Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.248
Filtrar
1.
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 , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Induração Peniana/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler
2.
Enferm. clín. (Ed. impr.) ; 30(1): 31-36, ene.-feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-186281

RESUMO

Objetivo: Determinar la asociación entre diagnósticos de enfermería respiratorios e intervenciones de enfermería en pacientes sometidos a cirugía toráícica o abdominal superior. Método: Estudio cuantitativo y transversal. Los participantes fueron 312 pacientes dentro de las primeras 48 horas después de cirugía torácica o del abdomen superior. Los pacientes fueron exminados por el equipo de investigación utilizando un instrumento con variables relacionadas con la función respiratoria. El equipo de investigación estableció la presencia de tres diagnósticos de enfermería e intervenciones usando la clasificación NANDA-I y la Clasificación de Intervenciones de Enfermería. Las correlaciones se analizaron con la prueba de chi-cuadrado o de Fisher. Resultados: Del total de 312 evaluaciones, la limpieza ineficaz de las vías aéreas estuvo presente en 185 evaluaciones (59,3%), patrón respiratorio ineficaz en 123 (39,4%) y deterioro del intercambio gaseoso en 141 (45,4). Los pacientes con limpieza ineficaz de las vías aéreas tenían más probabilidades de requerir manejo del dolor (OR: 2,27), fisioterapia torácica (OR: 2,96) y posicionamiento (OR: 1,8), mientras que los pacientes con deterioro del intercambio gaseoso tenían menos probabilidades de necesitar de manejo de las vías aéreas (OR: 0,13) y fisioterapia (OR: 0,28). Conclusiones: Aquellos pacientes con el diagnóstico de enfermería de limpieza ineficaz de las vias aéreas presentaron asociación con las intervenciones manejo del dolor, fisioterapia y posicionamiento, mientras el diagnóstico deterioro del intercambio gaseoso estuvo asociado con la intervención manejo de las vías aéreas y fisioterapia. Los resultados proporcionan una base para que las enfermeras desarrollen planes de atención efectivos y minimicen las complicaciones respiratorias postoperatorias


Objective: To determine associations between respiratory nursing diagnoses and nursing interventions in patients submitted to thoracic or upper abdominal surgery. Method: Cross sectional quantitative study. Participants were 312 adult patients within the first 48 hours after thoracic or upper abdominal surgery. Patients were examined by the research team using an instrument with variables related to the respiratory function. The research team established the presence/absence of three nursing diagnoses and proposed interventions using the NANDA-I classification and the Nursing Interventions Classification. Correlations were tested using the chi-square or Fisher's test. Results: From the total 312 examinations, ineffective airway clearance was present in 185 (59.3%) assessments, ineffective breathing pattern in 123 (39.4%), and impaired gas exchange in 141 (45.4%). Significant correlations showed that patients with ineffective airway clearance were more likely to require pain management (or: 2.27), chest physiotherapy (or: 2.96), and positioning (or:1.8), while patients with impaired gas exchange were less likely to require airway management (or: 0.13) and chest physiotherapy (or: 0.28). Conclusions: Patients with ineffective airway clearance had more chances of requiring pain management, chest physiotherapy, and positioning, while the nursing diagnosis impaired gas exchange was related with airway management and chest physiotherapy. The findings provide basis for nurses to develop effective care plans and to minimize postoperative respiratory complications


Assuntos
Humanos , Cirurgia Torácica/métodos , Diagnóstico de Enfermagem , Complicações Pós-Operatórias/enfermagem , Manejo da Dor , Cuidados de Enfermagem , 24960 , Estudos Transversais , Terminologia Padronizada em Enfermagem , Modalidades de Fisioterapia/enfermagem , Planejamento de Assistência ao Paciente/organização & administração
3.
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 , Enfermeiras Anestesistas , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/enfermagem , Ultrassonografia de Intervenção
4.
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 , Enfermeiras Anestesistas , Complicações Pós-Operatórias/enfermagem , Estudos Prospectivos , Resultado do Tratamento
5.
AANA J ; 87(2): 152-159, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31587729

