Eugenia Velludo Veiga

Assessment of the techniques of blood pressure measurement by health professionals

OBJECTIVE To assess blood pressure measurement by health professionals of a public hospital in S o Paulo State. METHODS Semi-structured interviews and direct observation were performed with a verification list according to the criteria reported by Perloff et al. One hundred and five health professionals took part in the study. After measuring blood pressure, the level of concordance between the way the procedure was performed and the recommended one was assessed. RESULTS Nurses and nurses aides abided by 40% of the recommended procedures for adequate blood pressure measurement. The other categories of health professionals (nursing and medicine teachers, physicians, residents, and nursing students) abided by approximately 70%. CONCLUSION Permanent educational activities aiming at standardizing blood pressure measurement should be implemented among the different categories of health professionals.

A farmacoterapia no idoso: revisão sobre a abordagem multiprofissional no controle da hipertensão arterial sistêmica

The greater prevalence of chronic diseases like systemic arterial hypertension among elderly people results in an increase of drugs use. Therefore, the incidence of a lot of drug-related problems (DRP) rises, and this leads to many health problems in the population. Based on literature, authors emphasize the multidisciplinary team approach (physicians, nurses and pharmacists) to activities directly related with pharmacotherapy for hypertension, granting elderly persons a better comprehension about taking care of their own health, to reduce DRP and achieve satisfactory adherence.La mayor prevalencia de las enfermedades cronicas entre los ancianos, tales como la hipertension arterial sistemica, implica el crecimiento del consumo de medicamentos. En consecuencia, aumenta la incidencia de problemas relacionados a los medicamentos (PRM), dejando a esta poblacion vulnerable a varios problemas de salud. Basados en la literatura, destacamos la actuacion multiprofesional (medico, enfermero y farmaceutico) en las actividades ligadas directamente a la farmacoterapia de la hipertension arterial sistemica, para proporcionar a los ancianos una mayor comprension de los cuidados con su salud, reducir los PRM y alcanzar la adhesion satisfactoria

Blood pressure measurement: arm circumference and cuff size availability.

To avoid inaccurate blood pressure (BP) readings, the American Heart Association (AHA) recommends cuff width (CW) encircling 40% of the arm circumference (AC) and cuff length at least 80-100%. This study aimed to identify inpatients AC, the corresponding cuff size and the cuff size availability. In total, 81 AC were measured in the right arm. The cuff sizes to fit them were calculated according to AHA AC/CW width 0.40 ratio. The AC varied from 17.5 to 40.5 cm and the corresponding cuff width from 6 to 16 cm. The standard cuff 12 by 23 cm, the only size available in the clinics, was appropriate for only 17.3% of the subjects, whose AC varied between 32.5 and 34.3 cm. The lack of availability of different cuff sizes continues being a challenging problem to be faced. The standard cuff available, 12 cm large, did not fit 82.7% of the identified AC, resulting in over or underestimated BP registers.To avoid inaccurate blood pressure (BP) readings, the American Heart Association (AHA) recommends cuff width (CW) encircling 40% of the arm circumference (AC) and cuff length at least 80-100%. Objective: To identify inpatientsAC, the corresponding cuff size and the cuff size availability. Methods: 81 AC were measured in the right arm. The cuff sizes to fit them were calculated according to AHA AC/CW width 0.40 ratio. Results: The AC varied from 17.5 to 40.5 cm and the corresponding cuff width from 6 to 16cm. The standard cuff 12 by 23 cm, the only size available in the clinics, was appropriate for only 17.3% of the subjects, whose AC varied between 32.5 and 34.3 cm. Discussion: The lack of availability of different cuff sizes continues being a challenge problem to be faced. Conclusion: The standard cuff available, 12cm large, did not fit 82.7 of the identified AC, resulting in over or underestimated BP registers.

