Ineffective Tissue Perfusion Research Articles

Comprehensive Nursing Care for Pediatric Patients with Congenital Heart Diseases: A Focus on Ventricular Septal Defect

During 2022, Peru faced significant challenges in managing congenital heart diseases, particularly ventricular septal defect (VSD), identified as one of the most common. According to the National Institute of Child Health San Borja (INSNSB), congenital heart diseases accounted for 30% of birth defects and were often associated with genetic syndromes such as trisomy 21. Early diagnosis and specialized care were essential to prevent severe complications like heart failure and developmental delays.Postoperative management in cardiovascular intensive care units was key to patient recovery. Protocols were implemented, including continuous hemodynamic monitoring, infection prevention, pain control, and respiratory therapy. Nursing staff played a crucial role, organizing care through the nursing process, which involved assessment, diagnosis, planning, implementation, and evaluation. During the assessment, diagnoses such as decreased cardiac output and ineffective tissue perfusion were identified.Additionally, education and emotional support for families were prioritized, strengthening the bond between the healthcare team and caregivers. During this period, the capacity of pediatric intensive care units was enhanced, although challenges such as unequal access to specialized services in rural areas persisted.In conclusion, the comprehensive care provided in Peru allowed significant progress in the treatment of VSD and other congenital heart diseases, contributing to improved quality of life for patients and their families

Nursing Process in Postoperative Preschoolers with Ventricular Septal Defect: A Humanized Approach

The ventricular septal defect (VSD) was identified as the most prevalent congenital heart disease, with a global incidence of 6-8 per 1,000 live births, according to WHO data and regional studies. In Latin America, this condition represented one of the leading causes of neonatal mortality. In Peru, the National Institute of Child Health San Borja estimated that 30% of congenital defects were heart diseases, many of which were associated with genetic alterations such as trisomy 21, 13, or 18.Postoperative management of VSD in preschoolers in cardiovascular intensive care units was considered crucial to prevent complications such as heart failure and ventilatory dysfunction. The nursing process, consisting of the stages of assessment, diagnosis, planning, implementation, and evaluation, was applied as a systematic tool to provide comprehensive care. During the assessment phase, the 11 functional health patterns of Marjory Gordon were used to identify actual and potential problems, while the priority diagnoses included decreased cardiac output, ineffective tissue perfusion, and dysfunctional ventilatory response.Implemented interventions included continuous hemodynamic monitoring, thoracic drain management, infection prevention, and pain control. These actions, along with a humanized approach and emotional support for families, improved clinical outcomes and strengthened the bond between the healthcare team and caregivers. The nursing process was key to ensuring proper recovery and providing quality care to pediatric patients affected by VSD

Nursing Process for a Preschooler Post-Operative from Ventricular Septal Defect Closure in Cardiovascular Intensive Care at an Institute in Lima, 2022

Congenital heart disease due to ventricular septal defect is a serious congenital defect most of the time and, although rare, can also be acquired following rupture of the interventricular septum during an acute myocardial infarction. The objective was to manage the nursing care process for a post-operative preschool patient. The study had a qualitative approach, focusing on a single case. The methodology followed the nursing care process. The assessment stage was conducted using the framework of the 11 functional health patterns of Marjory Gordon. The diagnostic stage was developed based on NANDA-I Taxonomy II, identifying nursing diagnoses and prioritizing three: decreased cardiac output, ineffective tissue perfusion, and dysfunctional ventilatory response to weaning, according to the SSPFR format (signs and symptoms, problem, related factor/risk factor/associated with). The planning stage was carried out considering the NOC and NIC taxonomies. During the implementation stage, care was administered, and the evaluation was based on the difference between baseline and final scores, respectively. The results showed a change score of +1, 0, +1. In conclusion, the nursing care process was successfully managed for the patient, providing high-quality care

