格伦手术后的护理。病例报告

IF 1.1 Q3 NURSING
Ester Álvaro-Sánchez RN
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引用次数: 0

摘要

导言格伦手术是左心发育不全综合征(HLHS)患儿的一种姑息性手术,其目的是部分调整全身静脉回流。评估马乔里-戈登(Marjorie Gordon)的 11 种功能性健康模式被用于护理评估,其中突出强调了营养-代谢模式和活动-运动模式的改变,因为这些模式与手术引起的血流动力学变化有关。诊断和计划由于这些诊断与此类手术中最常见的术后并发症有关,因此根据 NANDA-I 分类法,优先考虑了 8 个诊断:感染风险、液体量过大、休克风险、出血风险、心输出量下降风险、气体交换受损、气道清理无效和脑组织灌注无效风险。结果标准评分在入院 7 天后显示出良好的变化,只有 3 个在入院之初选定的诊断仍然有效。讨论通过制定和重新评估护理计划,可以有效监测患者的术后演变情况,并规范护理工作,确保安全和优质的医疗服务。由于现有书目中缺乏类似的病例报告,我们无法对各项行动进行比较,因此有必要披露这些科学文章,以确保最佳循证实践。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cuidados enfermeros en el postoperatorio de la cirugía de Glenn. A propósito de un caso

Introduction

Glenn surgery is used as a palliative procedure in children with Hypoplastic Left Heart Syndrome (HLHS) and its objective is to partially redirect the systemic venous return.

An individualized care plan is presented for a 7-month-old infant, admitted to the Pediatric Intensive Care Unit, after undergoing Glenn procedure. And is shown her evolution during admission.

Assessment

Marjorie Gordon's 11 functional health patterns are used for the nursing assessment, highlighting among the altered patterns, the nutritional-metabolic and the activity-exercise, due to their implication in hemodynamic changes derived from the surgery.

Diagnoses and planning

Due to their association with the most common postoperative complications in this type of surgery, 8 diagnoses were prioritised according to NANDA-I taxonomy: risk for infection, excess fluid volume, risk for shock, risk for bleeding, risk for decreased cardiac output, impaired gas exchange, ineffective airway clearance and risk for ineffective cerebral tissue perfusion.

In each of them, expected patient outcomes and nursing interventions, were selected using the NOC and NIC taxonomies, respectively.

Outcome criteria scores showed a favourable evolution after 7 days from admission, only 3 of the diagnoses selected at the beginning remain active.

Discussion

The development and reassessment of the nursing care plan has made it possible to make an effective monitoring of patient's postoperative evolution and to standardize nursing care, ensuring safe and quality health care.

The lack of similar case reports in available bibliography has prevented us from comparing actions, therefore it has been necessary to disclose these scientific articles to guarantee best evidence-based practice.

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来源期刊
CiteScore
2.50
自引率
23.10%
发文量
48
期刊介绍: Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.
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