Utilização do óxido nítrico como terapêutica: implicações para a enfermagem

El oxido nitrico (NO) es un gas que transmite senales dentro del organismo. La transmision de la senal del gas producido en una celula atraviesa la membrana de la celula vecina y regula su funcion. Este mecanismo constituye un principio innovador de senalizacion de sistemas biologicos. Los descubridores del oxido nitrico como molecula senalizadora ganaran el Premio Nobel en 1998. Este gas ha creado una revolucion en la medicina, solucionando antiguos problemas. El objetivo de este trabajo es revisar la participacion del (NO) en patologias tales como la sepsis, hipertension e hipertension pulmonar. Son abordados tambien, aspectos importantes sobre la prestacion de cuidados de enfermeria a los pacientes tratados con esta terapia.Nitric oxide (NO) is a gas that transmits signals in the organism. Such signal transmission takes place by means of the gas synthesis and release in different cell types. After it is released, the gas penetrates the membrane of a neighboring cell and regulates its function. Such mechanism represents an entirely new signaling principle in biological systems. The discoverers of NO as a signaling molecule were awarded the Nobel Prize in Medicine and Physiology in 1998. This discovery has revolutionized medicine and originated new treatments for old problems. In this study, we review the role of NO in some pathologies such as sepsis, arterial hypertension and pulmonary hypertension and Nitric Oxide is explained in terms of its current merit for treatment and its impact on nursing care.Nitric oxide (NO) is a gas that transmits signals in the organism. Such signal transmission takes place by means of the gas synthesis and release in different cell types. After it is released, the gas penetrates the membrane of a neighboring cell and regulates its function. Such mechanism represents an entirely new signaling principle in biological systems. The discoverers of NO as a signaling molecule were awarded the Nobel Prize in Medicine and Physiology in 1998. This discovery has revolutionized medicine and originated new treatments for old problems. In this study, we review the role of NO in some pathologies such as sepsis, arterial hypertension and pulmonary hypertension and Nitric Oxide is explained in terms of its current merit for treatment and its impact on nursing care.

Fatores que interferem na adesão terapêutica medicamentosa em hipertensos

ABSTRACT Objective: To characterize the factors that interfere in drug treatment compliance in a group of individuals with arterial hypertension. Methods: A non-experimental descriptive study that analyzed a sample of 80 patients diagnosed with arterial hypertension, who underwent medical treatment and were admitted to a university hospital during the period from March to May 2009. To collect data, the Instrument for Evaluation of Attitudes Regarding Taking Medication was applied. Results: In the studied population, 45.1% had sufficient degree of compliance to drug therapy. Individuals with controlled blood pressure, females, white, single, married or widowed, retired, aged between 40 and 59 years, and those aged above 80 years were the interviewees who answered positively regarding compliance and follow-up of drug therapy. Conclusion: Despite the fact that the number of factors that facilitate the process of compliance to drug treatment is greater than the number of complicating factors, we found that more than half of the patients surveyed had an insufficient degree of compliance with drug treatment for high blood pressure, which demonstrates the need to develop studies aimed to identify these factors and their contribution to the promotion of patient autonomy, acceptance, awareness and adaptation regarding their illness.OBJECTIVE: To characterize the factors that interfere in drug treatment compliance in a group of individuals with arterial hypertension. METHODS: A non-experimental descriptive study that analyzed a sample of 80 patients diagnosed with arterial hypertension, who underwent medical treatment and were admitted to a university hospital during the period from March to May 2009. To collect data, the Instrument for Evaluation of Attitudes Regarding Taking Medication was applied. RESULTS: In the studied population, 45.1% had sufficient degree of compliance to drug therapy. Individuals with controlled blood pressure, females, white, single, married or widowed, retired, aged between 40 and 59 years, and those aged above 80 years were the interviewees who answered positively regarding compliance and follow-up of drug therapy. CONCLUSION: Despite the fact that the number of factors that facilitate the process of compliance to drug treatment is greater than the number of complicating factors, we found that more than half of the patients surveyed had an insufficient degree of compliance with drug treatment for high blood pressure, which demonstrates the need to develop studies aimed to identify these factors and their contribution to the promotion of patient autonomy, acceptance, awareness and adaptation regarding their illness.

