Marília Mendes Nunes

Clinical Differentiation of Respiratory Nursing Diagnoses among Children with Acute Respiratory Infection

The aim of this study was to identify the defining characteristics that allow clinical differentiation of the nursing diagnoses, ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE). A secondary analysis with a cohort design was developed from 1128 records obtained during the hospital stay of 136 children with acute respiratory infection. Groups of defining characteristics with greater differentiation capacity were identified by multiple correspondence analyses. The results showed that the defining characteristics that better differentiate the studied diagnoses are agitation, irritability and diaphoresis for IGE; dyspnea, use of accessory muscles to breathe, orthopnea, and abnormal breathing pattern for IBP and excessive sputum, absence of cough, difficulty verbalizing, nasal flaring, and adventitious breath sounds for IAC. Twelve defining characteristics that can assist clinicians to differentiate the three main respiratory nursing diagnoses among children with acute respiratory infection were identified in this study.

Indicadores clínicos do diagnóstico de enfermagem: Proteção ineficaz em adolescentes com câncer

OBJECTIVE To investigate scientific evidence related to the term protection and clinical indicators and etiologic factors for nursing diagnosis Ineffective protection in adolescents with cancer. METHOD Integrative literature review in the databases of Scopus, Web of Science, National Library of Medicine and National Institutes of Health (PubMed) and Cochrane; by intersection of the descriptors protection and childhood cancer, which resulted in seven articles. These were insufficient for a comprehension of the term protection and aspects related to its impairment, therefore it was necessary to include a further three reference books. RESULTS Five clinical indicators and three etiologic factors associated to Ineffective protection were identified some of which were not cited in NANDA-International. CONCLUSIONS There are clinical and etiologic factors important for the identification of ineffective protection in adolescents with cancer.

Classification tree to screen for the nursing diagnosis Ineffective airway clearance

OBJECTIVE to identify the defining characteristics of Ineffective airway clearance with better predictive power using classification trees. METHOD the predictive power of the defining characteristics of Ineffective airway clearance was evaluated based on classification trees generated from the data of 249 children with acute respiratory infection. RESULTS Ineffective cough and adventitious breath sounds were identified as the main defining characteristics when screening for Ineffective airway clearance in accordance with trees based on three different computational algorithms. CONCLUSION Ineffective coughing and adventitious breath sounds had better predictive capacity for Ineffective airway clearance in the sample.

Processo de enfermagem informatizado: construção de tecnologia móvel para uso em neonatos

OBJECTIVE to build a mobile technology to assist nurses during data collection, diagnostic reasoning, and identification of interventions in neonates. METHOD methodological study with a qualitative approach. The development was carried out in three phases, namely: bibliographical survey, construction of a database of diagnosis/interventions, and development of the software. We used the development tools Ruby on Rails, IONIC 2, PostgresSQL, and Amazon EC2. RESULTS The developed technology received the name Natus, able to contribute to the development of the nursing process applied to patients of neonatal units. Its requirements are: to define human needs, select nursing diagnoses, select interventions, define time periods, and issue printed files. FINAL CONSIDERATIONS the technology built is a computerized tool that allows for the development of the nursing process, facilitating data collection, diagnostic reasoning, and identification and grouping of the clinical signs presented by the newborn in neonatal units.

Impaired comfort in children and adolescents with cancer

OBJECTIVE To determine the strength of the association between the clinical indicators of Impaired Comfort and the evaluation sector in the hospital, age group and sex of patients with cancer. METHOD Cross-sectional study, conducted in a childrens hospital, with 192 children and adolescents. For the collection, we used an instrument developed for the study. RESULTS The majority of the sample was male, with mean age of 11 years. The indicators most evidenced among the hospitalized patients were Crying, Report of lack of satisfaction with the situation, Report of feeling cold, and Report of feeling uncomfortable. Crying and Fear were more prevalent in children compared with adolescents, and boys were the ones that verbalized the most the Report of lack of satisfaction with the situation. CONCLUSION This study enabled determining the strength of the association of the indicators of Impaired Comfort expressed by children and adolescents with cancer.

Validation of Clinical Indicators of the Nursing Diagnosis of Ineffective Protection in Adolescents With Cancer

Purpose: To validate the clinical indicators of the nursing diagnosis of Ineffective protection in adolescents with cancer based on diagnostic accuracy measurements. Design and Methods: Measurements of sensitivity and specificity for the indicators were calculated using latent class analysis with random effects in a sample of 127 adolescents between 10 and 19 years of age. Results: The prevalence of diagnosis was estimated at 93.7%. The indicators deficient immunity and weakness showed higher sensitivity values, whereas opportunistic infections, recurrent infections, insomnia, mucosal lesions, and coughing showed high specificity. Conclusions: Seven indicators were clinically validated. Practice Implications: The validation of clinical indicators provides nurses with the knowledge of useful signs and symptoms to identify early spectra of a nursing diagnosis or confirm their presence in a specific population. In clinical practice, this knowledge contributes to an accurate diagnostic inference and the planning of nursing interventions directed to the idiosyncrasies of individuals. Highlights:The study clinically validates the indicators of nursing diagnosis Ineffective protection in adolescents with cancer.Seven clinical indicators presented better measures of accuracy, according to a latent class analysis with random effects.Some differences were observed in measures of accuracy in latent class models adjusted for specifics groups.