Post-cessation interventions for preeclampsia

Preeclampsia is characterized by high blood pressure associated with proteinuria or hypertension with or without proteinuria, it can complicate pregnancy affecting multiple organs and systems, being a high risk for the mother and fetus. They generally conclude in abdominal surgical delivery called cesarean section, which leads to various alterations in the patient's health. Objective: Expose the nursing interventions in the maintenance of tissue perfusion in post-cesarean patients due to preeclampsia.Methodology: Study qualitative clinical case, 15-year-old patient selected for convenience; In which the Nursing Care Process (PAE) was applied as a methodology and the data collection instrument was the assessment sheet according to the eleven functional patterns of Marjory Gordon. Results: Twelve nursing diagnoses were recognized, among them the main diagnosis was prioritized: ineffective tissue perfusion associated with M / P hypertension, alteration of skin characteristics and edema. Therefore, scientifically supported nursing interventions were planned that achieved favorable results in the patient. With regard to the main CR, malignant hypertension, an adequate health condition has been maintained but the risk remains in the following hours. Conclusions: The clinical condition of the post-cesarean patient with preeclampsia and eclampsia was identified, considering nursing interventions according to standardized diagnoses, achieving favorable results. The patient is being cared for because the risk of malignant hypertension persists.

Nursing Care of Infant with Epilepsy: A Case Study

Background: Epilepsy is a number of symptoms of impaired brain function which are characterized by recurrent seizures due to excessive discharge of the brain's electrical charge and it is reversible. The impact caused by epilepsy is growth and development disorders, including impaired intelligence function, language comprehension and cognitive function disorder. Morover, there are very complex disorders on the brain which can cause behavioral and learning disorders, physical and mental disabilities, and death. This study aimed to find out the infant nursing care on A patient with epilepsy. 
 Methods: This research uses a case study design. Data collection from assessment to evaluation in the in Arafah Room 1 of the Hospital in Banda Aceh on December 2022. Epileptic patients was observed or treated for 4 days. Data collection techniques ware carried out through interviews, observation, and documentation. Data analysis was carried out using narrative analysis.
 Results: Baby A with chief complaint of recurrent seizures. nursing diagnoses in the case of Baby A were ineffective breathing pattern, risk of ineffective tissue perfusion, risk of injury, lack of knowledge, and anxiety. The interventions provided are based on the Indonesian Nursing Intervention Standards which consist of observational, therapeutic and collaborative interventions.
 Conclusion: Nursing problems in Infant A after 4 days of treatment are show problem of ineffective breathing pattern and the the lack of knowledge about epilepsy was solved, the risk of ineffective cerebral tissue perfusion, the risk of injury, and anxiety were partially solved.

Using slow deep breathing for patient with hypertention having ineffective tissue perfusion

Hypertension is blood pressure that exceeds normal limits where systolic blood pressure> 140 mmHg and diastolic blood pressure> 90 mmHg. To overcome this, it is necessary to do non-pharmacological therapy, namely the application of Slow Deep Breathing Exercise. This study aims to apply the application of Slow Deep Breathing Exercise to decrease blood pressure in patients with hypertension with ineffective brain tissue perfusion. The method used in this research is a case study, with a sampling technique that is purposive sampling. The results of this study indicate that the application of Slow Deep Breathing Exercise can reduce blood pressure in patients with hypertension with ineffective brain tissue perfusion. The application of Slow Deep Breathing Exercise can lower blood pressure by activating the autonomic nerves so that vasodilation occurs in blood vessels.

Clinical indicators, nursing diagnoses, and mortality risk in critically ill patients with COVID-19: a retrospective cohort.

To identify clinical indicators and nursing diagnoses with the highest risk of mortality in critically ill patients with COVID-19. Retrospective cohort with the population of adults and elderly people with COVID-19 from an Intensive Care Unit. Categorical variables were described using absolute and relative frequencies and risk factors for mortality using Cox regression, with a confidence interval of 95%. The main clinical indicators of COVID-19 patients were dyspnea, fever, fatigue, cough, among others, and the Nursing Diagnoses at higher risk of mortality were Ineffective protection, Ineffective tissue perfusion, Contamination, Ineffective Breathing Pattern, Impaired spontaneous ventilation, Acute confusion, Frailty syndrome, Obesity, and Decreased cardiac output. It is worth mentioning that there was little information about the diagnoses of Domains 9, 10, and 12. This research infers the need to monitor the clinical indicators dyspnea, fever, fatigue, cough, among others, and the Nursing Diagnoses with the highest risk of mortality Ineffective protection, Ineffective tissue perfusion, Contamination, Ineffective Breathing Pattern, Impaired spontaneous ventilation in critically ill patients.

