimental group was 4.83%, which was lower than 16.66% in the control group, and the difference was statistically obvious (P < 0.05). Perioperative refined nursing intervention for colon polyp patients undergoing endoscopic electrosurgical resection can decrease postoperative adverse reactions; reduce postoperative mucosal perforation, blood in the stool, abdominal pain, and small bleeding; lower the incidence of postoperative complications; and allow patients to recover quickly, enhancing the life comfort of patient.


Assuntos
Algoritmos , Pólipos do Colo/diagnóstico por imagem , Pólipos do Colo/enfermagem , Ultrassonografia Doppler em Cores/enfermagem , Ultrassonografia Doppler em Cores/estatística & dados numéricos , China , Pólipos do Colo/cirurgia , Colonoscopia/efeitos adversos , Colonoscopia/métodos , Colonoscopia/enfermagem , Biologia Computacional , Eletrocoagulação/efeitos adversos , Eletrocoagulação/estatística & dados numéricos , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Informática em Enfermagem , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/enfermagem , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/enfermagem
5.
Comput Math Methods Med ; 2021: 4622064, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34737787

RESUMO

Thoracic surgery is the main surgical method for the treatment of respiratory diseases and lung diseases, but infections caused by improper care are prone to occur during the operation, which can induce pulmonary edema and lung injury and affect the effect of the operation and the subsequent recovery. Therefore, it is necessary to control the disease in time and adopt more scientific and comprehensive nursing measures. Based on the neural network algorithm, this paper constructs a neural network-based factor analysis model and applies the operating room management nursing to postoperative infection nursing after thoracic surgery and verifies the effect through the neural network model. The statistical parameters in this article mainly include the postoperative infection rate of thoracic surgery, patient satisfaction, postoperative rehabilitation effect, and complications. Through statistical analysis, it can be known that operating room management and nursing can play an important role in postoperative infection nursing after thoracic surgery, effectively reducing postoperative infection nursing after thoracic surgery, and improving the recovery effect of patients after infection.


Assuntos
Redes Neurais de Computação , Salas Cirúrgicas/organização & administração , Procedimentos Cirúrgicos Torácicos/enfermagem , Algoritmos , China , Biologia Computacional , Infecção Hospitalar/enfermagem , Análise Fatorial , Humanos , Modelos de Enfermagem , Salas Cirúrgicas/estatística & dados numéricos , Complicações Pós-Operatórias/enfermagem , Procedimentos Cirúrgicos Torácicos/estatística & dados numéricos
6.
PLoS One ; 16(10): e0258787, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34662355

RESUMO

Despite concerted research and clinical efforts, sepsis remains a common, costly, and often fatal occurrence. Little evidence exists for the relationship between institutional nursing resources and the incidence and outcomes of sepsis after surgery. The objective of this study was to examine whether hospital nursing resource quality is associated with postsurgical sepsis incidence and survival. This cross-sectional, secondary data analysis used registered nurses' reports on hospital nursing resources-staffing, education, and work environment-and multivariate logistic regressions to model their association with risk-adjusted postsurgical sepsis and mortality in 568 hospitals across four states. Better work environment quality was associated with lower odds of sepsis. While the likelihood of death among septic patients was nearly seven times that of non-septic patients, better nursing resources were associated with reduced mortality for all patients. Whereas the preponderance of sepsis research has focused on clinical interventions to prevent and treat sepsis, this study describes organizational characteristics hospital administrators may modify through organizational change targeting nurse staffing, education, and work environments to improve patient outcomes.


Assuntos
Recursos Humanos de Enfermagem Hospitalar/educação , Complicações Pós-Operatórias/enfermagem , Sepse/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Mortalidade , Admissão e Escalonamento de Pessoal , Complicações Pós-Operatórias/mortalidade , Sepse/etiologia , Sepse/enfermagem , Local de Trabalho , Adulto Jovem
7.
Clin Nurse Spec ; 35(5): 238-245, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34398545

