Érida Maria Diniz Leite

Diagnostic accuracy of the defining characteristics of the excessive fluid volume diagnosis in hemodialysis patients

Objetivo: avaliar a acuracia das caracteristicas definidoras do diagnostico de enfermagem volume de liquidos excessivo da NANDA Internacional, em pacientes submetidos a hemodialise. Metodo: trata-se de um estudo de acuracia diagnostica, com delineamento do tipo transversal, realizado em duas etapas. A primeira envolveu 100 pacientes de uma clinica de dialise e um hospital universitario do Nordeste do Brasil, investigando-se sobre a presenca e ausencia das caracteristicas definidoras do volume de liquidos excessivo. Na segunda etapa, estas caracteristicas foram avaliadas por enfermeiros diagnosticadores, que julgaram a presenca ou ausencia do diagnostico. Para analise das medidas de acuracia foram calculados sensibilidade, especificidade e valores preditivos positivo e negativo. Aprovado pelo Comite de Etica em Pesquisa sob o protocolo no 148.428. Resultados: o indicador mais sensivel foi o edema e os mais especificos foram congestao pulmonar, ruidos respiratorios adventicios e agitacao. Conclusao: as caracteristicas definidoras mais acuradas, consideradas validas para a inferencia diagnostica do volume de liquidos excessivo em pacientes submetidos a hemodialise sao edema, congestao pulmonar, ruidos respiratorios adventicios e agitacao. Assim, na presenca destas, o enfermeiro podera tracar, com seguranca, a presenca do diagnostico estudado.Objective: to evaluate the accuracy of the defining characteristics of the excess fluid volume nursing diagnosis of NANDA International, in patients undergoing hemodialysis. Method: this was a study of diagnostic accuracy, with a cross-sectional design, performed in two stages. The first, involving 100 patients from a dialysis clinic and a university hospital in northeastern Brazil, investigated the presence and absence of the defining characteristics of excess fluid volume. In the second step, these characteristics were evaluated by diagnostic nurses, who judged the presence or absence of the diagnosis. To analyze the measures of accuracy, sensitivity, specificity, and positive and negative predictive values were calculated. Approval was given by the Research Ethics Committee under authorization No. 148.428. Results: the most sensitive indicator was edema and most specific were pulmonary congestion, adventitious breath sounds and restlessness. Conclusion: the more accurate defining characteristics, considered valid for the diagnostic inference of excess fluid volume in patients undergoing hemodialysis were edema, pulmonary congestion, adventitious breath sounds and restlessness. Thus, in the presence of these, the nurse may safely assume the presence of the diagnosis studied.

Classe hidratação da NANDA Internacional em pacientes submetidos à hemodiálise: estudo transversal

Aim: to analyze the association of nursing diagnoses of the Hydration class of NANDA International and its components in hospitalized patients undergoing hemodialysis. Method: This is a cross-sectional study involving 50 patients at a university hospital in a city in northeastern Brazil. The diagnoses inference was performed by specialist nurses. The analysis was made through the use of descriptive and inferential statistics. The study was approved by the Ethics Committee under Opinion 392,535. Results: of the six diagnoses obtained, two were associated with its components involving an excessive volume of liquid with the following features: pulmonary congestion, edema and adventitious breath sounds, and the willingness to improve the fluid balance with an expressed desire to increase it. Discussion: the identified associations are related to the volume of fluid, and are constantly changing in the investigated patients. Conclusion: The volume of excessive liquids and the willingness to improve the fluid balance showed a significant association with some of its components. Descriptors: Nursing Diagnosis; Signs and Symptoms; Fluid Therapy; Renal Dialysis.

Clinical Indicators Of Nutrition In Hemodialysis Clients

Background: Nutritional aspects are relevant to reduce the morbidity and mortality of the hemodialysis clientele. Thus, the identification of clinical indicators of nutritionis fundamental to guide a qualified care. This study aimed to verify the occurrence of clinical nutritional indicators in patients undergoing hemodialysis. Cross-sectional study. Methods and Findings: The study was carried out with 50 patients in a hospital in northeastern Brazil selected by convenience. Collection took place through an interview form and physical examination from December 2013 to May 2014. Results were analyzed using descriptive statistics. Thirty three clinical indicators of nutrition were identified, and rates exceeded 50%. Among these, Altered blood pressure was present in 100% of the sample. Six indicators showed rates above 90%, namely: Anxiety, Azotemia, Thirst, Decreased hemoglobin, Regular nutrition and Lack of information. The limitation of the study relates to the fact that this was developed in a single center. Conclusion: Clinical indicators of nutrition are common among hemodialysis customers and relate to electrolyte and nutritional disorders. The identification of these indicators allows the appreciation of nutritional nursing phenomena and consequent effective interventions and positive responses regarding nutrition safety of hemodialysis patients.

