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1.
Nurs Times ; 112(26): 12-5, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27544957

RESUMO

Patient with spinal cord injuries have individualised care routines to help prevent complications. Disruption to these routines following admission to non-specialist settings can have long-term consequences. This article focuses on the key long-term problems of pressure ulcers, bladder and bowel dysfunction, and autonomic dysreflexia. Nurses working on general wards need to consider how to manage these problems when caring for patients with spinal cord injury.


Assuntos
Disreflexia Autonômica/enfermagem , Incontinência Fecal/prevenção & controle , Lesão por Pressão/prevenção & controle , Traumatismos da Medula Espinal/enfermagem , Bexiga Urinaria Neurogênica/enfermagem , Disreflexia Autonômica/etiologia , Defecação , Incontinência Fecal/etiologia , Incontinência Fecal/enfermagem , Hospitalização , Humanos , Educação de Pacientes como Assunto , Lesão por Pressão/enfermagem , Encaminhamento e Consulta , Higiene da Pele/enfermagem , Especialização , Traumatismos da Medula Espinal/complicações , Bexiga Urinaria Neurogênica/etiologia
2.
Rev Esc Enferm USP ; 47(1): 93-100, 2013 Feb.
Artigo em Português | MEDLINE | ID: mdl-23515808

RESUMO

This retrospective study, performed in 2009, aimed to identify nursing diagnoses and interventions for the care of patients with spinal cord injury. Data were collected from the nursing records of 465 patients with SCI undergoing rehabilitation. The nursing diagnosis Risk for autonomic dysreflexia was identified in 271 clinical records (58, 3%). Approximately 80 patients developed autonomic dysreflexia, with a predominance in young men around 35.7 years old, who had experienced a trauma as the main cause of the injury. Their neurological injury level was at the sixth thoracic vertebra or above. Nursing interventions were arranged in two groups, one focused on prevention and the other on treatment. An intervention guide was developed and can be used by nurses in their clinical practice of rehabilitation and can be included into information systems. The removal of the stimulus which causes autonomic dysreflexia was identified as the most effective therapy and the best intervention.


Assuntos
Disreflexia Autonômica/etiologia , Disreflexia Autonômica/enfermagem , Traumatismos da Medula Espinal/complicações , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Processo de Enfermagem , Estudos Retrospectivos , Adulto Jovem
3.
Rev. Esc. Enferm. USP ; 47(1): 93-100, fev. 2013. tab
Artigo em Português | LILACS | ID: lil-668197

RESUMO

O presente trabalho trata-se de estudo retrospectivo realizado em 2009 que objetivou identificar diagnósticos e intervenções de enfermagem para o cuidado de pacientes com lesão medular (LM). Os dados foram coletados de 465 prontuários de pacientes com LM em processo de reabilitação. Identificou-se o diagnóstico de enfermagem Risco para disreflexia autônomica em 271 (58,3%) prontuários, dos quais 80 pacientes desenvolveram disreflexia autônomica. Predominaram homens jovens, com idade média de 35,7 anos, sendo o trauma a principal causa da LM e o nível neurológico igual ou acima da sexta vértebra torácica. As intervenções de enfermagem foram organizadas em dois grupos, um voltado para a prevenção da disreflexia autonômica e outro, para seu tratamento. Desenvolveu-se um guia de intervenções para uso na prática clínica de enfermeiros reabilitadores e para inserção em sistemas de informação. Ressalta-se a importância da retirada do estímulo causador da disreflexia autonômica como terapêutica mais eficaz e como melhor intervenção na prática de enfermagem.


This retrospective study, performed in 2009, aimed to identify nursing diagnoses and interventions for the care of patients with spinal cord injury. Data were collected from the nursing records of 465 patients with SCI undergoing rehabilitation. The nursing diagnosis Risk for autonomic dysreflexia was identified in 271 clinical records (58, 3%). Approximately 80 patients developed autonomic dysreflexia, with a predominance in young men around 35.7 years old, who had experienced a trauma as the main cause of the injury. Their neurological injury level was at the sixth thoracic vertebra or above. Nursing interventions were arranged in two groups, one focused on prevention and the other on treatment. An intervention guide was developed and can be used by nurses in their clinical practice of rehabilitation and can be included into information systems. The removal of the stimulus which causes autonomic dysreflexia was identified as the most effective therapy and the best intervention.