Knowledge and practice outcomes after home blood pressure measurement education programs.

ObjectivesWe investigated the outcomes of three home blood pressure measurement (HBPM) education programs on adult knowledge and practice. MethodsWe chose a pretest/post-test design and randomly divided 95 adults into three groups: individual training (group A), group training (group B), and self-learning (group C), for education regarding HBPM in accordance with the Canadian Hypertension Education Program. Participants involved in groups A and B received interactive education led by a nurse. Participants in group C learned by themselves using an instruction booklet and a HBPM device lent to them for 7 days. Knowledge was assessed pretest and post-test by questionnaire. Skills were evaluated postintervention by direct observation. ResultsAnalysis of the 60 participants indicated significant knowledge improvement. Pretest scores of 38 (group A), 54 (group B), and 45% (group C) rose significantly to 97, 99, and 90%, respectively (pretest vs. post-test; P<0.0001). Individual and group training sessions were significantly more effective compared with the self-learning program, which was confirmed by differences between groups in post-test practice. Assessment scores: 74 (group A), 79 (group B), and 53% (group C; group A vs. group C; P=0.001, group B vs. group C; P=0.001). ConclusionOur findings indicate that adults attending an individual or group training program for HBPM retained its theoretical and practical principles better than those engaged in self-learning. Their success may be attributed to interaction with the nurse.

Medida da pressão arterial: circunferência braquial e disponibilidade de manguitos

To avoid inaccurate blood pressure (BP) readings, the American Heart Association (AHA) recommends cuff width (CW) encircling 40% of the arm circumference (AC) and cuff length at least 80-100%. This study aimed to identify inpatients AC, the corresponding cuff size and the cuff size availability. In total, 81 AC were measured in the right arm. The cuff sizes to fit them were calculated according to AHA AC/CW width 0.40 ratio. The AC varied from 17.5 to 40.5 cm and the corresponding cuff width from 6 to 16 cm. The standard cuff 12 by 23 cm, the only size available in the clinics, was appropriate for only 17.3% of the subjects, whose AC varied between 32.5 and 34.3 cm. The lack of availability of different cuff sizes continues being a challenging problem to be faced. The standard cuff available, 12 cm large, did not fit 82.7% of the identified AC, resulting in over or underestimated BP registers.To avoid inaccurate blood pressure (BP) readings, the American Heart Association (AHA) recommends cuff width (CW) encircling 40% of the arm circumference (AC) and cuff length at least 80-100%. Objective: To identify inpatientsAC, the corresponding cuff size and the cuff size availability. Methods: 81 AC were measured in the right arm. The cuff sizes to fit them were calculated according to AHA AC/CW width 0.40 ratio. Results: The AC varied from 17.5 to 40.5 cm and the corresponding cuff width from 6 to 16cm. The standard cuff 12 by 23 cm, the only size available in the clinics, was appropriate for only 17.3% of the subjects, whose AC varied between 32.5 and 34.3 cm. Discussion: The lack of availability of different cuff sizes continues being a challenge problem to be faced. Conclusion: The standard cuff available, 12cm large, did not fit 82.7 of the identified AC, resulting in over or underestimated BP registers.

Clientela com alterações cardíacas: perfil diagnóstico elaborado por alunos de enfermagem