RESUMO

PURPOSE: The aims of this study were to examine interrater agreement of delirium between clinical nurses and a clinical nurse specialist, determine delirium subtype prevalence, and examine associated patient, procedure, and hospital factors. DESIGN: A descriptive cross-sectional design and a convenience sample of nurses and patients on progressive care units were used in this study. METHODS: Clinical nurse specialist data were collected on a case report form, and clinician and patient data were obtained from electronic databases. Interrater agreement of delirium prevalence was assessed by κ statistic, and logistic regression models were used to determine patient factors associated with delirium. RESULTS: Of 216 patients, 23 had delirium; clinical nurses identified fewer cases than the clinical nurse specialist: 1.8% versus 10.7%; κ agreement, 0.27 (0.06, 0.49). By delirium subtype, hypoactive delirium was more frequent (n = 10). Factors associated with delirium were history of cerebrovascular disease (odds ratio [95% confidence interval], 2.8 [1.01-7.7]; P = .044), history of mitral valve disease (odds ratio [95% confidence interval], 0.31 [0.09-0.90]; P = .041), and longer perfusion time (odds ratio [95% confidence interval], 1.7 [1.1-2.7]; P = .016). One factor was associated with hypoactive delirium, longer perfusion time (odds ratio [95% confidence interval], 2.2 [1.3-4.2]; P = .008). CONCLUSIONS: Because clinician-clinical nurse specialist delirium agreement was low and hypoactive delirium was common, clinical interventions are needed.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos , Delírio/enfermagem , Enfermeiros Clínicos , Enfermeiras e Enfermeiros , Diagnóstico de Enfermagem/estatística & dados numéricos , Variações Dependentes do Observador , Complicações Pós-Operatórias/enfermagem , Idoso , Estudos Transversais , Delírio/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem , Complicações Pós-Operatórias/epidemiologia , Prevalência , Fatores de Risco
8.
Br J Nurs ; 30(6): S12-S18, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33769883

RESUMO

The functions of the lower parts of the bowel, namely the colon and rectum, are predominantly the absorption of fluids and elimination of faeces and flatus. Bowel surgery may be carried out in the treatment of colorectal cancer, inflammatory bowel disease or diverticular disease, and may involve the formation of a permanent or temporary stoma. The type of colorectal surgery carried out depends on the condition and where the problem occurs. Surgery can alter not only the bowel's anatomy but also its functioning. Bowel dysfunction can manifest as constipation, faecal incontinence or diarrhoea. Nurses are well placed to assist patients to resolve many of these problems as well as stoma issues.


Assuntos
Gastroenteropatias , Complicações Pós-Operatórias , Gastroenteropatias/enfermagem , Humanos , Complicações Pós-Operatórias/enfermagem
10.
Medicine (Baltimore) ; 99(48): e23127, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33235072

RESUMO

BACKGROUND: Prostate cancer (PC) is one of the most familiar disease of the male reproductive system globally. In treating the clinically localized PC, the radical prostatectomy is regarded as a gold standard, but it is associated with syndromes as urinary incontinence (UI), which can have a significant impact on patients' quality of life. Nurse takes responsibility in the management of the UI for their convenience compared with doctors to contact with patients and build better trust relationships with survivals. However, most of the studies focus on the physiological level, the psychological nursing intervention research is less. The purpose of the trial is to introduce a psychological intervention program and to study its effects on anxiety and depression after prostatectomy in IU patients. METHODS: This is a single-center randomized controlled trial that was authorized by Ethics Committee of the First People's Hospital of Chenzhou City (2020054). One hundred participants who undergo radical prostatectomy are analyzed. Inclusion criteria are the following: PC is diagnosed based on histological results; Participants in the study voluntarily sign the informed consent table; Severe UI after extubation; Patients with postoperative UI do not receive any drug treatment. Exclusion criteria are the followings: patients with the history of prostate operation; patients with the history of severe renal and liver malignancy; UI caused by reasons other than prostatectomy. The main outcomes are the degree of anxiety and depression 2 months after urinary catheter is removed. The secondary outcomes are the quality of life 2 months after urinary catheter is removed. All data are collected and analyzed by the Social Science software version 21.0 (SPSS, Inc., Chicago, IL) program. RESULTS: The relevant indexes of severe UI patients are compared in the table. CONCLUSION: Psychological nursing intervention may have a positive effect on depression and anxiety in the UI patients after receiving the radical prostatectomy.


