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A pessoa submetida a cirurgia cardíaca : Intervenção do enfermeiro especialista em enfermagem de reabilitação na unidade de cuidados intensivos
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Orientador(es)
Resumo(s)
A cirurgia cardíaca está associada a um conjunto de alterações fisiopatológicas, que colocam a pessoa suscetível ao desenvolvimento de complicações no período pós-operatório, particularmente respiratórias, com impacto negativo no tempo de internamento hospitalar, na morbilidade, mortalidade e nos custos em saúde, pelo que a sua prevenção e tratamento precoces são fundamentais.
O Enfermeiro Especialista em Enfermagem de Reabilitação detém competências que lhe permitem uma intervenção diferenciada à pessoa no pós-operatório de cirurgia cardíaca na Unidade de Cuidados Intensivos, através da implementação de planos de cuidados multidimensionais, centrados na pessoa e família, com o intuito de prevenir, minimizar e tratar as referidas complicações, bem como, melhorar a capacidade funcional, promover o autocuidado e a qualidade de vida.
O presente relatório de estágio procura evidenciar, de forma descritiva e reflexiva, o percurso de aquisição das competências especializadas de Enfermagem de Reabilitação e das competências do grau de Mestre, sustentado pela Teoria do Défice de Autocuidado de Dorothea Orem, bem como, por uma Revisão Integrativa da Literatura. As experiências vivenciadas e as atividades desenvolvidas durante o estágio, possibilitaram concretizar os objetivos delineados.
No âmbito da temática subjacente a este relatório, a pesquisa e o percurso de formação efetuados permitiram compreender que o Enfermeiro Especialista em Enfermagem de Reabilitação deve iniciar a sua intervenção de forma precoce, nas primeiras 24 horas de pós-operatório, quando garantidas condições de segurança que assentam na estabilidade clínica, hemodinâmica e elétrica do cliente. A evidência encontrada confirma que as intervenções a realizar incluem estratégias de mobilização precoce, técnicas de reeducação funcional respiratória e motora, treino dos músculos respiratórios, pressão positiva das vias aéreas, oxigenoterapia de alto fluxo e treino de atividades de vida diária, realizadas de forma individualizada, com vista à promoção da saúde, à prevenção de complicações e à capacitação da pessoa e família para uma transição segura para o domicílio.
Cardiac surgery is associated with a set of pathophysiological changes that make the person susceptible to the development of complications in the postoperative period, particularly respiratory disorders, which have a negative impact on the length of hospital stay, morbidity, mortality and health costs, which is why their prevention and early treatment are essential. The Specialist Nurse in Rehabilitation Nursing has the skills to provide a differentiated intervention for the person after cardiac surgery in the Intensive Care Unit, through the implementation of multidimensional care plans, on the person and family-centred care, with the aim of preventing, minimizing and treating these complications, as well as improving functional capacity, promoting self-care and quality of life. This internship report seeks to show, in a descriptive and reflective way, the path taken to acquire the specialized Rehabilitation Nursing skills and Master's degree skills, supported by Dorothea Orem's Self-Care Deficit Theory and an Integrative Literature Review. The experiences and activities developed during the internship made it possible to achieve the objectives outlined. In the context of the theme underlying this report, the research and formative path have allowed it to understand that the Specialist Nurse in Rehabilitation Nursing should start their intervention early, in the first 24 hours of the postoperative period, when safety conditions are guaranteed, based on the patient's clinical, hemodynamic and electrical stability. The evidence found confirms that this intervention include early mobilization strategies, respiratory and physical therapy techniques, respiratory muscle training, continuous positive airway pressure, high-flow oxygen therapy and activities of daily living training, carried out individually, in order to promote health, preventing complications and enabling the person and family to make a safe transition to home.
Cardiac surgery is associated with a set of pathophysiological changes that make the person susceptible to the development of complications in the postoperative period, particularly respiratory disorders, which have a negative impact on the length of hospital stay, morbidity, mortality and health costs, which is why their prevention and early treatment are essential. The Specialist Nurse in Rehabilitation Nursing has the skills to provide a differentiated intervention for the person after cardiac surgery in the Intensive Care Unit, through the implementation of multidimensional care plans, on the person and family-centred care, with the aim of preventing, minimizing and treating these complications, as well as improving functional capacity, promoting self-care and quality of life. This internship report seeks to show, in a descriptive and reflective way, the path taken to acquire the specialized Rehabilitation Nursing skills and Master's degree skills, supported by Dorothea Orem's Self-Care Deficit Theory and an Integrative Literature Review. The experiences and activities developed during the internship made it possible to achieve the objectives outlined. In the context of the theme underlying this report, the research and formative path have allowed it to understand that the Specialist Nurse in Rehabilitation Nursing should start their intervention early, in the first 24 hours of the postoperative period, when safety conditions are guaranteed, based on the patient's clinical, hemodynamic and electrical stability. The evidence found confirms that this intervention include early mobilization strategies, respiratory and physical therapy techniques, respiratory muscle training, continuous positive airway pressure, high-flow oxygen therapy and activities of daily living training, carried out individually, in order to promote health, preventing complications and enabling the person and family to make a safe transition to home.
Descrição
Palavras-chave
Enfermagem em reabilitação Cirurgia torácica Cuidados críticos Reabilitação cardíaca