No presente estudo buscaram-se os padroes de respostas humanas e as categorias diagnosticas identificadas por 16 alunos de graduacao em enfermagem junto a 22 pacientes portadores de alteracoes cardiacas, internados em um hospital escola. Foram encontrados 77 diagnosticos de enfermagem (D.E.), sendo 72,7% do padrao TROCAR, 10,3% do padrao CONHECER, 7,7% do padrao MOVER, 6,4% do padrao SENTIR e 2,5% do padrao RELACIONAR. As categorias diagnosticas encontradas com maior frequencia foram: Deficit de Conhecimento (9%); Debito Cardiaco Diminuido (7,7%); Excesso de Volume de Liquido (6,4%); Alteracao na nutricao para menos que o corpo necessita (6,4%) e Potencial para Infeccao (5,1%).The present study aimed at searching patterns of human responses and diagnoses categories identified by 16 undergraduate nursing students in 22 patients with cardiac alterations admitted in a School Hospital. 77 Nursing Diagnoses (ND) were found, 72,7% in the pattern of EXCHANGING, 7,7% in the pattern of MOVING, 6,4% in the pattern of FEELING and 2,5% in the pattern of RELATING. The predominant diagnoses categories were: knowledge deficit (9%), decreased cardiac output (7,7%), fluid volume excess (6,4%), altered nutrition less than body requirements (6,4%) and high risk for infection (5,1%).

Resources for Blood Pressure Screening Programs in Low Resource Settings: A Guide From the World Hypertension League

From the Department of Medicine, The University of Calgary, Calgary, AB, Canada; Departments of Medicine, Community Health Sciences and of Physiology and Pharmacology, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada; Public Health Foundation of India, New Delhi, India; World Hypertension League, Corvallis, MT; Department of Medicine, University of Calgary, Calgary, AB, Canada; American University of Beirut Medical Center, Beirut, Lebanon; Department of Nursing, Universit e du Qu ebec a Trois-Rivi eres, Quebec, QC, Canada; President Haiti Hypertension Center, State University of Haiti, Port Au Prince, Haiti; Colleagues in Care, Virginia Beach, VA; Douala School of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon; Universidad Nacional de C ordoba, C ordoba, Argentina; University of Sao Paulo, Ribeirao Preto, Brazil; and Beijing Hypertension League Institute, Beijing, China

VIVENCIAS DE UN EQUIPO MULTIPROFESIONAL EN LA ATENCIÓN AVANZADA PREhOSPITALARIA MÓVIL AL ADULTO EN SITUACIÓN DE EMERGENCIA CON PARO CARDIORRESPIRATORIO.

Estudio de caracter cualitativo y exploratorio que tuvo como objetivo investigar la vivencia del equipo multiprofesional en la asistencia al adulto con situacion de emergencia cardiorrespiratoria, en la unidad de suporte vital avanzado (USA) de atencion prehospitalaria movil (APH). Para la recoleccion de datos se utilizo la entrevista semi-estructurada que comprendio preguntas acerca del perfil sociodemografico y profesional, al igual que preguntas dirigidas al tema. La muestra fue constituida por 16 profesionales del USA. Los datos fueron organizados por medio del analisis de contenido segun Bardin (1977), identificando cuatro temas: percepciones de los profesionales acerca del APH movil avanzado, los sentimientos y emociones del equipo frente a la atencion de PCR, identificacion de los agentes estresantes en situacion de PCR y las reacciones de estres durante en la atencion. El equipo relata sus vivencias como un trabajo desafiante y dificil ante las situaciones inesperadas, desconocidas y angustiantes, siendo capaces de percibir satisfacciones personales y realizacion profesional. Se evidenciaron en las demas categorias analizadas las siguientes expresiones: la busqueda de conocimiento y constante capacitacion tecnica, habilidad y agilidad, toma de decisiones, trabajo en equipo, dificultad en lidiar con los sufrimientos de los familiares, manifestaciones emocionales, trabajar con altas temperaturas, dificultad de lidiar con la muerte, manifestando sentimientos de impotencia, frustracion y tristeza. Por lo tanto el equipo se enfrenta con la posibilidad de vivir con el sufrimiento psiquico al justificarlo como una necesidad de desarrollar la reflexion y discusion de los aspectos tecnicos, cientificos y eticos que se refieren a la atencion del paciente en PCR en las diferentes situaciones que ocurren durante la atencion, buscando asi una mejoria en la calidad prestada y en las relaciones interpersonales.