Estudio retrospectivas realizado en 2009 objetivando identificar diagnósticos e intervenciones de enfermería para el cuidado del paciente con lesión medular (LM). Datos colectados de 465 historias clínicas de pacientes con LM en rehabilitación. Se identificó el diagnóstico de enfermería Riesgo para disreflexia autonómica en 271 (58,3%) historias clínicas; 80 de tales pacientes desarrollaron Disreflexia autonómica. Predominaron hombres jóvenes, media etaria de 35,7 años, constituyéndose el trauma como causa principal de LM y nivel neurológico igual o por sobre sexta vértebra torácica. Las intervenciones de enfermería se organizaron en dos grupos: uno orientado a prevención de la disreflexia autonómica y otro para su tratamiento. Se desarrolló una guía de intervenciones para uso en práctica clínica de enfermeros rehabilitadores y para incorporación a sistemas de información. Se destaca la importancia de retirar el estímulo que provoca la disreflexia autonómica como terapéutica más eficaz y como mejor intervención en la práctica de enfermería.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Disreflexia Autonômica/etiologia , Disreflexia Autonômica/enfermagem , Traumatismos da Medula Espinal/complicações , Estudos Transversais , Processo de Enfermagem , Estudos Retrospectivos
4.
Hu Li Za Zhi ; 57(2 Suppl): S70-74, 2010 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-20405400

RESUMO

The subject of this article is a 20 year-old female with thoracic spinal cord injury with paraplegia suffered during a car accident. The article reports on the nursing experience in helping the patient manage her autonomic dysreflexia (AD), training the patient in self-catheterization, and using relevant social resources in order to achieve a successful return to her studies at school. The authors collected data using interviews, observations, and physical assessments between November 20 and December 30, 2008. The two nursing diagnoses of AD and inadequate preparation for a successful return to school during rehabilitation hospitalization were made during caring procedures. Holistic nursing assessment was employed and the Super-Link System Theory was applied to establish a link between the hospital and school. Individual nursing interventions used included understanding the inducement and treatment of AD, performing self-catheterization, and enhancing the support system by introducing successful clients and relevant social resources in order to transition the patient successfully to her new post-injury life. The patient consequently transitioned smoothly from rehabilitation hospital to school. The authors hope this case report will provide a useful reference for nurses charged with caring for patients with spinal cord injuries while still enrolled at school.


Assuntos
Traumatismos da Medula Espinal/enfermagem , Adulto , Disreflexia Autonômica/enfermagem , Feminino , Humanos , Traumatismos da Medula Espinal/psicologia , Traumatismos da Medula Espinal/reabilitação , Vértebras Torácicas/lesões
5.
Can Nurse ; 102(7): 20-5, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16989096

RESUMO

With the rapid expansion of telehealth lines in the United States and the establishment of provincially funded lines in Canada, a growing number of people use this convenient approach to establish their initial health needs and to pursue self-care. Telehealth providers, for the most part, rely on electronic protocols to offer triaging and advice. Unfortunately, standard protocols are misleading when a premorbid health condition such as a spinal cord injury is present. Symptoms such as a headache, diaphoresis or an elevated blood pressure, which are common occurrences in the general population, may indicate an emergency situation, namely autonomic dysreflexia (AD), when a mid-thoracic and higher spinal cord lesion is present. Since there is no available electronic protocol on AD, this emergency health condition is not recognized by the telehealth provider and may put the caller at risk of serious morbidity or even death. In this article, the authors present the clinical features of AD, the precipitating factors and the nursing management of an episode. The merits and pitfalls of electronic protocols are reviewed and an algorithm is presented to assist telehealth providers in recognizing AD.


Assuntos
Disreflexia Autonômica/enfermagem , Avaliação em Enfermagem , Consulta Remota , Algoritmos , Emergências , Humanos , Guias de Prática Clínica como Assunto , Fatores Desencadeantes
6.
Int J Nurs Terminol Classif ; 14(3): 96-107, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14649031

RESUMO

Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. New views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process. Application of the cognitive skills of critical thinking illustrates the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.


