Nursing Diagnoses In Patients Research Articles

Accuracy of the defining characteristics of respiratory nursing diagnoses in patients with COVID-19.

To analyze the accuracy of the defining characteristics of four respiratory nursing diagnoses (ND) in patients with COVID-19 and on oxygen therapy. This is a cross-sectional study conducted in four Brazilian public hospitals in two regions of the country. A total of 474 patients with COVID-19 receiving oxygen therapy were assessed. Latent-adjusted class analysis with random effects was used to establish the sensitivity (Se) and specificity (Sp) of the defining characteristics evaluated for each ND. Among the ND that constituted the study (impaired spontaneous ventilatory, impaired gas exchange, ineffective airway clearance, and dysfunctional ventilatory weaning response), the following defining characteristics had the highest simultaneous Se and Sp (>0.8): decrease in tidal volume, confusion, irritability, dyspnea, decreased breath sounds, orthopnea, impaired ability to cooperate and respond to coaching, and decrease in the level of consciousness. Recognizing the clinical signs that predict respiratory ND in patients affected by COVID-19 can contribute to the nurse's accurate diagnostic inference and designate the appropriate nursing interventions to achieve the desired results and avoid complications.

Nursing diagnoses in patients undergoing prostatectomy at the central hospital of Nampula, 1st semester of 2019

Introduction: The nursing diagnosis is a clinical assessment of a human response to health conditions/life processes, or a vulnerability to that response, by an individual, family, group or community. The research aims to describe the main nursing diagnoses in patients undergoing prostatectomy admitted to Surgery II at the Hospital Central de Nampula. Objectives: This is a descriptive study with a quantitative approach, involving patients admitted to surgery II undergoing prostatectomy. All patients with the medical diagnosis of benign prostatic hyperplasia or prostate cancer who underwent prostate surgery were included, thus all patients who underwent prostate surgery but who had other chronic diseases were excluded. Data were analyzed with SPSS statistical package to obtain descriptive analysis, percentage and use of the following Q-square statistical test of independence. Results: the study involved 33 patients undergoing prostatectomy, 54.5% of these patients had primary schooling and the most predominant age group was 66-75 years old (39.4%). A total of 461 nursing diagnoses were found, and the most frequent were: Impaired walking 5.4%, Constipation 4.8, Risk of infection 6.9, Risk of vascular trauma 7.4%, Acute pain 5.4% and Deficit in self-care for bathing 6.7%. The following diagnoses were associated with the nursing diagnosis: impaired walking p value 0.000, dentition p value 0.006, constipation (p value 0.001), risk of electrolyte imbalance p value 0.000) and risk of falls (p value 0.000). Conclusion: the use of the nursing process by nurses facilitates the survey of health problems in sick patients in order to intervene in care using real nursing diagnoses, risk and health promotion.

Understanding Hypervolemia in Chronic Kidney Disease

Introduction: Chronic Kidney Disease (CKD) is a progressive and irreversible decline in kidney function and a decreased Glomerular Filtration Rate (GFR). Decreased kidney function contributes to decreased water excretion and fluid overload caused by decreased GFR. A progressive decrease in GFR in renal disease leads to hypertension, sodium retention, and fluid overload. Discussion: CKD is kidney damage or also defined as a decrease in glomerular filtration rate (GFR) of less than 60 ml/minute/1.73m2 that occurs for 3 months or more. CKD is most caused by Diabetes Mellitus 64.1% and Hypertension 80.7%. One clinical manifestation in patients with CKD is an increase in fluid volume (hypervolemia). Hypervolemia is one of the nursing problems in the nursing care process. Based on the Indonesian Nursing Diagnosis Standard Book, hypervolemia is an increase in intravascular, interstitial, and/or intracellular fluid volume. The etiology of hypervolemia in CKD patients is a regulatory mechanism disorder associated with decreased GFR. Signs and symptoms both major and minor in hypervolemia nursing problems show that most patients have peripheral oedema of 53.8%, the prevalence of anemia is 52.3%, the prevalence of Haemoglobin 7-10 mg/dl is 68.3%, and the prevalence of oliguria is 16.3%. One of the actual nursing diagnosis in patients with CKD is hypervolemia related to the disturbance of regulatory mechanisms (a decrease in GFR). A progressive decrease in GFR can lead to sodium and fluid retention which causes fluid balance disturbances.

Nursing diagnoses in hospitalized patients with COVID-19 in Indonesia.