Nursing Experience Using Art Therapy With Parents Facing the Death of a Newborn

When a newborn requires immediate hospitalization due to a potentially life-threatening situation, parents face a sudden and significant increase in stress. This situation and the potential loss of their child will bring great grief and loss to the parents, which may lead to conditions that foster dysfunctional family dynamics. This article describes the author's experience providing hospice care to a dying infant with a group B streptococcus infection in the neonatal intensive care unit. The author served as the primary care nurse from April 5th to July 6th, 2019. Data were collected during direct care provision, observations, and interactions with parents, while overall systemic assessments were used in analysis to establish that the health problems of the case were: (1) existing infection: related to group B streptococcus; (2) ineffective tissue perfusion: insufficient perfusion of multiple organs, including brain, heart, lung, and kidney, due to sepsis infection; and (3) caregiver grief: facing the death of a newborn. Nursing care provided to the patient included maintaining individualized physical functions and retaining physical integrity during the end-of-life period. The nursing care provided to the parents included the use of art therapy to encourage them to express their inner emotions through the writing of memoirs and diaries and their participation in companionship. This intervention was designed to help the parents transition from the grief of denying the collapse to the fact that their baby had died. As Taiwanese culture typically avoids discussions of death, the nursing experience described in this article may provide a reference for caring for similar patients. This article highlights the beauty of nursing through art therapy, demonstrates the achievement of whole-person and family-centered nursing, shows how the case was successfully helped through the crisis, and illustrates how normal family functions may be maintained.

Analysis of Standard Nursing Statement Recorded in Electronic Nursing Record (ENR) System in Kidney Transplant Patients

Background and Purpose: The electronic nursing record (ENR), which includes a nursing process is an important data because it is the evidence of nursing care and nursing effect. Standard nursing statement is a template statement used in ENR system in many centers. But the frequency of standard nursing statement in ENR records, were not studied. The purpose of this study is to analyze the frequency of standard nursing statements used on ENR in kidney transplant (KT) patients. Material and methods: The Data were collected by retrospective review of ENR. 218 kidney transplant patients, whose transplantation was performed between Jan. 2010 and Dec. 2010 in a single center were enrolled. The nursing process statements, recorded in ENR system during admission for transplant surgery, were categorized by the International Classification for Nursing Practice (ICNP). This template was based on ICNP. Results: Total 291,674 nursing process statements were collected which means1337 statement per patients during 15days of admission. Diagnosis category was most frequent statement (33.9%). Five nursing diagnoses contents in the order of frequency were: risk for infection(12.55%), acute pain(11.9%), risk for impaired skin integrity(2.36%), ineffective tissue perfusion(1.77%), and deficient knowledge(1.61%). The greater part of nursing action statements were: assess for factor that increased the risk of infection, education and intervention for prevention of infection, and assessment of the pain. Standard nursing statements investigated the frequency of use as follows: standard nursing assessment statements(26.0%), standard nursing diagnosis statements(42.4%), standard nursing plan statements(26.5%), standard nursing intervention statements(36.2%), and standard nursing evaluation statements(21.6%). Discussion and conclusion: The main contents of ENR system in kidney transplant patient were prevention for infection, and pain management. Aside from these nursing care, succinct standardized nursing record guideline is needed specialized to kidney transplant patient. Education and further modification of standardized guidelines for the ideal nursing record, may be helpful in improving the quality of nursing records. This study will help nurses to perform their nursing processes more efficiently.

Pedlar inexpensive ergometer-based exercise program improves activity intolerance in a heart failure case

This paper reports on the efficacy of a pedlar inexpensive ergometer-based structured exercise program in improving activity intolerance in a heart failure case. Data were collected between May 15, 2010 and May 20, 2010 using physical assessments, observations, and interviews. Several home visits were conducted after hospital discharge until August 8. Health problems identified included disease-related weakness, inability to complete daily activities, activity intolerance, malnutrition, and ineffective tissue perfusion. In addition to providing nutrition and dietary guidance, we designed an exercise rehabilitation program to improve activity intolerance both during hospitalization and after hospital discharge. Outcome measurements included the six-minute walk test, blood pressure, heart rate, oxygen saturation, and self-perceived improvement. Improvements achieved by the 12th week of the exercise training program included: (1) Able to complete the six-minute walk test (initially unable). (2) Walking distance increased by 54 meters. (3) Target heart rate achieved 40-60% of the maximum heart rate. (4) Resting systolic blood pressure and heart rates decreased tremendously, and (5) Fatigue and shortness of breath improved greatly. Results indicate the pedlar inexpensive ergometer exercise program may help improve the health of heart failure cases suffering from activity intolerance.

