RESUMEN
This article describes the characteristics of unit-based nursing research, highlighting the experiences of staff nurses on two critical care units. On both units, study findings facilitated changes in practice. The authors evaluate their experience and offer suggestions to critical care nurses interested in unit-based research.
Asunto(s)
Investigación en Enfermería Clínica/organización & administración , Unidades de Cuidados Intensivos , Investigación en Enfermería/organización & administración , Personal de Enfermería en Hospital/provisión & distribución , Investigadores/provisión & distribución , Investigación en Enfermería Clínica/métodos , Humanos , Recursos HumanosAsunto(s)
Procedimientos Quirúrgicos Cardíacos/enfermería , Cardiopatías/enfermería , Trasplante de Corazón , Calidad de Vida , Procedimientos Quirúrgicos Cardíacos/psicología , Procedimientos Quirúrgicos Cardíacos/rehabilitación , Cardiopatías/psicología , Cardiopatías/rehabilitación , Humanos , Estilo de VidaRESUMEN
Infection is a major cause of morbidity and mortality in heart transplantation. Therefore protective isolation has been an inherent part of our postoperative regimen. For retrospective review we selected patients before and after modification of protective isolation. The intensity of protective isolation appeared to have no impact on incidence, morbidity, or mortality resulting from infection in these study groups.
Asunto(s)
Trasplante de Corazón , Infecciones Oportunistas/prevención & control , Aislamiento de Pacientes , Complicaciones Posoperatorias , Animales , Suero Antilinfocítico/uso terapéutico , Azatioprina/uso terapéutico , Ciclosporinas/uso terapéutico , Rechazo de Injerto , Caballos , Humanos , Unidades de Cuidados Intensivos , Infecciones Oportunistas/etiología , Complicaciones Posoperatorias/mortalidadAsunto(s)
Trasplante de Corazón , Inmunosupresores/efectos adversos , Calidad de Vida , Adulto , Azatioprina/efectos adversos , Ciclosporinas/efectos adversos , Disfunción Eréctil/inducido químicamente , Femenino , Humanos , Masculino , Trastornos de la Menstruación/inducido químicamente , Persona de Mediana Edad , Trastornos del Humor/inducido químicamente , Prednisona/efectos adversos , Enfermedades de la Piel/inducido químicamenteRESUMEN
This article discusses nursing care of the patient who requires hemodynamic monitoring. This will include care of the patient who requires intra-arterial pressure monitoring, central venous pressure (CVP) monitoring, left atrial pressure (LAP) monitoring, and monitoring of left heart pressures, cardiac output, and systemic vascular resistance using a pulmonary artery (PA) catheter.
Asunto(s)
Hemodinámica , Monitoreo Fisiológico , Atención de Enfermería , Función Atrial , Determinación de la Presión Sanguínea/instrumentación , Calibración , Cateterismo Cardíaco/instrumentación , Gasto Cardíaco , Presión Venosa Central , Humanos , Monitoreo Fisiológico/instrumentación , Transductores de PresiónRESUMEN
Stanford University Medical Center has successfully utilized a left ventricular assist device as bridge support for 9 days in a 52-year-old man awaiting heart transplantation. During this time he developed a pericardial tamponade, but no other serious medical complications occurred. Major nursing care issues focused on pain control, vigorous pulmonary toilet, and left ventricular assist device timing. This article outlines the responsibilities of critical care nurses and what was learned from the experience. The recipient was discharged home 106 days after heart transplantation.
Asunto(s)
Circulación Asistida , Trasplante de Corazón , Corazón Auxiliar , Circulación Asistida/enfermería , Corazón Auxiliar/enfermería , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Since the introduction of cyclosporine, 183 heart transplants have been performed at Stanford University Medical Center. Although cyclosporine has improved survival rates, it is also associated with progressive renal dysfunction. Seventeen of these recipients have been converted from cyclosporine-based therapy to azathioprine-based therapy because of significant nephrotoxicity. Fourteen of these recipients participated in a study to examine change in physical symptoms since immunoconversion. Most reported little change in physical symptoms following conversion, although 79% experienced rejection following the drug change. Overall, the change in immunosuppressive medications had little impact on perceived symptoms.
Asunto(s)
Azatioprina/efectos adversos , Ciclosporinas/efectos adversos , Trasplante de Corazón , Adolescente , Adulto , Azatioprina/uso terapéutico , Ciclosporinas/uso terapéutico , Femenino , Rechazo de Injerto , Humanos , Terapia de Inmunosupresión/efectos adversos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Trasplante Homólogo/mortalidadRESUMEN
This study investigated perceived life satisfaction and quality of life reported by heart transplant recipients. The impact of life change following transplantation and problems associated with side-effects of the immunosuppressive therapy were also examined. Questionnaires were mailed to one hundred heart transplant recipients. All had survived at least six months after the operation. Seventy-five completed the questionnaire. Eighty-nine percent of those reported good to excellent quality of life. Life satisfaction was reported as good to very satisfactory by 82%. The considerable change in life style following transplantation was mostly perceived as positive. All recipients experienced some side-effects from the immunosuppressive therapy. However, these physical symptoms had little impact upon the overall positive evaluation of life quality and life satisfaction.