Assuntos
Transtornos de Ansiedade/enfermagem , Processo de Enfermagem , Prostatectomia , Incontinência Urinária/enfermagem , Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Humanos , Masculino , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Resultado do Tratamento , Incontinência Urinária/prevenção & controle , Incontinência Urinária/psicologia
11.
Clin Interv Aging ; 15: 1505-1511, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32921996

RESUMO

AIM: Life expectancy and incidence of cancer among older adults are increasing. The aim of this study was to assess whether routinely used nursing screening tools can predict surgical outcomes in older adults with colorectal cancer. METHODS: Data of patients who underwent elective colorectal cancer surgery at Rabin Medical Center during the years 2014-2016 were collected retrospectively. Patients were divided into study group (age 80-89 y), and control group (age 60-69 y) for comparing surgical outcomes and six-month mortality. In the study group, screening tool scores were evaluated as potential predictors of surgical outcomes. These included Malnutrition Universal Screening Tool (MUST), Admission Norton Scale Scores (ANSS), Morse Fall Scale (MFS), and Charlson Co-morbidity Index (CCI). RESULTS: The study group consisted of 77 patients, and the control group consisted of 129 patients. Postoperative mortality and morbidity were similar in both groups. Nursing screening tools did not predict immediate postoperative outcomes in the study group. MUST and CCI were predictors for six-month mortality. CCI score was 9.43±2.44 in those who died within six months from surgery compared to 7.07 ±1.61 in those who were alive after six months (p<0.05). Post-operative complications were not associated with increased 30-day mortality. Advanced grade complications were associated with an increased six-month mortality (RR=1.37, 95% CI 0.95-1.98, p=0.013). CONCLUSION: Different screening tools for high-risk older adults who are candidates for surgery have been developed, with the caveat of necessitating skilled physicians and resources such as time. Routinely used nursing screening tools may be helpful in better patient selection and informed decision making. These tools, specifically MUST and CCI who were found to predict six-month survival, can be used to additionally identify high-risk patients by the nursing staff and promote further evaluation. This can be a valuable tool in multidisciplinary and patient-centered care.


Assuntos
Neoplasias Colorretais/cirurgia , Cirurgia Colorretal/estatística & dados numéricos , Avaliação em Enfermagem/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/enfermagem , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
AANA J ; 88(4): 325-332, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32718432

RESUMO

Anesthetic modalities to mitigate the development of phantom limb pain have not been standardized into an evidence-based, multimodal anesthesia protocol to promote improved patient outcomes. This quality improvement project involved the implementation of a lower extremity, amputation-specific anesthesia protocol. In the postimplementation group, 94 patients were anesthetized for their amputation using an Amputation Improved Recovery Enhanced Recovery After Surgery (ERAS) protocol. Patient outcomes before and after protocol implementation were compared. The rate of continuous peripheral nerve block placement was higher in the postimplementation group (37.2%) than the preimplementation group (29.6%, P = .337). The 2 groups did not differ on average pain scores and morphine equivalent consumption rates per patient during hospitalization. The postimplementation group had significantly lower mean pain scores during the first 24 hours after amputation (P = .046); fewer postoperative complications (P = .001), amputation revisions (P = .003), 30-day hospital readmissions (P = .049), and readmissions related to amputation surgery (P = .019); and higher rates of early phantom limb pain that resolved during hospitalization (P = .012). Use of a standardized anesthetic protocol designed for patients undergoing amputation improved patient outcomes. Trials of this protocol elsewhere may contribute to improved recovery for patients undergoing amputations.


Assuntos
Amputação Cirúrgica , Anestesia Geral , Extremidade Inferior , Membro Fantasma/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiros Anestesistas , Período Perioperatório , Membro Fantasma/enfermagem , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Melhoria de Qualidade
14.
Rev Bras Enferm ; 73(3): e20180355, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32267411

RESUMO

OBJECTIVES: to evaluate the evolution of clinical indicators that characterize airway permeability in patients in the postoperative period of thoracoabdominal surgeries and to analyze their relationship with the occurrence of the diagnosis "ineffective airway clearance". METHODS: descriptive, quantitative, longitudinal research with 60 patients who were followed for five consecutive days. Eleven indicators of the nursing outcome "respiratory status: airway permeability" were used. RESULTS: on the first day of evaluation, the most compromised indicators were: respiratory rate, cough, depth of breath and use of accessory muscles. During follow-up, most of the indicators presented a slight deviation from normal variation and, in the last evaluation, there was a predominance of indicators with some degree of impairment. CONCLUSIONS: with the aid of the Nursing Outcomes Classification, it was observed that patients submitted to thoracoabdominal surgeries may present compromised airway permeability even days after surgery.