Impaired Gas Exchange: Prognostic Clinical Indicators of Short-Term Survival in Children with Acute Respiratory Infection: Prognostic indicators IGE

PURPOSE To establish prognostic indicators of survival for impaired gas exchange (IGE) (00030). METHODS Secondary analysis of data from an open prospective cohort developed with a group of 136 children with acute respiratory infection (ARI). FINDINGS On Day 1, IGE (00030) was present in 42.6% of the sample. New cases arose until the last day of evaluation. With regards to defining characteristics, only hypoxemia and abnormal skin color were associated with a higher risk of developing diagnosis. CONCLUSIONS Children with ARI who exhibit hypoxemia and abnormal skin color had a worse prognosis for IGE (00030). IMPLICATIONS FOR NURSE PRACTICE Nurses can use the research findings as a predictive marker of the evolution of the patients health status.

ELABORAÇÃO DE INSTRUMENTO DE COLETA DE DADOS PARA INFERÊNCIA DOS DIANÓSTICOS DE ENFERMAGEM BAIXA AUTOESTIMA CRÔNICA E BAIXA AUTOESTIMA SITUACIONAL EM PACIENTES COM HUMOR DEPRIMIDO

2Enfermeiro. Doutor. Professor Associado IV da Universidade Federal do Ceará (UFC). Enfermeira. Doutora. Professora adjunta da Universidade Estadual do Ceará (UECE). Enfermeira. Mestre. Universidade Federal do Ceará (UFC). Enfermeira. Universidade Federal do Ceará (UFC). Enfermeiro. Coordenador de Enfermagem do CAPS AD do Município de QuixeramobimCeará. Enfermeiro. Especialista. Coordenador de Enfermagem do Hospital de Saúde Mental Professor Frota Pinto (HSM). ELABORAÇÃO DE INSTRUMENTO DE COLETA DE DADOS PARA INFERÊNCIA DOS DIANÓSTICOS DE ENFERMAGEM BAIXA AUTOESTIMA CRÔNICA E BAIXA AUTOESTIMA SITUACIONAL EM PACIENTES COM HUMOR DEPRIMIDO

Prognostic clinical indicators of short-term survival for ineffective breathing pattern in children with acute respiratory infection.

AIMS AND OBJECTIVES To identify prognostic clinical indicators of short-term survival for ineffective breathing pattern in children with acute respiratory infection. BACKGROUND Despite the studies of survival for nursing diagnosis, there is not enough evidence about the clinical indicators that are associated with a worse prognosis for ineffective breathing pattern. DESIGN A prospective cohort study. METHODS One hundred and thirty-six children were followed up for a minimum of six and a maximum of 10 consecutive days. The survival rate for ineffective breathing pattern was calculated using Nelson-Aalens method. An extended Cox model was adjusted to identify the main prognostic clinical indicators for this nursing diagnosis. RESULTS Over half of the sample had an ineffective breathing pattern at the first evaluation. The occurrence of new cases was observed until the ninth day of monitoring, and the survival rate after this day was low. According to the Cox model, the main clinical indicators of a poor prognosis were an abnormal breathing pattern, the use of accessory muscles, dyspnoea and increase in the anterior-posterior chest diameter. CONCLUSIONS Children with acute respiratory infection who present with an abnormal breathing pattern, the use of accessory muscles to breathe, dyspnoea and increased anterior-posterior diameter have a poor prognosis for an ineffective breathing pattern. RELEVANCE TO CLINICAL PRACTICE Survival analyses of nursing diagnoses allow the identification of clinical indicators that can be used in clinical practice as prognostic markers. The identification of indicators associated with a poor clinical prognosis allows nurses to intervene early and to maximise the possibility of a good outcome.

Estilo de vida sedentário em indivíduos com hipertensão arterial

OBJECTIVE to identify the prevalence of nursing diagnosis Sedentary lifestyle (SL) and to analyze its association with clinical indicators (CI) and related factors (RF) in patients with hypertension. METHOD cross-sectional study with 285 patients with hypertension at a reference center for outpatient care in Northeastern Brazil. To collect data it was used an instrument based on operational defi nitions of the CI and RF previously validated. Four nurses rated SL as present or absent. To evaluate the association between CI and RF with the presence of SL it was applied the chi-square test. The prevalence ratio and confi dence interval was calculated to verify the magnitude of the effect between RF and SL. RESULTS SL was identifi ed in 55.8% of the sample. Five IC and six RF showed a signifi cant association with SL. CONCLUSION the study identifi es main indicators for inference of SL as well as their possible causal factors among people with hypertension.