Assuntos
Competência Clínica , Diagnóstico de Enfermagem/métodos , Pensamento , Adolescente , Idoso , Ansiedade/diagnóstico , Ansiedade/enfermagem , Disreflexia Autonômica/diagnóstico , Disreflexia Autonômica/enfermagem , Baixo Débito Cardíaco/diagnóstico , Baixo Débito Cardíaco/enfermagem , Diabetes Mellitus Tipo 1/enfermagem , Diagnóstico Diferencial , Educação Continuada em Enfermagem/métodos , Feminino , Humanos , Intuição , Masculino , Memória , Pessoa de Meia-Idade
7.
Nurs Stand ; 17(32): 42-4, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12739226

RESUMO

Autonomic dysreflexia is a syndrome that affects those with a spinal cord lesion above the mid-thoracic level. The symptoms of the syndrome, its causes, how to recognise it, and how to alleviate it are described. The author explains how patients can be educated to recognise the symptoms of the condition, and take action to alleviate them.


Assuntos
Disreflexia Autonômica/terapia , Algoritmos , Disreflexia Autonômica/diagnóstico , Disreflexia Autonômica/enfermagem
9.
Nurs Times ; 99(50): 38-41, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14705423

RESUMO

Few diseases or injuries have greater potential for causing death or having a devastating impact on a person's quality of life than cervical spine trauma. All patients admitted to hospital after significant trauma must therefore be assumed to have a potentially unstable spinal fracture until it is proven otherwise, to prevent their sustaining further injury owing to inappropriate management. It is vital that nurses are familiar with the signs and symptoms of such injuries and aware of the appropriate management techniques.


Assuntos
Traumatismos da Medula Espinal/enfermagem , Disreflexia Autonômica/etiologia , Disreflexia Autonômica/enfermagem , Serviços Médicos de Emergência/métodos , Nutrição Enteral/enfermagem , Humanos , Remoção , Guias de Prática Clínica como Assunto , Choque Traumático/etiologia , Choque Traumático/enfermagem , Medula Espinal/anatomia & histologia , Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/fisiopatologia , Cateterismo Urinário/enfermagem
10.
MCN Am J Matern Child Nurs ; 27(2): 93-7, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-11984277

RESUMO

The purpose of this article is to help perinatal nurses understand how to more effectively care for women in labor who have spinal cord injuries (SCIs), especially those women who develop the complication of autonomic dysreflexia (AD). AD is a syndrome that can occur in patients with SCIs above the level of T6. Its symptoms include dangerous paroxysmal hypertension, resulting from abnormal interplay between the parasympathetic and sympathetic nervous systems. While this syndrome was not commonly encountered by perinatal nurses in childbirth settings in the past, the dramatic improvements in both acute care and rehabilitation for women with SCI has increased the numbers of women with SCI who become pregnant and experience childbirth. Therefore, it is essential that perinatal nurses be made aware of how to effectively identify AD, and what steps to take should it occur.


Assuntos
Disreflexia Autonômica , Enfermagem Neonatal/métodos , Complicações do Trabalho de Parto/enfermagem , Cuidado Pós-Natal , Quadriplegia/enfermagem , Disreflexia Autonômica/complicações , Disreflexia Autonômica/diagnóstico , Disreflexia Autonômica/enfermagem , Feminino , Humanos , Bem-Estar Materno , Enfermagem Neonatal/normas , Complicações do Trabalho de Parto/etiologia , Cuidado Pós-Natal/métodos , Cuidado Pós-Natal/normas , Guias de Prática Clínica como Assunto , Gravidez , Gravidez de Alto Risco , Quadriplegia/etiologia
13.
Int J Trauma Nurs ; 7(2): 43-8, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11313624

RESUMO

Spinal cord injuries are not as common as many other types of injuries. The victims are often young, the injury debilitating, and the effects devastating and incalculable. The acute management of patients with spinal cord injury can significantly affect the patient's eventual neurologic and functional outcome and ultimately their quality of life. Early interventions are aimed at reestablishing physiologic homeostasis, lessening the amount of secondary injury, and preserving neurologic function.


Assuntos
Traumatismos da Medula Espinal/enfermagem , Disreflexia Autonômica/etiologia , Disreflexia Autonômica/enfermagem , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/enfermagem , Humanos , Exame Neurológico/enfermagem , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/enfermagem , Choque/etiologia , Choque/enfermagem , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/fisiopatologia
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