RESUMO

Identification of elderly patients at high risk of poor outcomes following surgery remains difficult. Clinicians currently lack a tool to consistently aid them in this process. For instance, the ASA physical status score (ASA-PS) is one commonly used tool to identify high-risk surgical patients using comorbidities. However, this scoring system is too subjective to yield consistent results. According to retrospective research, the concept of frailty is a valid construct with the potential to create a generalizable method for improving poor healthcare outcomes by risk stratification. Research has shown frail patients have higher rates of morbidity, mortality, and postoperative complications. This article aims to explore the Phenotype Theory of Frailty and the Accumulated Deficits Theory of Frailty and possible anesthetic implications of incorporating frailty screening into patient care. Use of a modified frailty index as a tool in a high-quality preoperative evaluation may help practitioners risk-stratify patients. This can allow for earlier mobilization of care resources before surgery to improve outcomes.


Assuntos
Anestesia/efeitos adversos , Idoso Fragilizado , Avaliação Geriátrica , Complicações Pós-Operatórias/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Humanos , Modelos de Enfermagem , Fenótipo , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Risco
6.
Rev Infirm ; 68(254): 44-46, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31587854

RESUMO

During care follow-up, specifically local post-operative care, nurses closely monitor the surgical site both for healing and for local, regional or general risk of infection. In this context, they are on the front line of identifying and reporting any suspicious clinical conditions. We use the example of a patient who presented with textiloma following orthopaedic shoulder surgery.


Assuntos
Corpos Estranhos/enfermagem , Diagnóstico de Enfermagem , Complicações Pós-Operatórias/enfermagem , Humanos , Procedimentos Ortopédicos , Ombro/cirurgia
7.
J Nurs Manag ; 27(8): 1614-1619, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31424580

RESUMO

AIM: To explore and improve nursing care for infants after enterostomy. METHODS: A total of 483 infants who underwent enterostomy from January 2014 to January 2019 were enrolled in this study. RESULTS: During hospitalization and follow-up, there were 30 infants with peripheral skin complications, including 15 cases of allergic dermatitis, 13 cases of faecal dermatitis and two cases of avulsion injury. CONCLUSION: Without proper and effective nursing care, the peripheral skin complications of enterostomy-related can easily develop. Therefore, careful postoperative care and effective family follow-up and guidance are essential after discharge, and using WeChat to follow-up can provide timely and effective follow-up and guidance to patients. IMPLICATIONS FOR NURSING MANAGEMENT: This study summarizes the experience of nursing care for infants over a 5-year period. Nurses must provide sound care for infants after enterostomy, timely and effectively address complications, guide nursing care performed by family members and strengthen follow-up through the WeChat online support group to reduce the occurrence of complications.


Assuntos
Enterostomia/enfermagem , Cuidados de Enfermagem/métodos , Complicações Pós-Operatórias/enfermagem , China/epidemiologia , Enterostomia/efeitos adversos , Feminino , Humanos , Lactente , Masculino , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Estudos Retrospectivos , Cicatrização
9.
Curationis ; 42(1): e1-e5, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-31038327

RESUMO

BACKGROUND:  Health care professionals are expected to deliver safe and effective health services; however there is increased realisation that adverse events in the health system are a major cause of preventable morbidity and mortality. OBJECTIVES:  To conduct a retrospective audit of nursing-related morbidities in a state hospital in KwaZulu-Natal, South Africa. METHOD:  A retrospective audit of nursing-related morbidities documented by the surgical service was carried out using the Hybrid Electronic Medical Registry data for a period of 3 years - 01 November 2013 to 31 October 2016. RESULTS:  There were a total of 12 444 admissions to surgical service during the study period, with 461 nursing-related morbidities reported. There was an increase in the number of documented nursing-related morbidities noted during November 2015 to October 2016, with 79% of all reported nursing-related morbidities documented during this period. A total of 54% of nursing-related morbidities were associated with males (n = 248) and 46% (n = 213) with females. The most commonly documented nursing-related morbidity was drugs/medication (n = 167, 36%) with the second most common being adjunct management (n = 130, 28%). CONCLUSION:  The study has identified the most commonly documented nursing-related morbidities in the surgical service of a state hospital. The findings of the study could provide direction for further research and educational initiatives.


