Ineffective Breathing Pattern Research Articles

Nurses' Knowledge and Practice concerning Fluid and Electrolyte Balance among Patients with Congestive Heart Failure

Background: Critical care nurses have a vital role in identifying and treating the physiologicstressors experienced by critically ill patients that disrupt homeostasis such as the patients withCongestive Heart Failure (CHF). Aim of the study: to assess nurses’ knowledge and practiceconcerning fluid and electrolytes balance among patients with congestive heart failure andinvestigating the relation between their knowledge and practice. Subjects and Methods:Research design: Cross-sectional analytic design. Setting: The study was carried out at ZagazigMain University Hospital .Subjects:160 nurses and 160 CHF patients .Tools of data collection:a self-administered questionnaire sheet and an observation checklist. Results: nurses'knowledge about CHF and related fluid/electrolytes balance was high, with an overall goodpercentage having total satisfactory knowledge. The practice was deficient regarding assessmentof peripheral circulation, skin and mucous membranes, signs of altered tissue perfusion,ineffective breathing pattern, and alteration in fluid balance. Nurses’ knowledge was positivelyinfluenced by their age, and female gender. The practice was negatively influenced by theknowledge score and the number of medications taken by the patient, and the knowledge andpractice scores are negatively correlated. Conclusion: Hence, nurse’s age and gender as well asthe attendance of training courses are the factors influencing their knowledge, while the factorsaffecting practice are their knowledge and the number of medications given to patients. Inconclusion, nurses' knowledge about CHF and related fluid/ electrolytes balance is variable, withan overall good percentage of total satisfactory knowledge. The practice is generally higher. Theknowledge and practice scores are negatively correlated and the training courses have a negativeinfluence on nurses’ knowledge. Recommendations: The nurses working with patients with CHFimprove their knowledge, particularly the younger ones. The content and process of trainingcourses need to be revised, with more focus on applied knowledge.

Nurses’ knowledge and practice concerning fluid and electrolyte balance among patients with congestive heart failure

Background: Critical care nurses have a vital role in identifying and treating the physiologicstressors experienced by critically ill patients that disrupt homeostasis such as the patients withCongestive Heart Failure (CHF). Aim of the study: to assess nurses’ knowledge and practiceconcerning fluid and electrolytes balance among patients with congestive heart failure andinvestigating the relation between their knowledge and practice. Subjects and Methods:Research design: Cross-sectional analytic design. Setting: The study was carried out at ZagazigMain University Hospital .Subjects:160 nurses and 160 CHF patients .Tools of data collection:a self-administered questionnaire sheet and an observation checklist. Results: nurses'knowledge about CHF and related fluid/electrolytes balance was high, with an overall goodpercentage having total satisfactory knowledge. The practice was deficient regarding assessmentof peripheral circulation, skin and mucous membranes, signs of altered tissue perfusion,ineffective breathing pattern, and alteration in fluid balance. Nurses’ knowledge was positivelyinfluenced by their age, and female gender. The practice was negatively influenced by theknowledge score and the number of medications taken by the patient, and the knowledge andpractice scores are negatively correlated. Conclusion: Hence, nurse’s age and gender as well asthe attendance of training courses are the factors influencing their knowledge, while the factorsaffecting practice are their knowledge and the number of medications given to patients. Inconclusion, nurses' knowledge about CHF and related fluid/ electrolytes balance is variable, withan overall good percentage of total satisfactory knowledge. The practice is generally higher. Theknowledge and practice scores are negatively correlated and the training courses have a negativeinfluence on nurses’ knowledge. Recommendations: The nurses working with patients with CHFimprove their knowledge, particularly the younger ones. The content and process of trainingcourses need to be revised, with more focus on applied knowledge.

Prognostic clinical indicators of short-term survival for ineffective breathing pattern in children with acute respiratory infection.