The COVID-19 pandemic has become a global public health issue, and the roles of nurses are very much needed in providing nursing services in the current situation. The enforcement of appropriate nursing diagnoses for patients with COVID-19 is also fundamental in determining proper nursing care to help the patients achieve maximum health. This study aimed to describe and analyze nursing diagnoses in patients with COVID-19 treated in the isolation rooms and ICUs. This study used a secondary data analysis from hospital medical record data of patients with COVID-19 from early December 2020 to the end of February 2021. Data were selected using a cluster random sampling technique and analyzed using descriptive statistics. The results showed that the signs and symptoms of the patients with COVID-19 that often appeared were fever, cough, shortness of breath, and decreased consciousness. The common nursing diagnoses in the hospitalized patients with COVID-19 were hyperthermia, ineffective airway clearance, gas exchange disorder, self-care deficit, spontaneous ventilation disorder, spontaneous circulation disorder, knowledge deficit, and shock risk. This study offers an insight into nursing practices in the hospital setting, which can be used as a basis for nurses to perform complete nursing assessments and nursing diagnoses during the pandemic.

Identifying nursing interventions associated with the accuracy used nursing diagnoses for patients with liver cirrhosis

ABSTRACTObjective:to identify the nursing interventions associated with the most accurate and frequently used NANDA International, Inc. (NANDA-I) nursing diagnoses for patients with liver cirrhosis. Method:this is a descriptive, quantitative, cross-sectional study. Results:a total of 12 nursing diagnoses were evaluated, seven of which showed high accuracy (IVC ≥ 0.8); 70 interventions were identified and 23 (32.86%) were common to more than one diagnosis. Conclusion:in general, nurses often perform nursing interventions suggested in the NIC for the seven highly accurate nursing diagnoses identified in this study to care patients with liver cirrhosis. Accurate and valid nursing diagnoses guide the selection of appropriate interventions that nurses can perform to enhance patient safety and thus improve patient health outcomes.

Most frequent nursing diagnoses in patients admitted to the Epilepsy Unit

IntroductionEpilepsy is a neurological disease consisting of abnormal electrical discharges in the brain that produce a clinical condition, affecting 1–3% of the population. The Multidisciplinary Epilepsy Unit of the Hospital Universitario y Politécnico La Fe de Valencia, since 2006, has conducted studies with prolonged video-EEG monitoring of patients diagnosed with refractory epilepsy. The role of the unit is to provide these patients with both a diagnostic and a treatment solution. ObjectiveThis study aims to determine, using NANDA-NIC-NOC language, the basic needs of these patients and to assess how the quality of nursing care can be improved in this type of patient, during their admission and afterwards. MethodologyData were collected from a sample of 46 patients monitored in the unit between May and September 2013, and by using nursing assessment, data was obtained on the percentage occurrence of diagnosis. Results and conclusionsThe patients are very limited socially and occupationally, with added risks specific to the disease that we must not forget. The nursing role should be to standardise their situation as much as possible so that they can lead as full a life as possible, have proper health education, and prevent further injuries during admission (falls, etc.). From our experience, the epileptic patient support program from the Epilepsy Association of the Community of Valencia, and its incorporation into the Programa Respira for admission to the monitoring unit, gives good results.

Nurses Perception toward Using a New Eight Vital Signs Chart at ICUs

Background: Assessment of the traditional vital signs at ICUs as temperature, pulse, respiration, blood pressure and oxygen saturation are inadequate to determine patients’ clinical condition deteriorating; however assessment of eight vital signs should be included in a routine nursing assessment to improve patients’ outcomes for appropriate nursing diagnosis on proper time. Aim: To assess nurses’ perception toward using a new eight vital signs chart at ICUs Methods: Descriptive cross-sectional study design was used in this study composed of 45 nurses from all ICUs at the Beni-Suef University Hospital from November 2015 to January 2017, data were collected using structured interview to assess nurses’ perception toward using a new eight vital signs chart at ICUs. Results: The study findings demonstrate the distribution of all nurses’ perception items and found more than two third of the study sample (68.9%) were agreed to use eight vital signs, and almost all nurses had fantastic perception to eight vital signs, moreover about (84.4%) had adequate knowledge regarding assessment of pain, level of consciousness, urine output, as well as more than half of study sample reported the degree of importance is extremely important to assess additional three vital signs with basic vital signs (55.6%). However barrier may face nurses to assess pain, level of consciousness and urine output were reported high percentage (91.1%) and (97.8%) agreed to use the new eight vital signs chart at ICUs and defiantly it will help for better design of Nursing Diagnosis. Conclusion: ICUs’ nurses strongly agreed to apply new 8 vital signs chart at ICUs for meticulous designing of nursing diagnosis of patients’ clinically unstable. Recommendation: The study is recommended to consider the importance of application a new eight vital signs chart instead of traditional five vital signs and generalized it in the hospital documentation system.

