Vіsnik Naukovih Doslіdžen' (Jan 2018)
THE ROLE OF THE INTENSIVE THERAPY AND RESUSCITATION DEPARTMENT NURSE IN THE EVALUATION OF THE CONDITION DYNAMICS IN PATIENTS OPERATED ON ACUTE AND CHRONIC ABDOMINAL PATHOLOGY
Abstract
The reason for staying patients with abdominal pathology at the department of intensive therapy and resuscitation is the somatic severity of the initial state of the patient, complicated postoperative period, severe concomitant pathology and the need for constant qualified supervision and care. The aim of the study – to determine and analyze the dynamics of the severity of the condition of patients operated on acute and chronic abdominal pathology in the reanimation and intensive care unit on the basis of APA CHE II scoring, in the modification of A. P. Radzykhovskyi. Materials and Methods. A retrospective analysis of medical records of 85 patients who were in inpatient treatment in the intensive care unit for acute and chronic abdominal pathology was conducted. The severity of patients with postoperative periodic dynamics was determined using the APA CHE II grade scoring grade in the APA CHE II modification (1997) based on a set of clinical and laboratory data. Statistical processing of data was carried out by means of general statistics for calculating averages, comparing the mean values by means of non-parametric statistics using the MedCalc for Windows program. They found that the score of the APA CHE II score in the patient's assessment of severity was sufficiently informative for a quick and adequate assessment of the patient's condition in the work of another medical nurse. Results and Discussion. In the patients under study, there were various symptoms that indicate acute and chronic problems in the abdominal cavity. Among the most common symptoms there are: abdominal pain, vomiting with food remains, stagnant gastric contents, intestinal contents, with bile admixture, positive symptoms of peritoneal irritation (symptom of Shchotkin-Blumberg, muscle tension of the abdominal wall), paresis of the intestine, body temperature, tachycardia of shortness of breath, low blood pressure, neurological disorders, dry mouth, liver function, kidney function, changes in skeletal system, system of hemograms, etc. Our study showed that ball scoring of the status of patients under study APA CHE II, allows the nurse quickly and objectively assessing the severity of the atient's condition at a particular moment, as well as to see the objective dynamics of the severity of the condition of the patients. Conclusions. This monitoring allows you to accurately predict the further course of the disease, and the main timely detection of the deterioration of the patient. All these indicators can be used by another nurse in any period, in a short period of time and in any hospital, since they do not require special equipment and special laboratory tests and analyzes.
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