To identify prognostic clinical indicators of short-term survival for ineffective breathing pattern in children with acute respiratory infection. Despite the studies of survival for nursing diagnosis, there is not enough evidence about the clinical indicators that are associated with a worse prognosis for ineffective breathing pattern. A prospective cohort study. One hundred and thirty-six children were followed up for a minimum of six and a maximum of 10 consecutive days. The survival rate for ineffective breathing pattern was calculated using Nelson-Aalen's method. An extended Cox model was adjusted to identify the main prognostic clinical indicators for this nursing diagnosis. Over half of the sample had an ineffective breathing pattern at the first evaluation. The occurrence of new cases was observed until the ninth day of monitoring, and the survival rate after this day was low. According to the Cox model, the main clinical indicators of a poor prognosis were an abnormal breathing pattern, the use of accessory muscles, dyspnoea and increase in the anterior-posterior chest diameter. Children with acute respiratory infection who present with an abnormal breathing pattern, the use of accessory muscles to breathe, dyspnoea and increased anterior-posterior diameter have a poor prognosis for an ineffective breathing pattern. Survival analyses of nursing diagnoses allow the identification of clinical indicators that can be used in clinical practice as prognostic markers. The identification of indicators associated with a poor clinical prognosis allows nurses to intervene early and to maximise the possibility of a good outcome.

Clinical Differentiation of Respiratory Nursing Diagnoses among Children with Acute Respiratory Infection

The aim of this study was to identify the defining characteristics that allow clinical differentiation of the nursing diagnoses, ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE). A secondary analysis with a cohort design was developed from 1128 records obtained during the hospital stay of 136 children with acute respiratory infection. Groups of defining characteristics with greater differentiation capacity were identified by multiple correspondence analyses. The results showed that the defining characteristics that better differentiate the studied diagnoses are agitation, irritability and diaphoresis for IGE; dyspnea, use of accessory muscles to breathe, orthopnea, and abnormal breathing pattern for IBP and excessive sputum, absence of cough, difficulty verbalizing, nasal flaring, and adventitious breath sounds for IAC. Twelve defining characteristics that can assist clinicians to differentiate the three main respiratory nursing diagnoses among children with acute respiratory infection were identified in this study.

Respiratory Nursing Diagnoses: Presenting Evidence for Identification of the Defining Characteristics in Neonatal and Pediatric Populations.

To identify and summarize clinical data supporting selection of nursing diagnoses related to the respiratory system for pediatric and neonatal populations. A literature review conducted in indexed publications was used. The final sample consisted of 13 studies conducted in children with cardiac disease, respiratory infection, and asthma with nursing diagnoses such as ineffective breathing pattern, impaired gas exchange, and ineffective airway clearance. The higher frequency defining characteristics were dyspnea, abnormal breathing pattern, use of accessory muscle to breathe, change in frequency and respiratory rate, decreased SaO2 , and agitation. This literature review may provide a basis for consideration of important diagnostic criteria in the pediatric population; however, clinical validation in different stages of development is critical for ensuring diagnostic accuracy.

Defining the key clinical indicators for ineffective breathing pattern in paediatric patients: a meta-analysis of accuracy studies

The purpose of this study was to identify the key clinical indicators of ineffective breathing pattern among paediatric patients. When nurses perform clinical reasoning, certain characteristics represent the clinical indicators necessary to confirm the presence of a particular diagnosis. Some quantitative studies have reported the prevalence of ineffective breathing pattern in different samples of patients. However, these findings should be synthesised. Meta-analysis of quantitative nursing studies. Studies were identified via systematic searches of CINAHL, LILACS, PubMed and Scopus using the key search terms 'ineffective', 'breathing' and 'pattern'. Additional quality-related inclusion criteria were gleaned from the Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy, the Standards for Reporting of Diagnostic Accuracy and the Quality Assessment of Diagnostic Accuracy Studies. The pertinent results from each study were extracted and analysed via meta-analysis. Six studies using paediatric populations met the inclusion criteria. Summary measures indicated that the following defining characteristics had the highest accuracy values for ineffective breathing pattern among children: bradypnoea, dyspnoea, nasal flaring, orthopnoea, tachypnoea and the use of accessory muscles to breathe. This meta-analysis provides information regarding the accuracy of the clinical indicators of ineffective breathing pattern from studies sampling diverse paediatric populations. Nurses can better use clinical indicators to infer the presence of ineffective breathing pattern when they are aware of the most relevant defining characteristics. Nursing students and professionals can also improve their critical thinking abilities and diagnostic reasoning based on these findings.

Effects of Case Studies and Simulated Patients on Students' Nursing Care Plan.

The aim of this study is to determine the effects of using case studies and simulated patients in teaching students to plan their nursing care. The study sample consisted of 70 second-year nursing students. Study data were collected using a questionnaire and by evaluating students' nursing care plans. The highest percentages of diagnoses identified were altered oral mucous membrane, ineffective breathing pattern, disturbed sleep pattern: less than body requirement, impaired tissue integrity, pain, and risk for infection. The use of simulated patients in nursing education appears to help students evaluate realistic medical cases and clinical problems, and plan their nursing care.

