NPunto

10

Authors: Redondo Castán, L.C

Introduction This study is a systematic literature review about a case of an unconscious octogenarian patient at home where the nursing interventions performed are described. The etiology of the process that we studied after subsequent clinical follow-up was attributed to a process of severe hyponatremia. Objective The main objective of this paper is to summarize the updated scientific evidence related to the hyponatremia process and the signs and symptoms of this process to apply nursing interventions in the out-of-hospital environment. Methodology To carry out this study, a bibliographic search was carried out in the main databases, combining MESH search terms of scientific articles published in the last decade, clinical practice guidelines, protocols, manuals and interventions, and scientific literature. Results In the selected bibliography we did not find articles aimed at specific nursing interventions. The interventions performed in the case are included in the treatment of hyponatremia from the first contact with the patient until being discharged. Conclusions In unconscious patients in the out-of-hospital environment, the nursing assessment is incomplete. Access to the clinical history of patients at home is important, although the emergency makes it difficult to consult. Early intervention on assessed signs and symptoms is decisive for the recovery and prevention of complications, aspects closely related to the morbidity and mortality of this pathology. Monitoring in the out-of-hospital setting in the patient described is based on the following parameters: RF, HR, SatO2%, NIBP, diuresis, fluid therapy control, capnography in a non-intubated patient allows monitoring of the respiratory pattern, neurological assessment scales (AVDN, ECG, pupillary reactivity) and 12-lead electrocardiogram with rhythm strip. Knowing the complications of a prolonged decubitus, greater than 2 hours, such as: dehydration, decubitus ulcers, rhabdomyolysis, hypothermia and pneumonia. It is important to give continuity to nursing interventions from the first care until hospital discharge.

16

Authors: González Gómez, P

One of the most difficult tasks that an anesthesiologist can face is to provide a safe and effective anesthesia for surgery in a newborn. Neonatal patients undergoing surgical procedure often have disorders that are accompanied by multiple medical problems. Neonatal anesthesia requires a thorough understanding of the rapidly changing physiology and pathology of the neonate, as well as the pharmacokinetics and pharmacodynamics of the medications used to provide anesthesia, along with the development of monitoring equipment and techniques that have allowed the development of safe anesthesia Then, this knowledge must be incorporated into a well-planned anesthetic care plan.

26

Authors: García Lasheras, Y

Introduction: The pain experienced during labour is one of the most intense types of pain a woman can suffer throughout her life, being its treatment of great importance not only for its symptomatic relief, but because of the physiological changes this pain causes in both the mother and the foetus. Therefore, the anaesthetist intervention either during normal labour, Caesarean section and the emergency labour or emergency C-section will be of vital importance both for pain management and monitoring of physiological parameters and to ensure that the process is carried out in the most secure way possible, influencing in the memories the mother will have of all the experience. It is for this reason that this thesis is a study of the different types of obstetric anaesthesia and analgesia that exist, including updates developed within this specialty. Objectives: The main objective of this thesis is to identify the different types of anaesthesia and analgesia used in obstetrics and the updates related to them, as well as to identify which are the most common and effective types of anaesthesia and analgesia for labour and caesarean section and understand the importance of the anaesthesia service in obstetrics. Methods: A bibliographic review was conducted, using the databases PUBMED, CUIDEN, CINAHL, THE COCHRANE LIBRARY, MEDLINE, SciELO and GOOGLE SCHOLAR, as well as the printed format of the British journal “Anaesthesia”. Results: A total of 10 articles were reviewed, selected according to the criteria previously established, analysing the information relevant to the subject of this thesis in each of them. Conclusions: The results obtained show that neuraxial techniques are the most common, safest and more reliable type of anaesthesia and analgesia for both labour and caesarean section, being the epidural analgesia the technique of choice for labour and the spinal anaesthesia the technique of choice for caesarean section, with the exception of the emergency caesarean section which must contemplate general anaesthesia as a method of choice. However, it is still necessary to keep researching in the subject.