Myocardial oxygen consumption in the bed bath and shower bath in patients with acute coronary syndrome.

BACKGROUND: Bed and shower hygiene measures are performed by the nursing staff in patients admitted with Acute Coronary Syndrome (ACS). Few studies have evaluated the difference in energy consumption between the two types of bath. OBJECTIVES: To analyse and compare the variation in Heart Rate (HR), Systolic Blood Pressure (SBP) and rate-pressure-product (RPP) between bed and shower bath in ACS patients. DESIGN: Quantitative, analytical, prospective study. SETTINGS: This study was conducted in a Coronary Intensive Care Unit, including patients over 18 years admitted for ACS in Killip classes I and II. MAIN OUTCOME MEASURES: The level of myocardial oxygen consumption was assessed by calculating the RPP before, immediately after and 5 minutes after the first bed bath and the first shower bath. Differences in mean RPP before, during and 5 minutes after each body hygiene were compared using the paired-samples Student's t-test. RESULTS: Seventy patients were included. No important clinical variation was found in HR, SBP and RPP during bed bath and during shower bath. The comparison of HR, SBP and RPP between bed bath and shower showed no statistically significant difference. CONCLUSION: Bed bath and shower bath did not significantly increase energy expenditure in patients with acute coronary syndrome and there was no difference in energy expenditure between the two types of body hygiene.

Accuracy of the Defining Characteristics of Fatigue in Patients with Heart Failure as Identified by the 6-Minute Walking Test.

PURPOSE: Identify the prevalence of the nursing diagnosis (ND) Fatigue in patients with heart failure (HF) and to analyze the accuracy of its defining characteristics (DCs). METHODS: 50 patients were assessed for Fatigue through a distance ambulated <300m during the Six-Minute Walking Test (6MWT) and the report of insufficient energy. Sensitivity, specificity, positive and negative predictive values were calculated for the DCs associated with Fatigue. FINDINGS: The prevalence of Fatigue was 48%. No DCs were sensitive and specific for determining Fatigue. CONCLUSIONS: There were no DCs accurate enough to infer Fatigue. IMPLICATIONS FOR PRACTICE: A distance ambulated <300m during the 6MWT should be included as a DC of Fatigue.