Proceso de atención de enfermería en paciente con enfermedad renal crónica más derrame pleural.

Abstract

Introduction: Pleural effusion consists of abnormal accumulation of fluid in the pleural space. The pleura is the thin, thin layer of endothelial tissue, consisting of the visceral portion and parietal portion, among which is the pleural space that is occupied approximately by 5-15 milliliters of plasma exudate, called pleural fluid, which has Lubricating function in respiratory movements. Patients with chronic renal disease rarely have direct association with this pathology, but alterations at the pleural level constitute 10% of the incomes to hospital units, in the respiratory and medicine services Internal, as a result of a variety of infectious, inflammatory, and malignant conditions. Case presentation: Female patient of 69 years of age, enters Theophilus Dávila Hospital, day 15/08/2108 with history hypertension, diabetes mellitus type II, diagnosed with chronic Renal disease Terminal about 1 year ago, in therapy Kidney function Replacement 11 months with hemodialysis and for approximately 2 months on Peritoneal dialysis, Presenting clinical picture of 15 days approximately of evolution characterized by dyspnea of small and medium-sized efforts, edema in inferior limbs for a week ago asthenia, anorexia, bilateral lumbar pain of moderate intensity that is accompanied ago 24 Hours of chills and unquantified thermal boost, patient receives antibiotic treatment without improvement so it is decided to enter this health unit. blood pressure: 143/97, Pulse: 70x ´, Temperature: 37 °c, respirations: 20x ´, oxygen saturation: 90%, Weight: 75 kg, Size: 1.53cm., IMC: 32. The day 22/08/2018 is performed abdomen ultrasound with report of Pleural effusion, is requested blood culture, nasal and rectal swab report negative to bacterial growth, does not receive assessment by lung, 24/08/2018 patient in stable clinical conditions refers to feel asymptomatic nephrologist decides higher medical Indications of pharmacological treatment. P. A: 110/70 FC: 70X ´ FR: 20x ´ T°: 36,4 ° C SPO2:97%. General Objective: To apply the nursing care process using the Virginia Henderson model to meet the basic needs of the patient's mental, physical and social wellbeing. Method: A thorough search was carried out in different reliable bibliographic sources in databases: Scielo, REDALYC, MEDLINE, Dialnet, ScienceDirect, Scopus. Results: Different causes of pleural effusion were identified in the first place are infectious followed by Pneumonias and parapneumonic effusion, pulmonary tuberculosis, pulmonary tuberculosis plus HIV. With chronic Renal disease, no direct relationship was found in relation to the symptomatology in the Diagnostic guide and treatment of Pleural effusion indicates that the latter is variable and depends directly on the underlying cause, but the most common manifestations are : Pleuritic Pain, Dyspnea, dry cough. Conclusions: The risk factors associated with the development and progression of pleural effusion depend on underlying causes such as age, medical care, geographical location, plus cardiovascular, infectious and immunologic diseases, on the other hand the Signs and symptoms identified as the most common on pleural effusion are: pleuritic pain, dyspnea and cough. cough, and fever, which coincides with the patient's manifestation. By evaluating the case with Virginia Henderson's theory, it is determined that all basic needs are altered, but the aggravating factors for their health are reflected in the need to breathe normally. Within the nursing care process based on the taxonomies NANDA, NOC and NIC, the most outstanding problems fall on the diagnostic labels: ineffective respiratory pattern, excess volume of fluids, chronic pain, risk of falls, risk of Deterioration of skin integrity.