Risk for decreased cardiac output: validation of a proposal for nursing diagnosis

To verify the content validity of the nursing diagnosis risk for decreased cardiac output (RDCO). DCO is a phenomenon that is not restricted to individuals or environments that specifically focus on cardiovascular care. It is not only prevalent in cardiovascular care units, but also in post-anaesthesia units and non-cardiac care units among individuals with non-cardiogenic disorders. A significant decrease in cardiac output is a life-threatening situation, demonstrating the need for developing a risk nursing diagnosis for early intervention. The development of this diagnosis requires the construction of a diagnosis label, a definition of the diagnostic concept and the risk factors associated with the diagnosis. The research was carried out in two methodological stages based on the Fehring diagnosis content validation model. The quantitative analysis consisted of the calculation of the weighted mean of the values attributed by experts to each risk factor, the level of agreement/disagreement between the experts regarding the operational definitions of risk factors and the index of diagnostic content validity (DCV). The label 'risk for decreased cardiac output' was considered representative of a nursing diagnosis defined as 'at risk of developing a health status characterized by an insufficient quantity of blood pumped by the heart to meet physical metabolic demands'. Critical risk factors (DCV ≥ 0·7) were myocardial dysfunction (0·887), blood loss (0·875), increase in intrapericardial pressure (0·825), condition that leads to changes in cardiac rhythm and/or electrical conduction (0·812), deficient fluid volume (0·725), plasma loss (0·712), ineffective tissue perfusion (0·712) and electrolyte imbalance (0·7). The research identified eight risk factors with valid content for assessment of RDCO. The identification of risk factors for DCO assists nurses to intervene early and minimize the consequences of a deficient cardiac function.

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.

Nursing interventions implemented according to the most prevalent nursing diagnoses in intensive care: cross-sectional study

Context: Evaluating clinical practice based on standard language has become a necessity. Objective: This study aims to map nursing interventions according to the Nursing Interventions Classification (NIC), identifying the most prevalent Nursing Diagnoses in an intensive care unit within the first 24 hours of hospital admission. Method: Cross-sectional study. A cross-mapping method was used to analyze data collected from 150 medical records. A total of 195 diagnoses were identified, showing 21 different ones; and 1694 prescribed care. Result: The most recurrent diagnoses were Impaired Tissue Integrity and Impaired Skin Integrity, and the main intervention, Lesion Care (14.1% and 19.78%) was prescribed for both; Gas Exchange was affected by prevailing intervention Airway Control (29.76%), Ineffective Tissue Perfusion: cerebral and cardiopulmonary with priority intervention Neurologic Monitoring (38.3%) and Acute Cardiac Care (2.8%) respectively, the latter also being priority for Decreased Cardiac Output (1.3%). Conclusion: Most care was in line with the standard taxonomy of the Nursing Interventions Classification, though the interventions considered priority were limited.

Diagnósticos de enfermagem em adultos em tratamento de hemodiálise

OBJETIVO: Analisar a distribuição dos diagnósticos de enfermagem presentes em adultos de uma clínica de hemodiálise de Petrópolis - Rio de Janeiro. MÉTODOS: Estudo quantitativo do tipo transversal, de caráter exploratório e descritivo. Foram avaliados 20 pacientes nos meses de abril e maio de 2006. Os instrumentos de coleta de dados foram: roteiro de entrevista e exame físico. RESULTADOS: Verificou-se que metade eram mulheres, sendo a maioria casada, com média de 2 filhos. Foram identificados 16 diagnósticos de enfermagem, quatro desses acima do percentil 75, são eles: Risco de infecção; Perfusão tissular ineficaz: renal; Padrão de sono perturbado e Intolerância à atividade. CONCLUSÃO: O estudo proporcionou maior conhecimento da realidade desses pacientes, contribuindo para uma possível implementação de ações de enfermagem mais eficientes para a solução dos problemas identificados.