Assuntos
Manuseio das Vias Aéreas/enfermagem , Complicações Pós-Operatórias/enfermagem , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Diagnóstico de Enfermagem , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Período Pós-Operatório , Estatísticas não Paramétricas
15.
Crit Care Nurse ; 40(1): 46-55, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32006036

RESUMO

Junctional ectopic tachycardia is a common dysrhythmia after congenital heart surgery that is associated with increased perioperative morbidity and mortality. Risk factors for development of junctional ectopic tachycardia include young age (neonatal and infant age groups); hypomagnesemia; higher-complexity surgical procedure, especially near the atrioventricular node or His bundle; and use of exogenous catecholamines such as dopamine and epinephrine. Critical care nurses play a vital role in early recognition of dysrhythmias after congenital heart surgery, assessment of hemodynamics affecting cardiac output, and monitoring the effects of antiarrhythmic therapy. This article reviews the underlying mechanisms of junctional ectopic tachycardia, incidence and risk factors, and treatment options. Currently, amiodarone is the pharmacological treatment of choice, with dexmedetomidine increasingly used because of its anti-arrhythmic properties and sedative effect.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Enfermagem de Cuidados Críticos/normas , Enfermagem Pediátrica/normas , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/enfermagem , Taquicardia Ectópica de Junção/diagnóstico , Taquicardia Ectópica de Junção/enfermagem , Adulto , Enfermagem de Cuidados Críticos/educação , Currículo , Educação Continuada em Enfermagem , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Enfermagem Pediátrica/educação , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Guias de Prática Clínica como Assunto , Taquicardia Ectópica de Junção/tratamento farmacológico
16.
Medicine (Baltimore) ; 99(7): e18690, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049780

RESUMO

RATIONALE: Erectile dysfunction (ED) and Peyronie's disease (PD) are conditions commonly observed in andrology. Despite the surgical refinement and the technical improvement in this field, even in expert hands, detrimental consequences have been reported and it can be related to patient's comorbidities or misconduct in the postoperative period. In this article we report anecdotal cases of severe complications following penile surgery for ED and PD in high volume centers, describe the strategies adopted to treat it and discuss the options that would have helped preventing these events. PATIENTS' CONCERNS: The first case describes a patient with history of ED and PD causing penile shortening and a slight dorsal deviation of penile shaft. In the second case it is described a corporeal necrosis and urethral fistula following inflatable penile prosthesis implant. In the last case it is described the migration of reservoir into the abdomen after inflatable penile prosthesis implantation post-radical prostatectomy. DIAGNOSIS: All 3 patients were investigated with a penile doppler ultrasound with PGE1 intracorporeal injection for ED and PD diagnosis. An abdominal computed tomography scan and magnetic resonance imaging were ordered for patient of case three. INTERVENTIONS: The patients underwent different combined procedures depending on the case and including: glansectomy, penile prosthesis implantation associated with a penile elongation with double dorsal-ventral patch graft ("sliding technique"), penile urethroplasty with buccal mucosa graft, and laparotomy for reservoir removal. OUTCOMES: No further serious complications were reported after the procedures described. LESSONS: Penile surgery in patients with concomitant PD and systemic comorbidities can be at high risk of complications. As shown in this series there are possible dramatic evolution of these complications that may cause irreversible consequences to the patient. For this reason, a dedicated surgical and nursing team is necessary to reduce the chances that it happens. When this event occurs, a team trained in their management can improve the patient outcome.


Assuntos
Disfunção Erétil/cirurgia , Induração Peniana/cirurgia , Complicações Pós-Operatórias/enfermagem , Alprostadil/administração & dosagem , Disfunção Erétil/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Induração Peniana/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler
17.
Rev. bras. enferm ; 73(3): e20180355, 2020. tab
Artigo em Inglês | LILACS, BDENF | ID: biblio-1092581

RESUMO

ABSTRACT Objectives: to evaluate the evolution of clinical indicators that characterize airway permeability in patients in the postoperative period of thoracoabdominal surgeries and to analyze their relationship with the occurrence of the diagnosis "ineffective airway clearance". Methods: descriptive, quantitative, longitudinal research with 60 patients who were followed for five consecutive days. Eleven indicators of the nursing outcome "respiratory status: airway permeability" were used. Results: on the first day of evaluation, the most compromised indicators were: respiratory rate, cough, depth of breath and use of accessory muscles. During follow-up, most of the indicators presented a slight deviation from normal variation and, in the last evaluation, there was a predominance of indicators with some degree of impairment. Conclusions: with the aid of the Nursing Outcomes Classification, it was observed that patients submitted to thoracoabdominal surgeries may present compromised airway permeability even days after surgery.