Content validation of the diagnosis Ineffective Breathing Pattern

The goal of this study was to carry out a diagnostic content validation regarding the nursing diagnosis Ineffective Breathing Pattern – 00032, which was approved by the Taxonomy Committee of NANDA International for the years 2012–2014. A validation study, methodologically based on Fehring's Diagnostic Content Validation, was performed with 52 nurses and medical experts from four hospitals in Moravia and Bohemia who work in nursing care in adult intensive care units or on anaesthesia and resuscitation wards. Main findings1.The validity of the nursing diagnosis Ineffective Breathing Pattern – 00032 has a DCV weighted ratio of 0.63.2.The DCV weighted ratio of 0.84 of the defining characteristic “dyspnoea” ranks it among the major defining characteristics of the validated diagnosis.3.The DCV values of 12 defining characteristics between 0.74 and 0.52 ranked as minor defining characteristics of the validated diagnosis.4.The DCV values of three defining characteristics between 0.40 and 0.32 were considered irrelevant defining characteristics.5.A strong positive correlation was found between minor defining characteristics “decreased expiratory pressure” and “decreased inspiratory pressure” (r=0.831), between minor related factors “neuromuscular dysfunction” and “musculoskeletal impairment” (r=0.710) and between minor related factors “neurological immaturity” and “neuromuscular dysfunction” (r=0.732). ConclusionsThe experts only considered one major diagnostic characteristic significant – dyspnoea, and none of the related factors of Ineffective Breathing Pattern – 00032. Despite the limitation of this study, the overall validity of the tested nursing diagnosis is acceptable according to Fehring, without the need to remove the diagnosis from the list presented by the Taxonomy Committee of NANDA International.

A survey on inhalation effect of essence of peppermint on nausea and vomiting after abdominal surgery in patients who have been admitted to Besaat and Tohid hospitals in Sanandaj

Abstract Background and aim: Nausea and vomiting is among the most common complications in patients recovering from general anaesthesia , 30-70 of patients experience nausea and vomiting after surgery. Although variety of medications have been used to control this complication, it still remains as a problem. Armothpy a non pharmacologic intervention is suggested for treatment of many conditions and Pepprmint may be effectivein treatment of common digestive conditions. This aim of this study was to examine the efficacy of inhaling peppermint essence for prevention of nausea and vomiting after abdominal surgery in patients admitted in Beasssat and Tohid hospitals in Sanandaj in 2011. Method and materials: randomized clinical trial was conducted to examine the efficacy of Peppermint essence inhalation for prevention of post- surgical nausea and sample of the study consisted of 90 patients, which were randomly allocated to receive peppermint inhalation or saline normal. 2 × 2 gauze pad saturated with two drops of pure pharmacy-grade peppermint essence was used for 1 minute in intervention group. For patients in control group a 2 × 2 gauze pad saturated with 0. 9% normal saline was used. visual analog scale was used to rate Patients were followed in recovery and surgical ward for occurrence of nausea and Data were analyzed by SPSS software, version 17. Findings: There was not statistical difference between two groups in terms of confounding variables such as body mass index, length of anesthesia as well as type of anesthesia. 6. 7% of patients in peppermint group and 0% of patients in control group experienced mild Manwitney statistical test, showed no significant difference between the two groups in terms of nausea in recovery room. results indicated there was significant difference between the two groups in the 1392 ناتسمز ،83 هرامش ،23 هرود / 34 ناراکمه و یفجن هراهب severity of nausea in surgical ward. There was not a significant difference between two groups in term of numbers of Conclusion: findings of the study showed no diferrence between peppermint and saline in terms of prevetion of nausea and One reason can either be ineffective breathing patterns of patients after anesthesia or insufficient dose of peppermint which has affected the results of this study. It seems more studies with various shapes and amounts of peppermint are required in this regard. Keywords: Aromaterapy, Nausea & Vomiting, Peppermint REFERENCES Anderson L , Gross B (2004); Aromathrapy with peppermint isopropelalchol ,or placebo is equally effective in reliving post operative nausea. Journal of peri Anesthesia Nursing . 19(1) 35-29. Chadhary S et al (2008); Preoperation intravenous fluid therapy with crystalloid or colloid on post operativenauseav Incidence of post operative nausea and vomiting in patients at a university hospital. Biomed Pap med Fac Unit PalackyOlomuc Czech Repub . 157(1) 69-79. Ferruggiari L et al (2012); The effect of aromatherapy on post operative nausea in women undergoing surgical procedures. Journal of Perianesthesia Nursing . 27(4(246-251. Gan T G et al (2003); Consenus guid lines for managing post operative nausea and vomiting. International Anesthesia Research Society . 97(16) 2-71. Gan T G et al (2007); Societyfor ambulatory anesthesia guid lines for the management of post operative nausea and vomiting. Anesthesia & Analagesia . 105(1)16-25. Hunt R et al (2012); Aromatrapy as treatment for post operative randomized tril. International Anesthisia Analagesia Research Socity . 1(1)1-8. Pellegrin J et al (2009); Comparison of inhalation of isopropyl alcholvsprometazin in the treatment of post operative nausea and vomiting(ponv) in patients identified as at high risk for developing ponv. AANA Journal . 77(4) 293-299. Salehisormaghi MH (2008); Herb and Herbal Therapy . Second ed. Tehran: Doniaetaghzie. Smeltzer S Bare B (2011); Textbook of Medical- Surgical Nursing, Operating Room . Translated by Khachian 1392 ناتسمز ،83 هرامش ،23 هرود / 32 ناراکمه و یفجن هراهب A. Tehran Jameae Negar. (Persian). Shaha PP , Kundnani PKM (2004); A review of medicinal uses and pharmacological effects of menthe pipprita. Natural Product Radiance . 3(4) 214-224. Tate S (1997); Peper mint oilatreatment for postoperative nausea. Journal of Advanced Nursing . 26(1) 584-590.

