NURSES CARES IN THE UNIT OF POSTANAESTHETIC RESUSCITATION FOR PATIENTS GIVEN TO HYPOPHYSEAL SURGERY TRANSSPHENOIDALLY.
Abstract
Introduction: The patients with hypophyseal tumors given to transsphenoidal hypophysectomy (T.H.) can present multiple endocrine disorders and develop specific complications inherent in the surgical technology, together with hormonal alterations due to the manipulation of the gland. These alterations usually appear in the first 24 hours of postoperative period during their stay in the Post Anesthetia Care Unit (P.A.C.U.). Objectives: To unify nursing performance criteria. To elaborate a standardized care programme. To monitor and detect in advance potential complications in the immediate postoperative period of the patients given to hypophyseal surgery transsphenoidally, admitted to our unit. Methodology: We carried out a study on 30 patients operated on T.H. in our Hospital in the last two years, checking the first 24 hours of the postoperative period and collecting the following parameters: Haemodynamic Data (T.A., F.C., P.V.C., T ª); Hourly Diuresis, analytical data (Hb., Htco., ions, osmolaridad, acid – base balance); Water balance, complications and postoperative treatment. A program about standardized cares based on the P.A.C.U. nursing professionals experience was carried out following the taxonomy of N.A.N.D.A., N.I.C. and N.O.C. Results: The average age of the patients was over 37 +/-15 years old. The monitoring consisted of E.C.G., Sat. O2, arterial tension, P.V.C., T ª and hourly diuresis in all cases. The most frequent complication detected was the diabetes insipidus in 70% of the cases; other complications were nauseas, vomits in 20% and arterial hypertension in 15%. Conclusions: By means of the application of the programme of standardized cares in the patients given to hypophyseal surgery transsphenoidally, the care quality has been improved. As well as a quick control of the postoperative complications has been detected. The patient stay in the P.A.C.U. has been shortened and the beginning of an early treatment of the diabetes insipidus has been facilitated.Downloads
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