RESUMEN Objetivos: valorar la evolución de los indicadores clínicos que caracterizan la permeabilidad de las vías aéreas en pacientes en el posoperatorio de cirugías toracoabdominales y evaluar su relación con la ocurrencia del diagnóstico "desobstrucción ineficaz de las vías aéreas". Métodos: investigación descriptiva, cuantitativa, longitudinal en la cual participaron 60 pacientes que recibieron seguimiento por cinco días. Se utilizaron 11 indicadores del resultado de enfermería "estado respiratorio: permeabilidad de las vías aéreas". Resultados: en el primer día de evaluación, los indicadores más comprometidos fueron: frecuencia respiratoria, tos, profundidad de la respiración y utilización de músculos accesorios. Durante el seguimiento, se verificó que la mayor parte de los indicadores presentó una leve desviación de la variación normal y, en la última evaluación, hubo un predominio de indicadores con algún grado de comprometimiento. Conclusiones: con la ayuda de la Clasificación de los resultados de enfermería, se observó que los pacientes sometidos a cirugías toracoabdominales pueden presentar comprometimiento de la permeabilidad de las vías aéreas incluso después de algunos días de realizar el procedimiento quirúrgico.


RESUMO Objetivos: avaliar a evolução dos indicadores clínicos que caracterizam a permeabilidade das vias aéreas em pacientes no pós-operatório de cirurgias toracoabdominais e analisar sua relação com a ocorrência do diagnóstico "desobstrução ineficaz das vias aéreas". Métodos: pesquisa descritiva, quantitativa, longitudinal realizada com 60 pacientes que foram acompanhados por cinco dias consecutivos. Foram utilizados 11 indicadores do resultado de enfermagem "estado respiratório: permeabilidade das vias aéreas". Resultados: no primeiro dia de avaliação os indicadores mais comprometidos foram: frequência respiratória, tosse, profundidade da respiração e uso de músculos acessórios. Durante o acompanhamento, verificou-se que a maior parte dos indicadores apresentou desvio leve da variação normal e, na última avaliação, houve predomínio de indicadores com algum grau de comprometimento. Conclusões: com auxílio da Classificação dos resultados de enfermagem, observou-se que pacientes submetidos a cirurgias toracoabdominais podem apresentar comprometimento da permeabilidade das vias aéreas mesmo após dias da realização do procedimento cirúrgico.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/enfermagem , Manuseio das Vias Aéreas/enfermagem , Período Pós-Operatório , Diagnóstico de Enfermagem , Estudos Longitudinais , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/métodos , Estatísticas não Paramétricas
18.
Rev. enferm. UERJ ; 27: e45758, jan.-dez. 2019. ilus
Artigo em Português | LILACS, BDENF | ID: biblio-1099963

RESUMO

Objetivo: identificar e analisar as evidências disponíveis na literatura sobre as complicações de estomia intestinal e pele periestoma. Método: revisão integrativa, em bases virtuais de dados, com inclusão de estudos do tipo ensaio clínico randomizado, publicados nos idiomas inglês, espanhol e português, no período de maio 2013 a maio de 2019. Resultados: foram selecionados 19 estudos e agrupados em três categorias: técnicas cirúrgicas apontando técnicas inovadoras acerca do tipo de suturas, ressecção e exteriorização de alça intestinal, além de reforços para prevenção de hérnias; barreiras de pele e equipamentos coletores, abordando principalmente as barreiras de pele para prevenção e tratamento da dermatite; cuidados de enfermagem mostrando cuidados e programas de acompanhamento, como visitas domiciliares, consultas e programas educativos. Conclusões: As estratégias descritas nos estudos revisados são importantes na medida em que poderão enriquecer o conhecimento do enfermeiro e dessa forma reduzir complicações de estomia e pele periestoma e melhorar a qualidade de vida dessas pessoas.


Objective: to identify and analyze the evidence available in the literature on the complications of intestinal ostomy and peristomal skin. Method: integrative review in virtual databases, including randomized clinical trialstudies published in English, Spanish and Portuguese, from May 2013 to May 2019. Results: 19 studies were selected and grouped into three categories: surgical techniques pointing innovative techniques about the type of sutures, resection and externalization of the intestinal loop, in addition to reinforcements to prevent hernias; skin barriers and collecting equipment, mainly addressing skin barriers for the prevention and treatment of dermatitis; nursing care showing care and follow-up programs such as home visits, consultations, and educational programs. Conclusion: the strategies described in the reviewed studies are important as they may enrich the knowledge of nurses and thus reduce complications of ostomy and peristome skin and improve the quality of life of these people.