Priority interventions from the NIC and expected results from the NOC in patients with a nursing diagnosis of Ineffective breathing pattern

The aim of the study was to validate the priority interventions from the Nursing Interventions Classification (NIC) and the expected results from the Nursing Outcomes Classification (NOC) in patients hospitalized in an intensive care unit, with a nursing diagnosis of ineffective breathing pattern.Twenty experts helped with the verification of the priority interventions and expected results. They assigned scores to individual interventions and results, using a Likert scale. During testing, the experts had to indicate with the help of the Likert scale how they perform the various activities in the selected NIC and how they evaluate different indicators in the selected NOC. They could select from the following scale: 1=not at all, 2=seldom, 3=sometimes, 4=many times, 5=always. The data were consequently analysed by assigning a value to each of the responses (1=0; 2=0.25; 3=0.5; 4=0.75; 5=1). The maximum value that could be achieved in the evaluated field was 1, and the minimum was 0. Activities (for NIC) and indicators (for NOC) which were assigned a value of ≥0.8, were identified as priority use, and when they were assigned a value of ≤0.5, they were excluded on the grounds that the nurses performed them minimally or not at all. Others were taken as commonly used.Based on an analysis of the related NIC (specifically: respiratory monitoring 3350, ventilation assistance 3390, chest physiotherapy 3230, airways suctioning 3160 and airways management 3140), we concluded that only 62 activities from a total number of 158 were used by nurses. In the NOC, from a total number of 83, 50 indicators were assessed and 32 can be considered typically rated. On the basis of the results, our experts considered most of the NIC interventions unusable. On the other hand, more than half of the NOC indicators were rated as useful.The results of the study point to the fact that the introduction of the classification systems NIC and NOC would require further testing in clinical practice in the Czech Republic in order for them to be used effectively.

Conceptual validation of the defining characteristics of respiratory nursing diagnoses in neonates

OBJECTIVE: To develop and validate conceptual and operational definitions for the defining characteristics of the respiratory nursing diagnoses, ineffective breathing pattern, impaired gas exchange and impaired spontaneous ventilation, in newborns.METHODS: This was a methodological study of conceptual validation of the defining characteristics of three respiratory nursing diagnoses, by consensus analysis of a committee of five specialist nurses, and then a group of five non-nursing professionals, using the Delphi technique.RESULTS: After two rounds of evaluation, consensus was obtained that was equal to or greater than 80% on all of the definitions, which were then considered validated.CONCLUSION: The definitions developed for the defining characteristics of three nursing diagnoses were validated with a high level of consensus.