Diagnósticos de enfermagem em clínica cirúrgica

Objetivo Identificar a frequência dos diagnósticos de enfermagem em pacientes de clínica cirúrgica. Métodos Estudo transversal, descritivo e exploratório, de abordagem quantitativa, com dados referentes a 28 pacientes. O instrumento de coleta de dados foi desenvolvido pelos pesquisadores, com base em padrões funcionais de saúde. Resultados Foram encontrados 301 diagnósticos de enfermagem, com média de 12 por paciente. Somente quatro diagnósticos apresentaram frequência acima de 50%. Os mais frequentes foram: “risco de infecção”, “integridade da pele/tissular prejudicada”, “disposição para bem-estar espiritual”, “disfunção sexual” e “padrão do sono perturbado”. Diagnósticos que se enquadram no domínio 13 (Crescimento/Desenvolvimento) não foram documentados nesta amostra. Conclusão Os achados demostraram ampla variedade de diagnósticos na população estudada, reflexo da diversidade de cuidados a serem prestados. A identificação das necessidades de cuidados favorece a implantação de intervenções específicas, contribuindo para a qualidade da assistência de enfermagem.

VALIDAÇÃO DO DIAGNÓSTICO DOR ÓSSEA E SUAS INTERVENÇÕES DE ENFERMAGEM NO MIELOMA MÚLTIPLO

Estudo descritivo, cujo objetivo fora validar o diagnóstico de enfermagem Dor Óssea no mielomamúltiplo e suas intervenções de enfermagem. Realizada busca bibliográfica para construção das afirmativas eutilizada a Classificação Internacional para a Prática de Enfermagem®. Em seguida, por meio de formulário, asafirmativas foram submetidas à validação de conteúdo por especialistas em enfermagem oncológica atuantesnum hospital universitário. A análise ocorreu por meio de estatística simples, considerando a variável deinteresse: índice de concordância, com resultado superior a 0,75. O diagnóstico de Dor Óssea e as intervençõesatingiram índice de concordância de 1,0 e de 0,90 respectivamente. A validação aponta para a relevânciado diagnóstico de enfermagem nos pacientes com mieloma múltiplo e reflete a possibilidade de melhoria daqualidade assistencial através das intervenções de enfermagem padronizadas.

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.

Diagnósticos de enfermagem para pacientes com toxicidade hematológica pós-quimioterapia antineoplásica com base na CIPE®

Objective: to compose affirmative the nursing diagnosis, based on ICNP® Version 1.0, for patients with hematological toxicity after antineoplastic chemotherapy. Methodology: a descriptive exploratory study developed from identification of priorities in terms of ICNP®, for the construction of affirmative the nursing diagnosis for patients with haematological toxicity after antineoplastic chemotherapy, using the construction of affirmative criterion provided by International Council of Nurses and in accordance with ISO 18.104. Results: since the terms were constructed eleven affirmative the nursing diagnosis: Immunologic impairment process; Fever; Dyspnea; Impaired skin integrity; Fading; Inability to perform self-care in hospitalization or in domicile; Risk for infection; Risk for septic shock; Risk for hemorrhaging process; Risk for trauma; Risk for non adherence to treatment. Conclusion: conclude that the results of the study demonstrated the service to the proposed objective and it is expected that these diagnoses nursing care applied in patients with haematological toxicity after antineoplastic chemotherapy is possible to achieve an effective assistance to this clientele. Descriptors: nursing, nursing diagnosis, chemotherapy, neoplasm, classification, practice nursing.

Nursing Diagnoses of Burned Patients and Relatives’ Perceptions of Patients’ Needs

The aims of this study were to identify the nursing diagnoses of burn patients in the period 1 week before hospital discharge and to determine whether their relatives had similar perceptions of the patients' problems. A qualitative case study was conducted with 10 burn patients and 10 family members. One week before hospital discharge, the nursing diagnoses of the patients and the relatives' perceptions of the patients' were identified and compared. Thirty different diagnoses related to physical and psychosocial aspects were identified. The family members reported concerns mainly related to physical care, specifically wound care and prevention of infection, and psychosocial aspects, while patients were primarily concerned with the latter. Nursing diagnoses for these patients and their relatives' perceptions frequently overlapped; however, the emphasis of the families' attention was on the physical aspects. Anticipating family members' perceptions about the patients' problems is important in order to promote strategies that will improve patient care after hospital discharge.

