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A pessoa com doença renal crónica: Contributos do enfermeiro especialista em Enfermagem Médico-Cirúrgica, na área de enfermagem à Pessoa em Situação Crónica
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O presente relatório constitui um relato descritivo, fundamentado e crítico-reflexivo do percurso
formativo realizado no âmbito do Estágio de natureza profissional com relatório – Módulo II –
unidade curricular do plano de estudos do Mestrado em Enfermagem Médico-Cirúrgica, na área
de Enfermagem à Pessoa em Situação Crónica, a funcionar na Escola Superior de Enfermagem
do Porto.
A base estruturante deste relatório foi a implementação de um projeto de estágio intitulado "A
pessoa com doença renal crónica: contributos do enfermeiro especialista em enfermagem
médico-cirúrgica na área da pessoa em situação crónica", concebido para responder a
necessidades identificadas previamente nos mesmos contextos clínicos em que decorreu o
Estágio. A operacionalização do projeto assentou na definição de objetivos específicos e na
implementação de ações diferenciadas, orientadas para as necessidades individuais das
pessoas com Doença renal crónica pessoa e adaptadas aos contextos clínicos.
O estágio decorreu em duas unidades especializadas: uma unidade de internamento de
nefrologia e uma unidade de hemodiálise. Neste âmbito, foram prestados cuidados de
enfermagem a pessoas em diferentes fases da terapêutica de substituição da função renal,
nomeadamente em programa regular de hemodiálise e em fase pós-transplante renal. As
intervenções de enfermagem privilegiaram a promoção da adaptação à doença, a capacitação
para o autocuidado, a autogestão do regime terapêutico e a vigilância do acesso vascular, bem
como a gestão de sinais e sintomas ou a monitorização clínica com recurso a exames
complementares, como o ecodoppler. Este percurso teve como denominador comum a conceção
de cuidados de enfermagem. A título de exemplo deste processo de conceção, é apresentado na
plataforma pedagógica «e4nursing» um caso clínico relativo a uma pessoa em início de
hemodiálise. Este caso, para além de ser apresentado com base na ontologia de enfermagem, é
enquadrado nas teorias do Autocuidado e das Transições.
A realização deste estágio revelou-se extremamente enriquecedora, contribuindo
determinantemente para o desenvolvimento das competências comuns e específicas do
enfermeiro especialista previstas nos Regulamentos n.º 429/2018 e n.º 140/2019 da Ordem dos
Enfermeiros. Destaca-se, em particular, o reforço das competências clínicas, de gestão, de
tomada de decisão e de reflexão crítica no acompanhamento da pessoa com doença renal
crónica em contexto de internamento hospitalar e de ambulatório.
This report is a descriptive, well-founded and critical-reflective account of the training carried out as part of the Professional Internship with report - Module II - a curricular unit of the Master's Degree in Medical-Surgical Nursing, in the area of Nursing for People in Chronic Situations, at the Escola Superior de Enfermagem do Porto. The structuring basis of this report was the implementation of an internship project entitled "The person with chronic kidney disease: contributions of the specialist nurse in medical-surgical nursing in the area of the person in a chronic situation", designed to respond to previously identified needs in the same clinical contexts in which the internship took place. The operationalization of the project was based on the definition of specific objectives and the implementation of differentiated actions, geared towards the individual needs of people with chronic kidney disease and adapted to the clinical contexts. The internship took place in two specialized units: a nephrology inpatient unit and a hemodialysis unit. In this context, nursing care was provided to people at different stages of renal function replacement therapy, namely in a regular hemodialysis program and in the postrenal transplant phase. The nursing interventions focused on promoting adaptation to the disease, training for self-care, self-management of the therapeutic regimen and monitoring vascular access, as well as managing signs and symptoms or clinical monitoring using complementary tests such as Doppler ultrasound. The common denominator of this journey was the design of nursing care. As an example of this design process, a clinical case concerning a person starting hemodialysis is presented on the “e4nursing” teaching platform. This case, as well as being presented on the basis of nursing ontology, is framed within the theories of Self- Care and Transitions. This internship proved to be extremely enriching, making a decisive contribution to the development of the common and specific competences of specialist nurses, as set out in Regulations 429/2018 and 140/2019 of the Order of Nurses. Particularly noteworthy is the strengthening of clinical, management, decision-making and critical reflection skills in the care of people with chronic kidney disease in inpatient and outpatient settings.
This report is a descriptive, well-founded and critical-reflective account of the training carried out as part of the Professional Internship with report - Module II - a curricular unit of the Master's Degree in Medical-Surgical Nursing, in the area of Nursing for People in Chronic Situations, at the Escola Superior de Enfermagem do Porto. The structuring basis of this report was the implementation of an internship project entitled "The person with chronic kidney disease: contributions of the specialist nurse in medical-surgical nursing in the area of the person in a chronic situation", designed to respond to previously identified needs in the same clinical contexts in which the internship took place. The operationalization of the project was based on the definition of specific objectives and the implementation of differentiated actions, geared towards the individual needs of people with chronic kidney disease and adapted to the clinical contexts. The internship took place in two specialized units: a nephrology inpatient unit and a hemodialysis unit. In this context, nursing care was provided to people at different stages of renal function replacement therapy, namely in a regular hemodialysis program and in the postrenal transplant phase. The nursing interventions focused on promoting adaptation to the disease, training for self-care, self-management of the therapeutic regimen and monitoring vascular access, as well as managing signs and symptoms or clinical monitoring using complementary tests such as Doppler ultrasound. The common denominator of this journey was the design of nursing care. As an example of this design process, a clinical case concerning a person starting hemodialysis is presented on the “e4nursing” teaching platform. This case, as well as being presented on the basis of nursing ontology, is framed within the theories of Self- Care and Transitions. This internship proved to be extremely enriching, making a decisive contribution to the development of the common and specific competences of specialist nurses, as set out in Regulations 429/2018 and 140/2019 of the Order of Nurses. Particularly noteworthy is the strengthening of clinical, management, decision-making and critical reflection skills in the care of people with chronic kidney disease in inpatient and outpatient settings.
Descrição
Palavras-chave
Enfermagem Doença Renal Crónica Autogestão do Regime Terapêutico Ecodoppler