Objetivo: identificar y analizar la evidencia disponible en la literatura sobre las complicaciones de la ostomía intestinal y la piel peristomal. Método: revisión integradora en bases de datos virtuales, incluidos estudios de ensayos clínicos aleatorizados publicados en inglés, español y portugués, de mayo de 2013 a mayo de 2019. Resultados: se seleccionaron 19 estudios y se agruparon en tres categorías: técnicas quirúrgicas que apuntan técnicas innovadoras sobre el tipo de suturas, resección y externalización del asa intestinal, además de refuerzos para prevenir hernias; barreras cutáneas y equipos de recolección, principalmente para abordar las barreras cutáneas para la prevención y el tratamiento de la dermatitis; atención de enfermería que muestra programas de atención y seguimiento, como visitas domiciliarias, consultas y programas educativos. Conclusiones: Las estrategias descritas en los estudios revisados on importantes ya que pueden enriquecer el conocimiento de las enfermeras y, por lo tanto, reducir las complicaciones de la ostomía y la piel peristómica y mejorar la calidad de vida de estas personas.


Assuntos
Humanos , Adulto , Enterostomia/efeitos adversos , Enterostomia/enfermagem , Dermatite/enfermagem , Enfermagem Baseada em Evidências , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Qualidade de Vida , Dermatite/prevenção & controle
19.
AANA J ; 87(4): 313-316, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31587716

RESUMO

Horner syndrome is a known complication of cervical approaches to brachial plexus blocks due to local anesthetic-induced oculosympathetic paresis. It has rarely been described in relation to ultrasound-guided brachial plexus blocks in children. This syndrome is usually self-limiting but may cause apprehension to the child, parents, and the treating physicians until its resolution. We report delayed manifestations of Horner syndrome in 2 children following ultrasound-guided infraclavicular and subclavian perivascular blocks.


Assuntos
Anestésicos Locais/efeitos adversos , Bloqueio do Plexo Braquial/efeitos adversos , Síndrome de Horner/diagnóstico , Bloqueio do Plexo Braquial/enfermagem , Criança , Diagnóstico Diferencial , Síndrome de Horner/induzido quimicamente , Síndrome de Horner/enfermagem , Humanos , Masculino , Enfermeiros Anestesistas , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/enfermagem , Ultrassonografia de Intervenção
20.
AANA J ; 87(2): 115-123, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31587724

RESUMO

Postoperative cognitive dysfunction, a subtle deterioration of cognitive function after exposure to anesthetics, is reported in 10% to 50% of surgical cases. Delivery of excessive inhalation anesthetics based on minimum alveolar concentration produces greater deep hypnotic times, which may contribute to postoperative cognitive dysfunction. This study tested the impact on cognitive function of balanced anesthetic using electroencephalographic (EEG) guidance vs usual anesthesia. We studied 88 surgical patients: 45 randomly assigned to balanced anesthetic technique with EEG guidance and 43 to standard treatment. Cognitive function was evaluated with the Cambridge Neuropsychological Test Automated Battery-Mild Cognitive Impairment at 3 intervals (preoperatively, 3-5 days postoperatively, and 3-5 months postoperatively). Additionally, 37 age- and sex-matched individuals not undergoing surgery or anesthesia were evaluated at the same intervals. Better outcomes were seen in the intervention group compared with usual care in the short-term/visual memory cognitive domain (P = .02) at 3 to 5 days, but not at 3 to 5 months. Delivery of anesthesia using EEG monitoring systems can reduce cumulative deep hypnotic time without negatively affecting patient physiologic stress, surgical conditions, or cognitive function. Our findings provide data to support optimal anesthetic approaches to improve cognitive function after anesthesia with volatile anesthetics.


Assuntos
Anestésicos Inalatórios/farmacologia , Cognição/efeitos dos fármacos , Eletroencefalografia , Monitorização Fisiológica , Complicações Pós-Operatórias/prevenção & controle , Idoso , Anestesia Geral , Anestesiologia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiros Anestesistas , Complicações Pós-Operatórias/enfermagem , Estudos Prospectivos , Resultado do Tratamento
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