Aplicación de métodos antropométricos en el proceso de enfermería de la investigación enfermera

Fernández, Silvia Domínguez; León, Sonsoles García; Bazán, María Julia Ajejas; Cerro, José Luis Pacheco del; Marques-Vieira, Cristina Maria Alves; Rivas, Francisco Javier Pérez

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (suppl 6) • 2020 • https://doi.org/10.1590/0034-7167-2019-0604 copiar

Aplicación de métodos antropométricos en el proceso de enfermería de la investigación enfermera

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos:

identificar técnicas y medidas antropométricas relacionadas con diagnósticos e intervenciones de enfermería, incluidas en NANDA-International (NANDA-I) y Clasificación de Intervenciones de Enfermería (NIC), respectivamente.

Métodoss:

estudio descriptivo. Revisión de las taxonomías NANDA-I y NIC por profesores de Enfermería de la Universidad Complutense de Madrid.

Resultados:

se identificaron 24 diagnósticos de enfermería, 20 intervenciones de enfermería y 71 actividades de enfermería que requerían el uso de mediciones antropométricas.

Conclusiones:

las mediciones antropométricas son necesarias para establecer numerosos diagnósticos e intervenciones de enfermería, comúnmente utilizados en la práctica asistencial. Sería útil sistematizar el uso de técnicas antropométricas en la aplicación del proceso de enfermería y estandarizar el proceso de capacitación de las enfermeras.

Descriptores:
Antropometría; Proceso de Enfermería; Diagnóstico de Enfermería; Investigación en Enfermería; Estándares de Referencia

DOMAIN	CLASS	NURSING DIAGNOSIS	WEIGHT	BMI	MUAC/AC	PERCENT BODY FAT	HEIGHT CURVES	HEIGHT	WAIST CIRCUMFERENCE	MUSCLE MASS
DOMAIN 1: Health promotion	CLASS 1: HEALTH AWARENESS	[00168] Sedentary lifestyle	X	X		X
	CLASS 2: HEALTH MANAGEMENT	[00231] Risk for frail elderly syndrome	X	X	X	X		X		X
	CLASS 2: HEALTH MANAGEMENT	[00257] Frail elderly syndrome	X	X	X	X		X		X
DOMAIN 2: Nutrition	CLASS 1: INGESTION	[00002] Imbalanced nutrition: less than body requirement	X	X				X	X
		[00232] Obesity	X	X				X	X
		[00233] Overweight	X	X				X	X
		[00234] Risk for overweight	X	X				X	X
DOMAIN 4: Activity/Rest	CLASS 2: ACTIVITY/EXERCISE	[00085] Impaired physical mobility	X	X	X	X		X		X
		[00088] Impaired walking	X	X	X	X		X		X
		[00089] Impaired wheelchair mobility	X	X	X	X		X		X
		[00090] Impaired transfer ability	X	X	X	X		X		X
		[00091] Impaired bed mobility	X	X	X	X		X		X
		[00237] Impaired sitting	X	X	X	X		X		X
DOMAIN 4: Activity/Rest	CLASS 2: ACTIVITY/EXERCISE	[00238] Impaired standing	X	X	X	X		X		X
		[00093] Fatigue	X	X	X	X		X		X
		[00092] Activity intolerance	X	X	X	X		X		X
		[00094] Risk for activity intolerance	X	X	X	X		X		X
		[00102] Feeding self-care deficit	X	X				X	X
DOMAIN 6: Self-perception	CLASS 3: BODY IMAGE	[00118] Disturbed body image	X	X		X		X		X
DOMAIN 11: Safety/ Protection	CLASS 2: PHYSICAL INJURY	[00035] Risk for injury	X	X	X	X		X		X
		[00155] Risk for falls	X	X	X	X		X		X
		[00249] Risk for pressure ulcer	X	X				X	X
	CLASS 6: THERMOREGULATION	[00005] Risk for imbalanced body temperature	X	X				X
DOMAIN 13: Growth/Development	CLASS 1: GROWTH	[00113] Risk for disproportionate growth					X	X

DOMAIN	CLASS	INTERVENTIONS	WEIGHT	BMI	IDEAL WEIGHT	PERCENT BODY FAT	WAIST CIRCUMFERENCE	TRICEPS SKIN FOLD /MID-UPPER ARM MUSCLE CIRCUMFERENCE
DOMAIN 1: Physiological: Basic	CLASS A: Activity and Exercise Management	[0226] Exercise therapy: muscle control		X			X
DOMAIN 1: Physiological: Basic	CLASS A: Activity and Exercise Management	[0180] Energy management	X
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	[1050] Feeding	X
		[5246] Nutritional counseling	X
		[1803] Self-care assistance: feeding	X
		[1280] Weight reduction assistance	X			X
		[1240] Weight gain assistance	X
		[1100] Nutrition management	X
		[1030] Eating disorders management	X
		[1260] Weight management	X		X	X
		[1120] Nutrition therapy	X	X		X
		[1160] Nutritional monitoring						X
DOMAIN 2: Physiological: Complex	CLASS L: Skin/Wound Management	[3520] Pressure ulcer care	X
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	[4120] Fluid management	X
DOMAIN 2: Physiological: Complex	CLASS G: Electrolyte and Acid-Base Management	[2080] Fluid/electrolyte management	X
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	[4040] Cardiac care	X
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	[4250] Shock management	X
DOMAIN 3. Behavioral	CLASS R: Coping Assistance	[5220] Body image enhancement	X	X
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	[4130] Fluid monitoring	X
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	[4260] Shock prevention	X