Ineffective Breathing Pattern: Defining Characteristics in Children With Acute Respiratory Infection

To determine the accuracy of NANDA-I defining characteristics for the nursing diagnosis, ineffective breathing pattern, in children with acute respiratory infection. This was a prospective cohort study in 136 children. Measures of accuracy were calculated for the defining characteristics. Use of accessory muscles to breathe presented the best measure of accuracy. Alterations in depth of breathing presented a high value of sensitivity. Altered chest excursion and orthopnea presented high values of specificity. Use of accessory muscles to breathe showed the best predictive capacity for ineffective breathing pattern. Measures of accuracy can contribute to an accurate diagnostic inference process, improving patient assessment and facilitating rapid, accurate diagnosis.

Estudio longitudinal de los diagnósticos de enfermería respiratorios en niños con infección respiratoria aguda

To determine the baseline prevalence and incidence rates of Impaired Gas Exchange (IGE), Ineffective Airway Clearance (IAC) and Ineffective Breathing Pattern (IBP) in children with acute respiratory infection. A prospective open cohort study was conducted in two public hospitals specialized in child care in the months from January to June of 2011. The sample consisted of 136 children with acute respiratory infection, which lasted a minimum of six and maximum of ten consecutive days. The data were collected through examination of the child and interviews with their parents. The diagnostic inference process was developed by trained nurses. The three diagnoses showed high rates at the beginning of follow-up period, with a reduction in the days after. There were similar rates of IBP and IGE. The temporal development of IBP was similar to that of IAC, but in lower proportions. Incidence rates in cases per 100 person / day were to IAC 39.28, 17.04 for DIG, and 13.31 for PRI. The three diagnoses studied appeared early and in high proportions. New cases of IAC appear more quickly when compared to the other two diagnoses.

Análise de atividades não realizadas pela equipe de enfermagem para o diagnóstico padrão respiratório ineficaz em idosos

Estudo transversal, descritivo, que objetivou identificar as atividades da Classificação de Intervenções de Enfermagem consideradas prioritárias para Padrão Respiratório Ineficaz e não realizadas para pacientes idosos, internados em um hospital escola do estado de Goiás. Participaram do estudo 43 profissionais de enfermagem e a coleta de dados foi realizada no período de outubro a dezembro de 2008, após aprovação pelo Comitê de Ética. Observou-se que, dentre as 67 atividades consideradas prioritárias para o referido diagnóstico, sete eram realizadas por todos os participantes; as demais, com frequência percentual variada, não eram realizadas, sendo o motivo principal para isto sua execução por profissional de outra área. Entende-se que a não realização destas atividades pela enfermagem pode resultar em alterações no campo de abrangência da assistência de enfermagem; que há necessidade de aparato legal na descrição das atividades que compõem a prática profissional exclusiva da enfermagem e a de natureza interdisciplinar.

Clinical indicators of "ineffective breathing pattern" in children with congenital heart disease

Clinical indicators of ineffective breathing pattern in children with congenital heart disease. To analyze the accuracy of clinical predictors of nursing diagnosis "Ineffective breathing pattern in children with congenital heart disease". 1:1 case-control study with 30 children with congenital heart disease. Fifteen children with the nursing diagnosis "Ineffective breathing pattern" (cases) were compared with other 15 without this diagnosis (controls). A total of 15 clinical indicators were analyzed for their sensibility, specificity, predictive values, likelihood ratios and area under the ROC curve. Four indicators showed an area under the ROC curve > 70%: chest x-ray findings (0.750), adventitious breath sounds (0.737), coughing (0.710) and asymmetric chest expansion (0.702). The indicators of the chest x-ray findings and adventitious breath sounds had a better overall performance for the identification of ineffective breathing pattern. These findings suggest that both indicators can be useful for inference of ineffective breathing pattern. Moreover, the presence of the diagnosis was associated with a greater likelihood of the presence of cough, and its absence with an increased probability of the absence of asymmetric chest expansion and percussive sounds. The comparison among populations with different diseases and carriers of the same nursing diagnosis shows that the predictive ability of clinical indicators can be influenced.