Acurácia diagnóstica das características definidoras do diagnóstico volume de líquidos excessivo de pacientes em hemodiálise

Objetivo: avaliar a acuracia das caracteristicas definidoras do diagnostico de enfermagem volume de liquidos excessivo da NANDA Internacional, em pacientes submetidos a hemodialise. Metodo: trata-se de um estudo de acuracia diagnostica, com delineamento do tipo transversal, realizado em duas etapas. A primeira envolveu 100 pacientes de uma clinica de dialise e um hospital universitario do Nordeste do Brasil, investigando-se sobre a presenca e ausencia das caracteristicas definidoras do volume de liquidos excessivo. Na segunda etapa, estas caracteristicas foram avaliadas por enfermeiros diagnosticadores, que julgaram a presenca ou ausencia do diagnostico. Para analise das medidas de acuracia foram calculados sensibilidade, especificidade e valores preditivos positivo e negativo. Aprovado pelo Comite de Etica em Pesquisa sob o protocolo no 148.428. Resultados: o indicador mais sensivel foi o edema e os mais especificos foram congestao pulmonar, ruidos respiratorios adventicios e agitacao. Conclusao: as caracteristicas definidoras mais acuradas, consideradas validas para a inferencia diagnostica do volume de liquidos excessivo em pacientes submetidos a hemodialise sao edema, congestao pulmonar, ruidos respiratorios adventicios e agitacao. Assim, na presenca destas, o enfermeiro podera tracar, com seguranca, a presenca do diagnostico estudado.Objective: to evaluate the accuracy of the defining characteristics of the excess fluid volume nursing diagnosis of NANDA International, in patients undergoing hemodialysis. Method: this was a study of diagnostic accuracy, with a cross-sectional design, performed in two stages. The first, involving 100 patients from a dialysis clinic and a university hospital in northeastern Brazil, investigated the presence and absence of the defining characteristics of excess fluid volume. In the second step, these characteristics were evaluated by diagnostic nurses, who judged the presence or absence of the diagnosis. To analyze the measures of accuracy, sensitivity, specificity, and positive and negative predictive values were calculated. Approval was given by the Research Ethics Committee under authorization No. 148.428. Results: the most sensitive indicator was edema and most specific were pulmonary congestion, adventitious breath sounds and restlessness. Conclusion: the more accurate defining characteristics, considered valid for the diagnostic inference of excess fluid volume in patients undergoing hemodialysis were edema, pulmonary congestion, adventitious breath sounds and restlessness. Thus, in the presence of these, the nurse may safely assume the presence of the diagnosis studied.

La exactitud diagnóstica de las características definidoras del diagnóstico volumen de líquidos excesivo de pacientes en hemodiálisis

Objetivo: avaliar a acuracia das caracteristicas definidoras do diagnostico de enfermagem volume de liquidos excessivo da NANDA Internacional, em pacientes submetidos a hemodialise. Metodo: trata-se de um estudo de acuracia diagnostica, com delineamento do tipo transversal, realizado em duas etapas. A primeira envolveu 100 pacientes de uma clinica de dialise e um hospital universitario do Nordeste do Brasil, investigando-se sobre a presenca e ausencia das caracteristicas definidoras do volume de liquidos excessivo. Na segunda etapa, estas caracteristicas foram avaliadas por enfermeiros diagnosticadores, que julgaram a presenca ou ausencia do diagnostico. Para analise das medidas de acuracia foram calculados sensibilidade, especificidade e valores preditivos positivo e negativo. Aprovado pelo Comite de Etica em Pesquisa sob o protocolo no 148.428. Resultados: o indicador mais sensivel foi o edema e os mais especificos foram congestao pulmonar, ruidos respiratorios adventicios e agitacao. Conclusao: as caracteristicas definidoras mais acuradas, consideradas validas para a inferencia diagnostica do volume de liquidos excessivo em pacientes submetidos a hemodialise sao edema, congestao pulmonar, ruidos respiratorios adventicios e agitacao. Assim, na presenca destas, o enfermeiro podera tracar, com seguranca, a presenca do diagnostico estudado.Objective: to evaluate the accuracy of the defining characteristics of the excess fluid volume nursing diagnosis of NANDA International, in patients undergoing hemodialysis. Method: this was a study of diagnostic accuracy, with a cross-sectional design, performed in two stages. The first, involving 100 patients from a dialysis clinic and a university hospital in northeastern Brazil, investigated the presence and absence of the defining characteristics of excess fluid volume. In the second step, these characteristics were evaluated by diagnostic nurses, who judged the presence or absence of the diagnosis. To analyze the measures of accuracy, sensitivity, specificity, and positive and negative predictive values were calculated. Approval was given by the Research Ethics Committee under authorization No. 148.428. Results: the most sensitive indicator was edema and most specific were pulmonary congestion, adventitious breath sounds and restlessness. Conclusion: the more accurate defining characteristics, considered valid for the diagnostic inference of excess fluid volume in patients undergoing hemodialysis were edema, pulmonary congestion, adventitious breath sounds and restlessness. Thus, in the presence of these, the nurse may safely assume the presence of the diagnosis studied.