		INTERVENCIONES	ACTIVIDADES
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Feeding	1. Identify the prescribed diet.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Feeding	2. Record the intake, if appropriate.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Nutritional counseling	1. Determine the patient's intake and eating habits.
			2. Set realistic mid- and short-term goals for the change in nutritional status.
			3. Use accepted dietary standards to help the patient assess the appropriate dietary intake.
			4. Help the patient record what he usually eats in a 24-hour period.
			5. Review with the patient the measurement of fluid intake and elimination, hemoglobin values, blood pressure readings or weight gain and loss, if applicable.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Self-care assistance: feeding	1. Check the patient's weight, if applicable.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Weight reduction assistance	1. Determine the patient's desire and motivation to reduce weight or body fat.
			2. Determine with the patient the amount of weight loss desired.
			3. Set a weekly weight loss goal.
			4. Weigh the patient weekly.
			5. Recommend the adoption of diets that lead to the achievement of long-term goals in weight loss.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Weight gain assistance	1. Weigh the patient at the intervals determined, if applicable.
			2. Analyze the possible causes of low body weight.
			3. Periodically monitor the daily consumption of calories.
			4. Periodically check serum albumin, lymphocyte and electrolyte levels.
DOMAIN 1: Physiological: Basic	CLASS A: Activity and Exercise Management	Energy management	1. Control the dietary intake to ensure sufficient energy resources.
DOMAIN 1: Physiological: Basic	CLASS A: Activity and Exercise Management	Nutritional management	1. Determine the patient's nutritional status and their ability to meet nutritional needs.
			2. Instruct the patient about nutritional needs.
			3. Help the patient determine the guidelines or food pyramids most appropriate to meet nutritional needs and preferences.
			4. Adjust the diet as necessary.
			5. Monitor calories and food intake.
			6. Monitor weight loss and weight gain trends.
			7. Teach the patient to control calories and dietary intake.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Eating disorders management	1. Establish the desired weight gain.
			2. Monitor the necessary physiological parameters (vital signs and electrolyte levels).
			3. Weigh daily (at the same time of day and after evacuation).
			4. Monitor the daily caloric intake of food.
			5. Control the patient's weight routinely.
			6. Determine the acceptable margin of weight variation relative to the reference margin.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Weight management	1. Determine the ideal body weight of the individual.
			2. Determine the ideal body fat percentage of the individual.
			3. Encourage the individual to record their weight weekly, if applicable.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Nutritional monitoring	1. Weigh the patient at the established intervals.
			2. Monitor the trends of weight loss and gain.
			3. Monitor skin fold measurements: triceps skin fold thickness, mid-upper arm muscle circumference and mid-upper arm circumference.
			4. Monitor levels of albumin, total protein, hemoglobin and hematocrit.
			5. Check growth and development.
			6. Control caloric and nutritional intake.
DOMAIN 1: Physiological: Basic	CLASS A: Activity and Exercise Management	Exercise therapy: muscle control	1. Determine the accuracy of the body image.
DOMAIN 1: Physiological: Basic	CLASS A: Activity and Exercise Management	Exercise therapy: muscle control	2. Reorient the patient regarding body awareness.
DOMAIN 1: Physiological: Basic	CLASS D: Nutrition Support	Nutrition therapy	1. Complete a nutritional assessment, if applicable.
			2. Control the ingested food/fluids and calculate the daily caloric intake, as appropriate.
			3. Control laboratory values, as appropriate.
			4. Check whether dietary guidelines meet daily dietary needs, if applicable.
DOMAIN 2: Physiological: Complex	CLASS L: Skin/Wound Management	Pressure ulcer care	1. Ensure sufficient dietary intake.
			2. Control nutritional status.
			3. Verify sufficient caloric intake and high-quality protein intake.
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	Fluid management	1. Weigh daily and control evolution.
			2. Check for patient weight changes before and after dialysis, if applicable.
			3. Control food/fluid intake and calculate caloric intake, as appropriate.
			4. Monitor the nutritional status.
DOMAIN 2: Physiological: Complex	CLASS G: Electrolyte and Acid-Base Management	Fluid/electrolyte management	1. Weigh daily and assess the evolution.
			2. Keep accurate records of intake and output.
			3. Provide the appropriate prescribed diet to restore the specific fluid or electrolyte balance.
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	Cardiac care	1. Encourage the patient to maintain caloric intake at a level that allows achieving the desired weight.
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	Cardiac care	2. Focus the assistance and therapeutic objectives to allow the patient to continue controlling their weight, not smoking and to be as active as possible.
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	Shock management	1. Monitor the hydration status, including weight, hourly diuresis and intake and output.
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	Fluid monitoring	1. Monitor the weight.
			2. Monitor the intake and output.
			3. Keep an accurate record of the intake and output.
DOMAIN 2: Physiological: Complex	CLASS N: Tissue Perfusion Management	Shock prevention	1. Control weight, intake and diuresis daily.
DOMAIN 3: Behavioral	CLASS R: Coping Assistance	Body image enhancement	1. Determine the patient's body expectations, according to the stage of development.
			2. Use a forward-looking guide in patient preparation for predictable body image changes.
			3. Determine if the dislike perceived by certain physical characteristics creates dysfunctional social paralysis in adolescents and other high-risk groups.
			4. Determine if there has been a recent physical change in the patient's body image.
			5. Observe if there are affirmations that identify perceptions of body image that have to do with shape and body weight.
DOMAIN 3: Behavioral	CLASS R: Coping Assistance	Body image enhancement	6. Use drawings of oneself as a mechanism for evaluating the perceptions of a child's body image.
			7. Determine the perceptions of the patient and the family on changes in body image relative to reality.
			8. Help the patient at risk of suffering from anorexia or bulimia develop more realistic body image expectations.

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Silvia Domínguez Fernández. E-mail: sildom01@ucm.es