Assuntos
Morbidade/tendências , Auditoria de Enfermagem/estatística & dados numéricos , Hospitais Estaduais/organização & administração , Hospitais Estaduais/estatística & dados numéricos , Humanos , Auditoria de Enfermagem/métodos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/enfermagem , Estudos Retrospectivos , África do Sul/epidemiologia
10.
Br J Community Nurs ; 24(4): 154-159, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30969852

RESUMO

As the rate of prostate cancer detection increases, so does the rate at which radical prostatectomy is performed. Post-prostatectomy incontinence (PPI) or urine leakage affects around 20% of men who undergo this procedure. Although affected individuals must be supported in maintaining hygiene with the use of urine capture devices, definitive treatment should also be offered if appropriate. A range of management options are available, from incontinence pads to artificial urinary sphincters. However, an understanding of the aetiology of the leak as well as patient factors is vital if the correct treatment option is to be selected. This article describes the potential causes of PPI and explores management options for this condition.


Assuntos
Complicações Pós-Operatórias/prevenção & controle , Prostatectomia , Incontinência Urinária/prevenção & controle , Enfermagem em Saúde Comunitária , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/enfermagem , Incontinência Urinária/etiologia , Incontinência Urinária/enfermagem
11.
Br J Nurs ; 28(7): 414-420, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30969864

RESUMO

BACKGROUND: postoperative cognitive changes can increase morbidity and mortality, demand for postoperative care and social and health costs, and can lead to dementia. AIM: this article discusses perioperative variables that can be used to identify patients who are more vulnerable to experiencing cognitive decline after surgery. It also highlights some screening tools that could be useful for early detection and for planning nursing care. METHOD: a literature search was conducted using the Medline, CINAHL, PsychINFO and Cochrane Library databases from 2010 to 2018. Google Scholar was also consulted. The reference lists of relevant articles covering postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) were reviewed for further relevant papers. CONCLUSION: assessment and evaluation of a patient's cognitive resources before and after surgery can lead to clinical interventions to support the person's coping mechanisms; health professionals can reduce the short- and long-term effects of cognitive decline. Screening tools could be used as part of a strategy to minimise postoperative cognitive changes.


Assuntos
Demência/prevenção & controle , Papel do Profissional de Enfermagem , Complicações Pós-Operatórias/prevenção & controle , Demência/enfermagem , Humanos , Complicações Pós-Operatórias/enfermagem
12.
Rehabil Nurs ; 44(3): 151-160, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31034457

RESUMO

PURPOSE: The aim of the study was to reduce postoperative edema in total knee and hip arthroplasty rehabilitation patients. DESIGN: A pre- and posttest design was used for this quality improvement project at a rehabilitation facility. METHODS: Staff and patient edema education was standardized. Staff pre- and posttests were administered. Patients were interviewed to assess for knowledge of edema management. Chart audits were assessed for edema management and length of stay. FINDINGS: Average staff knowledge scores (n = 50) increased pre- to posteducational video (64% vs. 70%). Of patients interviewed posteducation (n = 24), 38% were able to list two characteristics of edema. Two chart audits completed pre- and posteducation demonstrated that the majority of patients (n = 30 per group) had edema upon admission (96% vs. 97%). However, length of stay decreased by 3 days (19.2 vs. 16.3). CONCLUSION: Standardized postoperative edema education can improve staff and patient edema knowledge and management. CLINICAL RELEVANCE: Edema education is recommended for orthopedic patients in rehabilitation facilities.