Clinical validation of the signs and symptoms and the nature of the respiratory nursing diagnoses in patients under invasive mechanical ventilation*

The aims of this study were to validate the signs and symptoms of the respiratory nursing diagnoses impaired gas exchange, ineffective airway clearance and ineffective breathing pattern in patients under mechanical ventilation; to verify whether intubation time and ventilatory modalities were related factors for respiratory nursing diagnoses; to verify the occurrence of shared signs and symptoms in the diagnoses and compare them with North American Nursing Diagnosis Association's proposition and to ascertain whether respiratory nursing diagnoses occur in isolated or associated patterns. The need for mechanical ventilation is common in several patients admitted to intensive care units. Therefore, critical care nurses should identify the respiratory nursing diagnoses of high incidence. Descriptive observational study, with 177 evaluations of surgical and medical critically ill adult patients undergoing invasive mechanical ventilation. The study adopted Fehring's Modified Clinical Diagnostic Validity Model, with a suggested alteration. The critical signs and symptoms were the same as proposed by North American Nursing Diagnosis Association, when the diagnoses were separately identified, although no particular sign and symptom was found for ineffective breathing pattern. Impaired gas exchange and ineffective airway clearance were identified as having 88 (49.7%) evaluations sharing the critical signs and symptoms. Intubation time and ventilation modality were related factors for the development of ineffective airway clearance and ineffective breathing pattern. The critical signs and symptoms of impaired gas exchange were abnormal blood gases and hypoxemia. For ineffective airway clearance, they were rhonchi and decreased breath sounds. No highlights were found for ineffective breathing pattern signs and symptoms. Validation by experts has confirmed these findings. The interface between ineffective airway clearance and impaired gas exchange was confirmed by the presence of the shared critical signs and symptoms. Studies like this are relevant to clinical practice because they evaluate the adequacy of Taxonomy II for patients under mechanical ventilation in clinical practice, thus allowing for the intensive care nurses to go from one mechanical and routine practice to a critical, reflexive practice, committed to professional progress.

Diagnósticos de enfermagem de pacientes em período pós-operatório imediato de colecistectomia laparoscópica

Os objetivos deste estudo foram identificar e analisar os diagnósticos de enfermagem de pacientes no período pós-operatório imediato de colecistectomia laparoscópica. Foi elaborado e validado um instrumento de coleta e registro de dados. Foram avaliados 15 pacientes adultos no período pós-operatório imediato de colecistectomia laparoscópica: 4 homens e 11 mulheres, com idade média de 45 anos. Os diagnósticos de enfermagem identificados foram: Integridade tissular prejudicada (100%), Risco para infecção (100%), Percepção sensorial perturbada (100%), Risco para aspiração (100%), Risco para função respiratória alterada (80%), Hipotermia (60%), Risco para temperatura corporal desequilibrada (40%), Nutrição desequilibrada: mais do que as necessidades corporais (33,3%) e Dor aguda (26,7%). Todos os pacientes foram admitidos em regime ambulatorial e receberam alta do Centro de recuperação pós-anestésica, apresentando ainda os diagnósticos de enfermagem Integridade tissular prejudicada e Risco para infecção.

The influence of ostomy surgery on body image in patients with cancer

A one group repeated measures design was used to describe changes in body image in 45 patients treated with ostomy for bowel or bladder cancer. Body image was measured preoperatively and at two postoperative points: 1 month and in 6 months or postclosure. The Body Cathexis Scale, Draw-a-Person, and subjective responses to open-ended questions were used. There was a significant difference in Body Cathexis scores between the immediate 1 month postoperative period and 6 months later (F(2, 88) = 3.13, p = .049). Body image scores did not change significantly between the preostomy and first postostomy measures. Qualitative data suggested that cancer diagnosis and its associated concerns were paramount on subjects' minds preoperatively and thus negatively influenced body image before the creation of the ostomy. Although altered body image is an appropriate nursing diagnosis for patients with ostomy in both the preoperative and postoperative periods, other issues may be dominant especially in the preoperative period.