Diagnósticos de enfermagem respiratórios para crianças com infecção respiratória aguda

OBJETIVOS: Identificar a prevalência dos diagnósticos de enfermagem: Padrão respiratório ineficaz (PRI), Desobstrução ineficaz de vias aéreas (DIVA), Troca de gases prejudicada (TGP) e Ventilação espontânea prejudicada (VEP) suas características definidoras e fatores relacionados, em crianças com infecção respiratória aguda. MÉTODOS: Estudo de abordagem quantitativa, transversal, com 151 crianças. Os dados foram coletados por meio de entrevista e de avaliação pulmonar. Para análise dos dados, foi utilizada a estatística descritiva e inferencial. RESULTADOS: O diagnóstico mais prevalente foi PRI. Ruídos adventícios respiratórios e tosse ineficaz foram às características definidoras mais prevalentes. Ruídos adventícios respiratórios aumentam em 80% a chance para DIVA. Entre os fatores relacionados, destacaram-se: secreções nos brônquios e secreções retidas. Secreções nos brônquios favorecem em 80% a ocorrência de PRI e em 60% de DIVA. Verificou-se associação estatisticamente significante entre as características e fatores relacionados com os diagnósticos estudados. CONCLUSÃO: Os quatro diagnósticos foram identificados em crianças com infecções respiratórias agudas, apresentando prevalências distintas.

Diagnósticos enfermeros en niños con cardiopatías congénitas: diferencias por género y edad

Aims To assess the relationship between gender and age and development of nursing diagnoses in children with congenital heart disease. Method Cross-sectional study conducted on forty five children with congenital heart disease. Those nursing diagnoses with a frequency greater than 50% were selected for the association analysis, to which the chi-squared or Fisher tests were applied. The Levene test for homogeneity of variance and then the t-test was used to compare the mean age between children with and without the nursing diagnosis. Results The children had mean age of 4.74 months (SD = 3.78 months) and 66.7% (30) were boys. The female gender was associated with the nursing diagnosis activity intolerance ( P = .009) and delayed growth and development ( P = .013). The presence of the nursing diagnoses impaired gas exchange, ineffective breathing pattern, ineffective tissue perfusion, decreased cardiac output and activity intolerance was associated with younger children. On the other hand, the children who presented risk of infection and delayed growth and development had higher mean of age. Conclusions The population of girls had a higher risk for activity intolerance and delayed growth and development. Furthermore, younger children showed a higher risk for diagnoses related to respiratory and cardiovascular problems.

Clinical profile and nursing diagnosis of patients at risk of pressure ulcers

This cross-sectional study characterizes patients at risk of Pressure Ulcers (PUs) and identifies their corresponding Nursing Diagnoses (NDs). The sample consisted of 219 hospitalizations of adult patients at risk for developing a PU established through the Braden Scale. Data concerning the results of the application of the Braden Scale were retrospectively collected from the patients’ medical files and statistically analyzed. Most patients were elderly women hospitalized for an average of nine days, affected by cancer, cerebrovascular, lung, cardiovascular and metabolic diseases. The most frequent NDs were Risk for infection, Self-care deficit syndrome, Bathing/hygiene self-care deficit, Impaired physical mobility, Imbalanced nutrition: less than body requirements, Ineffective breathing pattern, Impaired tissue integrity, Acute pain, Impaired urinary elimination, Impaired skin integrity, and Risk for impaired skin integrity. We conclude that most NDs are common in clinical nursing practice.

Operational definitions of outcome indicators related to ineffective breathing patterns in children with congenital heart disease

Objective The development of operational definitions leads to accurate assessments of health conditions. Many health indicators in the Nursing Outcomes Classification require the development of operational definitions. We sought to determine the validity of operational definitions for indicators of nursing outcomes that assess respiratory status in children with congenital heart disease. Patients and Methods Eight trained nurses evaluated 45 children with congenital heart disease who were aged ≤1 year and previously diagnosed with ineffective breathing patterns. The statistical analysis included median differences, intraclass correlations, and cluster analyses. Results and Conclusions The nonuse of definitions produced inconsistencies in evaluations among evaluators. This inconsistency was not evident in the group using operational definitions. Two indicators were significant in all statistical analyses: asymmetrical chest expansion and percussed sounds.

Clinical Indicators of Ineffective Breathing Pattern in Children With Congenital Heart Diseases

The study aims to assess indicators of Nursing Outcomes Classification (NOC) related to the nursing diagnosis Ineffective Breathing Pattern (IBP) in children with congenital heart disease (CHD). The study used a cross-sectional study carried out in 63 children with CHD up to 2 years old. Seventeen operational indicators of NOC related to IBP were evaluated. Seven indicators presented statistically significant differences between children with and without IBP. Impaired expiration was the indicator assessed with greatest frequency in both groups. The study showed differences in the clinical indicators between children with and without IBP. The use of NOC indicators allowed an assessment of the differences and the level of respiratory impairment among children with and without IBP.