Estudio retrospectivo de un casointervención enfermera a una paciente con neumotórax bilateral, neumoperitoneo y enfisema subcutáneo masivo durante una cirugía endourológica

Abstract

It is introduced the care plan of a 70-year-old woman with multiple medical surgeon history and high anesthetic risk (ASA III). It is performed to the patient a percutaneous nephrolithotomy with holmium laser after being diagnosed of right ureteric stone disease. During the surgery the patient suffers a severe hemodynamics decompensation. She is diagnosed with bilateral pneumothorax, pneumoperitoneum, which causes an abdominal compartment syndrome and massive subcutaneous emphysema. The objective of this work is to present the clinical case and to define the process of individualized nursing care according to NANDA diagnosis, Nursing outcomes (NOC) and Nursing interventions (NIC), according to its retrospective review. Two altered needs: breathing/circulation and elimination. Diagnoses were prioritized according to the NANDA taxonomy: 000030 Impaired gas exchange, 00032 Ineffective breathing pattern, 0029 Decreased cardiac output, 00202 Risk for ineffective gastrointestinal perfusion, 00179 Risk of unstable blood glucose, 00004 Risk of infection, 00005 Risk of imbalance body temperature and 00035 Risk of injury. The present case is complex and exceptional. It requires early action to avoid a fatal consequence. This publication can help to identify similar cases and establish the nursing care and collaborative care plan.