Shock mixto en paciente con infarto agudo de miocardio: intervenciones enfermeras / Mixed shock in patients with acute myocardial infarction: Nursing interventions

El tratamiento del shock cardiogénico incluye el uso de terapias de asistencia circulatoria cuando el tratamiento médico ha sido insuficiente y pueden ser un puente a decisión ya que conceden tiempo para evaluar la situación del paciente y tener en cuenta las diferentes opciones terapéuticas existentes. El objetivo de este artículo es desarrollar un plan de cuidados óptimo e individualizado utilizando la taxonomía NANDA-NOC-NIC. Observación clínica Se realizó una valoración enfermera según las necesidades de Virginia Henderson donde destacaron 2 necesidades alteradas: respiración y circulación, ya que la paciente precisó de ventilación mecánica invasiva (VMI) y requirió soporte de asistencia circulatoria mecánica. Intervenciones De acuerdo con las necesidades destacadas, se priorizaron 5 diagnósticos según la taxonomía NANDA utilizando el modelo de Análisis de Resultado del Estado Actual (AREA): riesgo de disminución del gasto cardíaco, deterioro de la ventilación espontánea, deterioro de la integridad tisular, riesgo del síndrome de desuso, riesgo de infección y riesgo de hipotermia. Discusión y conclusiones Los criterios de resultados evidenciaron una evolución favorable pasadas 96h. El desarrollo del lenguaje estandarizado NANDA-NOC-NIC nos permitió organizar el plan de cuidados enfermero. (AU)

Introduction and objectives We present a clinical case of a 40-year-old woman diagnosed with acute myocardial infarction (AMI) in Killip I who was admitted to our hospital. She experienced complications in the haemodynamic lab and in the operating room, including cardiogenic and anaphylactic shock requiring ventricular assist support. Conservative management support with inotropes and vasopressors in cardiogenic shock has been shown to be insufficient in many patients to maintain adequate perfusion and prevent irreversible multiple organ dysfunction syndrome. For this reason, short-term mechanical circulatory support systems are increasing substantially. The objective of this article is to develop optimal and individualised care plans using the NANDA, NOC, NIC taxonomies. Clinical observation An evaluation based on Virginia Hendersońs basic needs was made, and two altered needs stood out: breathing and circulation. The patient required mechanical ventilation and mechanical circulatory support. Interventions In relation to the highlighted needs, six diagnoses were prioritized according to the NANDA taxonomy using the Análisis de Resultado del Estado Actual (AREA) (Outcome-Present State Test (OPT)) model: risk of decreased cardiac output, impaired spontaneous ventilation, impaired tissue integrity, risk of disuse syndrome, risk of infection and risk of hypothermia. Discussion and conclusions Outcome criteria scores showed a favourable evolution after 96h. The development of a standardized NANDA-NOC-NIC language allowed us to organize the nursing care plan. (AU)

Mixed shock in patients with acute myocardial infarction: Nursing interventions.

INTRODUCTION AND OBJECTIVES: We present a clinical case of a 40-year-old woman diagnosed with acute myocardial infarction (AMI) in Killip I who was admitted to our hospital. She experienced complications in the haemodynamic lab and in the operating room, including cardiogenic and anaphylactic shock requiring ventricular assist support. Conservative management support with inotropes and vasopressors in cardiogenic shock has been shown to be insufficient in many patients to maintain adequate perfusion and prevent irreversible multiple organ dysfunction syndrome. For this reason, short-term mechanical circulatory support systems are increasing substantially. The objective of this article is to develop optimal and individualised care plans using the NANDA, NOC, NIC taxonomies. CLINICAL OBSERVATION: An evaluation based on Virginia Henderson's basic needs was made, and two altered needs stood out: breathing and circulation. The patient required mechanical ventilation and mechanical circulatory support. INTERVENTIONS: In relation to the highlighted needs, six diagnoses were prioritized according to the NANDA taxonomy using the Análisis de Resultado del Estado Actual (AREA) (Outcome-Present State Test (OPT)) model: risk of decreased cardiac output, impaired spontaneous ventilation, impaired tissue integrity, risk of disuse syndrome, risk of infection and risk of hypothermia. DISCUSSION AND CONCLUSIONS: Outcome criteria scores showed a favourable evolution after 96 h. The development of a standardized NANDA-NOC-NIC language allowed us to organize the nursing care plan.

Mixed shock in patients with acute myocardial infarction: Nursing interventions. / Shock mixto en paciente con infarto agudo de miocardio: intervenciones enfermeras.

INTRODUCTION AND OBJECTIVES: We present a clinical case of a 40-year-old woman diagnosed with acute myocardial infarction (AMI) in Killip I who was admitted to our hospital. She experienced complications in the haemodynamic lab and in the operating room, including cardiogenic and anaphylactic shock requiring ventricular assist support. Conservative management support with inotropes and vasopressors in cardiogenic shock has been shown to be insufficient in many patients to maintain adequate perfusion and prevent irreversible multiple organ dysfunction syndrome. For this reason, short-term mechanical circulatory support systems are increasing substantially. The objective of this article is to develop optimal and individualised care plans using the NANDA, NOC, NIC taxonomies. CLINICAL OBSERVATION: An evaluation based on Virginia Hendersons basic needs was made, and two altered needs stood out: breathing and circulation. The patient required mechanical ventilation and mechanical circulatory support. INTERVENTIONS: In relation to the highlighted needs, six diagnoses were prioritized according to the NANDA taxonomy using the Análisis de Resultado del Estado Actual (AREA) (Outcome-Present State Test (OPT)) model: risk of decreased cardiac output, impaired spontaneous ventilation, impaired tissue integrity, risk of disuse syndrome, risk of infection and risk of hypothermia. DISCUSSION AND CONCLUSIONS: Outcome criteria scores showed a favourable evolution after 96h. The development of a standardized NANDA-NOC-NIC language allowed us to organize the nursing care plan.