Assuntos
Edema/enfermagem , Enfermagem em Reabilitação/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Psicometria/instrumentação , Psicometria/métodos , Melhoria de Qualidade , Qualidade da Assistência à Saúde/normas , Enfermagem em Reabilitação/métodos , Inquéritos e Questionários
13.
Rev. Rol enferm ; 42(4,supl): 69-74, abr. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-187205

RESUMO

Las fístulas enterocutáneas son un problema mayor en la práctica quirúrgica. En general son secundarias a complicaciones postoperatorias. Hasta el 90% de los casos se desarrolla después de una cirugía. La morbilidad y la mortalidad continúan siendo muy elevadas a pesar de los avances en el manejo de esta patología. Las tres complicaciones principales de los pacientes con fístulas son desequilibrio hidroelectrolítico, desnutrición y sepsis, las cuales están en relación con la localización de la fístula, el gasto, las características bioquímicas y electrolíticas de la descarga y la condición patológica subyacente. El objetivo final en el manejo de los pacientes con fístulas es el cierre de la misma. En 1964, Chapman propuso un plan de tratamiento de los pacientes con base en cuatro prioridades. El propósito del tratamiento médico es el cierre espontáneo de la fístula o la preparación del paciente para cirugía. La instalación de un apoyo nutricional adecuado juega un papel esencial para el éxito del tratamiento. El control de la sepsis es una prioridad; la sepsis descontrolada debe ser atacada rápidamente ya que es la principal causa de muerte. El cierre espontáneo ha aumentado en los últimos años; sin embargo, es probable que todavía una gran parte de los pacientes necesite tratamiento quirúrgico, y éste debe ser realizado en el momento adecuado


No disponible


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Fístula Cutânea/etiologia , Fístula Cutânea/enfermagem , Fístula Intestinal/etiologia , Fístula Intestinal/enfermagem , Ferida Cirúrgica/enfermagem , Complicações Pós-Operatórias/enfermagem , Ileostomia/efeitos adversos
14.
Rev. Rol enferm ; 42(4): 294-301, abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-186972

RESUMO

IntroduccIón. La disfunción cognitiva postoperatoria (DCPO) es una complicación frecuente, generalmente subestimada y que comporta un impacto negativo en la calidad de vida de los pacientes y sus familias. La heterogeneidad de los estudios clínicos publicados hasta la fecha actual explica la falta de una definición clara y estandarizada del constructo. Objetivo. Examinar críticamente el concepto de DCPO con el fin de desarrollar una concepción precisa y diferenciada de este fenómeno. Método. Análisis de concepto fundamentado en la técnica descrita por Wilson a partir de la revisión de la literatura publicada para examinar las características que definen el concepto y sus atributos. resultados. La DCPO es una complicación derivada del acto quirúrgico y anestésico; su etiología es desconocida, aunque la hipótesis fisiopatológica más aceptada es la de la neuroinflamación. Los factores de riesgo evidenciados son la edad avanzada y un nivel educacional bajo. Es un trastorno transitorio y reversible en la mayoría de los casos; de no ser así, puede desencadenar demencia. La enfermera tiene un papel fundamental en la identificación y en la detección precoz de los signos y síntomas asociados. conclusIones. El análisis resultante de este trabajo ayuda a dilucidar el concepto y permite diferenciarlo de otros afines. Se pone de manifiesto la relevancia clínica del trastorno y permite apuntar nuevas estrategias de intervención para mejorar la seguridad de los pacientes y la práctica clínica


