THESES
Nursing diagnosis in victims of serious cranioencephalic trauma: a contribution to the nursing assistance (abstract)*. Dissertation. Aracaju, 2008
Maria do Carmo de Oliveira Ribeiro**
This is a descriptive exploratory and filed study, with a qualitative-quantitative approach that intended to describe the care and nursing diagnoses in TBI victims. It was developed at the HUSE of the ICU, Aracaju/SE and was composed of six stages thus designated: drafting of the roadmap interview, interviews accomplishment, creation and validation of the data collection instrument, data collection, identification and validation of nursing diagnoses.
The victims of TBI (n=18) were mostly men (77.8%), aged among 16 to 45 years (72.2%), married (50%0, who have suffered trauma by conveyance accident (55.6%) in public road (72.2%), wich had 4 to 8 points in GSC (88.9%) and had isoborneol and reactive pupils (72.2%), with loss of consciousness (72.2%.) submitted to surgical treatment (64.7%) and a CT (100%) and that remained hospitalized at the ICU on 14-day average for men and 5.7-day for women.
The nursing diagnoses found in the victims with serious TBI were: verbal communication injury, spontaneous ventilation injury, ineffective airway clearance, ineffective standard respiratory, mobility injury in bed, bath and hygiene self-care deficit, deficiency in self-care with food, ineffective tissular cerebral infusion, injury deglutition, disturbed nutrition, excessive volume of liquids, injury oral mucosa, distuberd integrity skin, ineffective tissular renal infusion, ineffective tissular intestinal infusion, hyperthermia, risk of aspiration, risk of seclusion, risk of constipation, risk of disuse syndrome, risk of infection, risk of unbalanced body temperature, risk of injury skin integrity and of lesion. The assessment form of the TBI victims was validated by teachers in the nursing field and nurses of the branch under study. Finally, twenty five nursing diagnostic were validated, 68% of real type and 32% of potential.
Key words: brain injuries, nursing cares, intensive treatment units, nursing process.