• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 1
  • Tagged with
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Procedimentos dolorosos e alteraÃÃes nos parÃmetros fisiolÃgicos em recÃm-nascidos sob oxigenoterapia / PAINFUL PROCEDURES AND PHYSIOLOGICAL PARAMETER ALTERATIONS IN NEWBORN INFANTS UNDER OXIGENOTHERAPY.

AndrÃa Lopes Barbosa 08 February 2010 (has links)
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / RecÃm-nascidos (RNs) que apresentam funÃÃo pulmonar prejudicada, seja pela prematuridade ou por algum diagnÃstico que interfira no sistema respiratÃrio, necessitam, geralmente, de algum tipo de oxigenoterapia. Objetivou-se avaliar os parÃmetros fisiolÃgicos (FR, FC, pulso e SpO2) na execuÃÃo de alguns procedimentos dolorosos (aspiraÃÃo do TOT/VAS, coleta de gasometria, passagem de cateter central de inserÃÃo perifÃrica-PICC e retirada de curativo) realizados pelos(as) enfermeiros(as) em RNs submetidos à oxigenoterapia em uma Unidade de Terapia Intensiva Neonatal (UTIN). Para tanto, realizou-se um estudo longitudinal do tipo antes e depois, de carÃter quantitativo, em uma UTIN de uma instituiÃÃo pÃblica de referÃncia na cidade de Fortaleza-CearÃ, durante o perÃodo de dezembro de 2008 a junho de 2009. Fizeram parte da amostra 125 RNs com, no mÃnimo, seis horas de vida e internados em leitos de alto risco, que utilizavam alguma forma de oxigenoterapia por um perÃodo mÃnimo de seis horas e que se encontravam clinicamente estÃveis. A coleta de dados efetivou-se por meio da observaÃÃo sistemÃtica e os dados foram registrados em formulÃrios, contemplando algumas variÃveis independentes, tais como os procedimentos dolorosos realizados pelos enfermeiros(as) e algumas variÃveis dependentes, como os parÃmetros fisiolÃgicos de FR, FC, juntos aos visualizados no monitor durante os procedimentos (pulso, SpO2). AlÃm destas variÃveis, estudou-se tambÃm as caracterÃsticas de base dos RNs quanto Ãs condiÃÃes de nascimento (peso ao nascer, sexo, tipo de parto, Apgar, Capurro) e durante a internaÃÃo na UTIN (data e horÃrio da internaÃÃo, data do inÃcio da utilizaÃÃo e modalidade de oxigenoterapia instalada ao ser admitido na UTIN, modalidade de oxigenoterapia e peso no momento da coleta, acomodaÃÃo, dieta, medicaÃÃo). Tais dados foram adquiridos por meio do prontuÃrio, com o propÃsito de correlacionÃ-los com as referidas variÃveis. Os resultados mostraram que 92,8% dos RNs eram prÃ-termo e 7,3%, a termo, sendo que 56,8% nasceram de parto cesÃrea e 43,2%, de parto vaginal. Quanto ao peso dos bebÃs estudados, 92,0% pesaram abaixo de 2500g e apenas 7,2%, acima de 2500g. As hipÃteses diagnÃsticas mais presentes foram prematuridade (93,6%) e SÃndrome do Desconforto RespiratÃrio-SDR, (52,8%). Ao avaliar o conjunto de parÃmetros fisiolÃgicos para os quatro procedimentos pesquisados, houve alteraÃÃes (p<0,05) de FR e FC para os RNs em Oxi-Hood e CPAP e de pulso (p<0,05) para os RNs em Oxi-Hood, CPAP e VM, sendo a SpO2 o Ãnico parÃmetro que nÃo sofreu variaÃÃo significativa (p>0,05) na prÃtica de aspiraÃÃo do TOT/VAS. Na gasometria, houve variaÃÃes (p<0,05) de todos os parÃmetros fisiolÃgicos, porÃm, para tal procedimento, as alteraÃÃes foram diferentes em cada modalidade de oxigenoterapia, ocorrendo variaÃÃes de FC, pulso e SpO2 nos RN em Oxi-Hood e alteraÃÃes de FR e pulso nos RNs em VM. Entretanto, na passagem de cateter percutÃneo e na retirada de curativo, nÃo houve alteraÃÃes estatisticamente significantes (p>0,05). PropÃe-se aos enfermeiros(as) desenvolverem intervenÃÃes que possam manter as variaÃÃes dos parÃmetros de FR, FC, pulso e SpO2 dentro da faixa de normalidade na execuÃÃo destes procedimentos. / Newborn infants that have impaired lung function because of prematurity or any other diagnosis that interferes in the respiratory system, usually need some type of oxigenotherapy. The objectives of this study were to evaluate physiological parameters (RR, HR, Pulse, SpO2) in neonates submitted to oxigenotherapy in a Neonatal Intensive Care Unit (NICU) during the execution of some painful procedures carried out by nurses (orotracheal suction, upper airway suction, blood collectium to gasometry, insertion of a Peripherally Inserted Central Catheter â PICC - and withdrawing of curative). For this purpose, it was developed a before and after longitudinal and quantitative study in a Neonatal Intensive Care Unit of a public institution of reference in the city of Fortaleza-Ceara, in the period of December 2008 to June 2009. The sample was composed of 125 clinically stable newborns hospitalized in high-risk beds with at least six hours of life, and submitted to some type of oxigenotherapy for at least six hours. The data collecting was accomplished by systematic observation and the data were recorded in research forms that contained some independent variables, such as painful procedures carried out by nurses and some dependent variables such as the physiological parameters, like RR, HR and others that were visualized in the cardiac monitor during the procedures (pulse, SpO2). Additionally to these variables, it was studied both characteristics of the newborns regarding the birth conditions (birth weight, gender, type of labour, Apgar score, capurro) and regarding the period of hospitalization in the NICU (date and time of hospitalization, date and type of oxigenotherapy when the baby was admitted in the NICU, oxigenotheray modality and newborn weight at the time of the data collection, accommodation, diet and medication). These data were obtained through the medical charts, with the purpose of correlating them to those variables. The results showed that 92,8% of the neonates were preterm infants and 7,3% were term infants. Regarding the type of labor, 56,8% of the babies were delivered by caesarean section and 43,2% of them born by vaginal labor. According to the weight of the babies under the study, 92,0% weighted below 2500g while only 7,2% were above 2500g. The most common diagnostic hypotheses founded were prematurity (93,6%) and Respiratory Distress Syndrome - RDS (52,8%). The evaluation of the physiological parameters of the four procedures accessed in this study showed some variations (p<0,05) of RR and HR in the newborns using hood and CPAP, and variation of pulse (p<0,05) for the newborns in hood, CPAP and MV; however, the SpO2 was the only parameter that did not suffer any significant variation (p>0,05) regarding the suction of either orotracheal tube or upper airway. Concerning the gasometry, variations were found (p<0,05) in all physiological parameters; nevertheless, the alterations related to this procedure were different for each oxigenotherapy modality, occurring changes in HR, pulse and SpO2 in newborn using hood, and alterations in RR and pulse in neonates under MV; however, regarding the insertion of a PICC and the withdrawing of curative, no statistically significance alterations were found (p>0,05). It is proposed to the nurses to develop interventions that can keep the variations of the parameters of RR, HR, pulse and SpO2 in normal levels during the execution of these procedures.

Page generated in 0.0748 seconds