Background. Postoperative Cognitive Dysfunction (POCD) is a frequent complication, generally underestimated and has a very negative impact on patients and their family's quality of life. At present there is no clear concept nor standardized definition POCD, possibly to the heterogeneity of the published scientific literature. Objective. To review with criticism the POCD’s concept by analyzing the current state of scientific literature in order to develop an accurate conception of this phenomenon. Method. To review the published literature and apply concept analysis based on Wilson's method to examine the characteristics that define the concept and its attributes. Results. The POCD is a complication derived from the surgical and anesthetic act, its etiology is unknown, although the most accepted physiopathological hypothesis is neuroinflammation. The most evidenced risk factors are advanced age and a low educational level. In most cases, it is a transient and reversible disorder, otherwise it can trigger dementia. Nurses play a fundamental role in the identification and early detection of associated signs and symptoms. Conclusions. The analysis resulting from this work might help to clarify the concept of POCD and allowing to establish its differences from other similar entities. It highlights the clinical relevance of the disorder and allows us to point out new intervention strategies to improve patient safety and clinical practice


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Complicações Pós-Operatórias/enfermagem , Disfunção Cognitiva/etiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Fatores de Risco
15.
Br J Nurs ; 28(3): 157-160, 2019 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-30746972

RESUMO

Thousands of bariatric surgery procedures are performed in the UK each year, including gastric bypass surgery. The one anastomosis gastric bypass (OAGB) is increasingly performed in the UK, and nurses may find themselves providing care for patients who have undergone this procedure. This article outlines the anatomical and physiological changes associated with OAGB, routine care of these patients in the short and long term, and the identification and management of complications.


Assuntos
Derivação Gástrica/enfermagem , Humanos , Diagnóstico de Enfermagem , Complicações Pós-Operatórias/enfermagem , Estômago/anatomia & histologia , Estômago/fisiologia , Reino Unido
16.
J Clin Nurs ; 28(9-10): 1708-1718, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30653776

RESUMO

AIMS AND OBJECTIVES: To describe patient-reported extremity symptoms after robot-assisted laparoscopic cystectomy in patients with bladder cancer. BACKGROUND: Preventive activities for remaining patient safety due to correct positioning play an important part in perioperative nursing care.Extremity injuries are well-known after prolonged surgery, especially in robot-assisted urologic surgery in the steep Trendelenburg position. The risk of injury increases due to patient-related and operative risk factors. METHODS: A quantitative prospective observational study was conducted. Patients were followed up with the QuickDASH (Disabilities in the Arm, Shoulder and Hand), Lower Extremity Functional Scale (LEFS) and a study-specific questionnaire 7-10 days and monthly, up to six months after surgery in patients with extremity symptoms. The study adheres to STROBE (strengthening the reporting of observational studies in epidemiology) guidelines, see Supporting information File S1. RESULTS: Out of the 94 included participants, 46.8% (n = 44) experienced extremity symptoms 7-10 days after surgery. Pain, numbness and weakness were the most frequent symptoms. There was a discrepancy between the patients reported symptoms and the documentation in the patient records. Only 13.6% (n = 3) of the reported pain was documented, respectively 27.5% (n = 11) of other symptoms. CONCLUSION: A large proportion of the patients report postoperative extremity symptoms after robot-assisted laparoscopic cystectomy. Prevention of complications in the perioperative setting, are together with follow-ups, important nursing activities for maintaining patient safety and may both prevent and detect postoperative extremity symptoms and injuries. RELEVANCE TO CLINICAL PRACTICE: This study reveals the need of accurate documentation regarding extremity symptoms in digital patient records, as well as continuous follow-ups during the hospital stay and after hospital discharge to enable detection of treatable extremity injuries. The result of this study also indicates the importance of nursing activities such as evidence-based positioning guidelines in the operating theatre for optimal positioning.


Assuntos
Cistectomia/efeitos adversos , Posicionamento do Paciente/efeitos adversos , Posicionamento do Paciente/enfermagem , Enfermagem Perioperatória/métodos , Complicações Pós-Operatórias/enfermagem , Adulto , Idoso , Cistectomia/enfermagem , Extremidades/lesões , Feminino , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/enfermagem , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Prospectivos , Fatores de Risco , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/enfermagem , Neoplasias da Bexiga Urinária/enfermagem , Neoplasias da Bexiga Urinária/cirurgia
18.
Adv Neonatal Care ; 19(3): 212-218, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30694819

RESUMO

BACKGROUND: Human milk is a life-saving medical intervention. Infants with congenital heart disease are at an increased risk for necrotizing enterocolitis, chylothorax, feeding difficulties, and growth failure. In the absence of evidence-based care, their mothers are also at risk for low milk supply and/or poor breastfeeding outcomes. PURPOSE: Summarize the role of human milk and clinical outcomes for infants with congenital heart disease (CHD). Summarize methods of ideal breastfeeding support. METHODS/SEARCH STRATEGY: PubMed, Cochrane Library, and CINAHL were the databases used. The terms used for the search related to CHD and necrotizing enterocolitis were "human milk" and "necrotizing enterocolitis" and "congenital heart disease." This resulted in a total of 17 publications for review. FINDINGS: Infants receiving exclusive human milk diet are at a lower risk for necrotizing enterocolitis and will have improved weight gain. Infants with chylothorax who receive skimmed human milk have higher weight-for-age scores than formula-fed infants. Maternal breastfeeding education correlates with decreased risk of poor breastfeeding outcomes. IMPLICATIONS FOR PRACTICE: Human milk is the ideal source of nutrition for infants with CHD and should be encouraged by the care team. Evidence-based lactation education and care must be provided to mothers and families prenatally and continue throughout the infant's hospitalization. If a mother's goal is to directly breastfeed, this should be facilitated during the infant's hospital stay. IMPLICATIONS FOR RESEARCH: Evaluate the role between human milk and the incidence of necrotizing enterocolitis, feeding difficulties, and clinical outcomes in the population of infants with CHD.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Quilotórax/enfermagem , Enterocolite Necrosante/epidemiologia , Cardiopatias Congênitas/enfermagem , Leite Humano , Complicações Pós-Operatórias/enfermagem , Ganho de Peso , Extração de Leite , Transtornos do Crescimento/epidemiologia , Cardiopatias Congênitas/cirurgia , Humanos , Recém-Nascido , Mães/educação
19.
Crit Care Clin ; 35(1): 151-168, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30447777

RESUMO

Infections in solid organ transplant recipients are complex and heterogeneous. This article reviews the clinical syndromes that will likely be encountered in the intensive care unit and helps to guide in the therapy and management of these patients.


Assuntos
Enfermagem de Cuidados Críticos/normas , Controle de Infecções/normas , Transplante de Órgãos/efeitos adversos , Transplante de Órgãos/enfermagem , Cuidados Pós-Operatórios/normas , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/enfermagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto
20.
Crit Care Clin ; 35(1): 169-186, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30447778

RESUMO

Despite improvements in overall graft function and patient survival rates after solid organ transplantation, complications can lead to significant morbidity and mortality. Cardiovascular complications include heart failure, arrhythmias leading to sudden death, hypertension, left ventricular hypertrophy, and allograft vasculopathy in heart transplantation. Neurologic complications include stroke, posterior reversible encephalopathy syndrome, infections, neuromuscular disease, seizure disorders, and neoplastic disease. Acute kidney injury occurs from immunosuppression with calcineurin inhibitors or as a result of graft failure after kidney transplantation. Gastrointestinal complications include infections, malignancy, mucosal ulceration, perforation, biliary tract disease, pancreatitis, and diverticular disease. Immunosuppression can predispose to infections and malignancy.


Assuntos
Enfermagem de Cuidados Críticos/normas , Controle de Infecções/normas , Nefropatias/enfermagem , Transplante de Órgãos/efeitos adversos , Transplante de Órgãos/enfermagem , Cuidados Pós-Operatórios/normas , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/enfermagem , Idoso , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/enfermagem , Feminino , Gastroenteropatias/etiologia , Gastroenteropatias/enfermagem , Humanos , Nefropatias/etiologia , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/enfermagem , Guias de Prática Clínica como Assunto
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA