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.

4

Authors: Navarro López, L

Oral health refers to a good quality of life. There are different alterations in the oral area that produce disease and serious consequences, some risk factors that favor the presence of pathologies are poor diet with excessive consumption of carbohydrates, inadequate oral hygiene, consumption of tobacco and alcohol. In this article we refer to oral health during pregnancy being a stage that if these problems appear can lead to serious consequences by not preventing or curing them. Another point to address is the importance of fluoride as a public health tool that increases resistance to acid attack on enamel. It is also named the infantile bruxism that is a pathology that although it is more prevalent in adults also affects the young population and finally the detection of orthodontic problems is noted.

19

Authors: Reguera Suárez, L

Colorectal cancer (CRC) is cancer that begins in the colon or rectum. It is one of the most frequent malignancies of the digestive tract, the second most frequent in developed countries and responsible for 10% of cancer deaths. The risk factors for CRC are: age over 50, male, diet high in saturated fats and processed meats, and tobacco use. The fundamental treatment is surgical removal, with the consequent creation of a digestive ostomy of elimination, which causes a series of repercussions in the life of the patient. The nursing professional has a very important role in health education to the ostomized patient.

24

Authors: Vázquez Álvarez, A

The presence of an ostomy produces in the patient the appearance of many negative feelings such as, among others, sadness, fear and anxiety. Being an ostomy sufferer interferes with the activities of the daily life of ostomized people and also hinders their social integration; Fortunately, today there are many collection systems and accessories that help to promote the quality of life of these patients. It is essential that health personnel know all aspects of the ostomized patient, both psychological and care, since a correct and multidisciplined approach is essential to avoid more serious complications.

29

Authors: Gómez Rodríguez, I

Patients with a stoma are becoming more numerous and is that, the most emerging pathologies worldwide, among which are colon and rectal cancer, require a bowel bypass by resection of the colon completely or part of it. In Spain, there are programs for the early detection of colorectal cancer, since in our country it is the cancer with the highest incidence in both sexes. These programs are aimed at the age groups between 50 and 59 years, because it is in this age group that most cases are reported1. Still, 1 in 3 people diagnosed with this type of neoplasm die. Survivors of this type of neoplasm will carry a stoma. The stomatotherapy nurse will be responsible for empowering both the patient and his or her family to provide post-surgery care, as well as psychological support to help the patient adapt to this change. This research will also address other types of stomata, as they are of very high prevalence in our country, and it is necessary to understand them and the necessary care to provide in each case. It is important that, in each case, the care is individualized since, although it may seem to us that a stoma is always a stoma, either in the patient or in the patient, what will mark the favorable evolution or will not be the care done by the carrier of that stoma.

10

Authors: Manuel Romero, O

Introduction: Serious trauma is understood as a patient with one or more traumatic lesions, which pose a vital risk. Today it is considered a global pandemic. Objective: This study aims to carry out a systematic review in order to determine if the administration of hemoderivatives in pre-hospital decreases mortality in polytraumatic patients in hypovolemic shock. Two secondary objectives will be obtained by determining whether the use of blood products improves hemodynamic status on arrival at the hospital and whether their use decreases the number of subsequent transfusions during admission to the hospital. Methodology: A bibliographic search of scientific articles has been conducted using the most important databases, together with the combination of MESH search terms. Results: There is currently no clear consensus on survival. It does appear to improve the hemodynamic level of these patients and subsequently decrease transfusion requirements. Conclusions: It seems reasonable the use of hemoderivatives during pre-hospital resuscitation eventhat there are contradictory results in terms of survival, fact that justifies more studies.

21

Authors: Paricio del Castillo, R

Healthy families are those that have healthy and gratifying family ties and foster positive emotions such as happiness and curiosity, as well as accept negative ones such as fear sorrow and anger. Therefore these families allow the development of all their members and meet their physical and emotional needs. The COVID-19 pandemic has led to a significant psychosocial deterioration of families and has had a negative impact on the mental health of mothers, fathers and infant and adolescent sons and daughters. In the past few decades, the implementation of Mindfulness-based programmes has been presented as highly cost-effective and efficient interventions to promote emotional well-being. Practice of Mindfulness within family relationships, particularly during the perinatal stage, could encourage emotional regulation and thus improve the well-being of fathers and especially mothers who go through gestation, delivery and breastfeeding.  Moreover, it would also improve the mental and emotional health of the underage family members. This paper is a review about the potential beneficial effects on families of Mindfulness based practices as a population-level prevention and mental health promotion tool.

24

Authors: Martín Ginés, C

The state of alarm experimented Spain has led to extraordinary measures being taken, such as the confinement of the population, social distancing, and quarantine. This bibliographic review seeks to obtain data about the impact on mental health of such measures and their correct management. Objectives: this essay aims to know the impact on mental health of the current confinement produced by the alarm state due to COVID-19 disease and its correct management. Methodology: we have made a bibliographic review based on the search of articles in different databases. Conclusion: this essay has studied a big variety of articles about the impact of confinement on mental health in different groups of the population and what should be its management. We can conclude that we live in extraordinary times that are going to have a greater or lesser psychological impact on our society. Therefore, our actions should be aimed at screening risk groups and both preventive and action measures in the event of psychological disorders.

24

Authors: Salvador Coscujuela, S

Dementias are syndromes that occur with cognitive impairment in several domains, which usually interferes significantly with the performance and normal functioning of people who suffer from them. This affects family members who will be exposed to significant physical, social, emotional and financial costs during the disease. Patients and caregivers suffer significant losses. The death of the patient is the last, but not the only loss that occurs in this context. Given the large number of losses that occur during these processes, it is of special relevance to know how the grieving process that patients and family members undergo is. Grief is defined as the psychological reaction that occurs after the loss of someone or something significant. It is a normal, natural and non-pathological process. The objective of the present work is to review the literature and the main studies that have been published about grief in dementias. To achieve this objective, a bibliographic search has been carried out in the main databases in order to find all those works that explore the theme of grief, both from the point of view of caregivers and the patients themselves and that refer to both anticipated grief and grief after death. The results of the bibliographic search show that many works focus on some particular aspects or moments of grief. For this reason, the present work has attempted to integrate the main findings and to present grief as a broad and global phenomenon that is present continuously after diagnosis. Studying grief in dementias is essential as it contributes to normalizing natural reactions to losses and makes it possible to explain some symptoms (depressive or anxious, for example) without the need to use a diagnosis of a mental health pathology. In addition to exploring grief, this work will provide alternatives for its evaluation and psychotherapeutic interventions aimed at giving emotional support to the main agents involved.

28

Authors: Sierra Tendero, N

Alzheimer´s disease is a neurodegenerative, chronic, progressive and incurable disease. It is the most common type of dementia today. The moment a person and their family are diagnosed with Alzheimer´s, their life takes a 180º turn. The most effective intervention is made up of pharmacological and non-pharmacological treatment. Although this intervention will not produce a recovery, it will treat the person´s symptoms, which will positively influence their quality of life. Among the non-pharmacological therapies is Occupational Therapy. The main objective of this is for the individual to achieve the highest degree of independence and quality of life through occupation. The occupational therapist will work holistically, intervening in the cognitive, physical and social sphere. The intervention at home will be based mainly on retraining of daily life activities, home adaptation, a program of cognitive stimulation, psychomotor skills and a leisure and free time program. This treatment will not cure or stop the progression of the disease, but it will improve the quality of life of the person and their main caregiver.

36

Authors: López Trueba, M.M

IAA (Animal-assisted interventions) are the basis of TAA (2), understood as interventions in which an animal is incorporated and used as part of the treatment, as a therapeutic resource, with the straight objective of promoting the improvement in physical, social, emotional and cognitive functions of the user, with the dog (or other animal) as a motivating element. They must always be leaded by a multidisciplinary health professionals team. It also can be defined as an innovative therapeutic process in which the animal is the bond, the bridge, the motivator ... of actions, gestures and emotions that conduce healing or significant improvement processes in people. These projects have the ability to inspire and motivate people to undertake constructive activities which they would not have done otherwise. There are more and more studies that support that therapy as a science and its effectiveness (3). According to Tucker (4), TAA (Animal Assisted Therapy) is a direct intervention with pre-designed objectives for situations of functional dependence, psychiatric or behavioral disorders, where an animal that meets specific criteria participates, as an essential part of the treatment. It is carried out in a wide variety of settings, individually or in groups, using different animals. The presence of a professional who master the animal is required, join a team of health professionals. The whole process must be previously designed and subsequently evaluated. In Spain this therapy is called Companion Animal Assisted Therapy (TAAC). In these interventions (5), the fundamental element is the dog (or other animals) since it is a motivating and stimulating element in itself, a fact that contributed to the development of TAA until its arrival in Europe. James A. Serpell, Director of the Center for the Interaction of Animals and Society at the University of Pennsylvania, at the opening lecture of the VII Congress "Companion Animals, Source of Health," by Affinity, noted that there was a close relationship between the increasing companion animals in households and the changes that are taking place in Western societies. The fact that more and more people are living alone, as well as that there is a greater number of single-parent families and that socialization is reduced due to the lack of spare time available, has favored, according to Serpell, the entrance of animals at home, counteracting with his affection and unconditional love the lack of emotional ties that people are currently experiencing. For this reason, more and more research are being carried out in this field; as well as the applications of TAP (Dog Assisted Therapy) in public institutions such as prisons, schools, hospitals and nursing homes.

7

Authors: Serrano Rosúa, C

This is a clinical case that refers to complex wounds and the management of these cases. She is a 68-year-old woman who has a superficial trophic lesion on the distal lateral outer face of the lower left extremity (near the malleolus) since a month and a half ago when she appeared and consulted her CAP doctor. Due to a poor diagnosis initially made at the time of the onset of her ulcer or due to a poorly suited treatment pattern for the type of wound, the patient presents a poor evolution of her treated lesion from the beginning to the primary care level. Due to the poor evolution of the ulcer is decided its transfer to hospital level. After being revalued by a team of experts in complex wounds, a correct diagnosis of your ulcer is made and a new treatment schedule adapted to your needs and characteristics of your wound at that time is applied. Our patient is diagnosed with a hypertensive Martorell ulcer. Probably related to its history of poorly controlled hypertension of years of evolution and the type of ulcer it presents. For this reason the need for a team of professionals trained in complex wounds and specialized in cures. Hence the importance of making a correct and early diagnosis to be able to adapt the subsequent treatment and avoid complications in the patient’s health, higher costs in healthcare, greater results in cures...

22

Authors: Álvarez Muñiz, N

Diabetes Mellitus is a chronic disease characterized by chronic hyperglycemia. In this disease lifestyle is very important, so bad habits such as sedentarism, poor eating habit or obesity favor the appearance of this or the development of complications. One of the most important complications of diabetes and, in turn, of peripheral arterial disease and neuropathy that it produces, is diabetic foot. Diabetic foot consists of ulceration, infection, or gangrene in the foot. The first step in the treatment of diabetic foot is to treat the cause for which it occurs, as is the case with revascularization when it is caused by peripheral arterial disease. Although initially this lesion is treated in primary care, it may need to be referred to other more specialized services and end with serious consequences such as loss of the limb. The consequences of the development of diabetic foot can be devastating, for this reason, it is important to make good prevention. It is vital to have a good health education for both diabetes disease and foot self-care in these patients.

23

Authors: Morilla Martín, A

Introduction and justification: Diabetes includes pathologies due to metabolic disorders that have in common hyperglycemia. The International Diabetes Federation, in 2019, indicates that 463 million adults had diabetes, and the deaths were 4.2 million. The Human Genome Project identified polymorphisms that can determine the genotype and phenotype, and therefore the probability of suffering from a certain disease. Objectives: To examine the effect of possible interactions between diet and genetics on glucose homeostasis, insulin resistance and risk of type 2 diabetes mellitus (DM2). Methodology: A review of the last 10 years at Pubmed is carried out using an electronic search strategy, after which articles are screened according to previously defined inclusion and exclusion criteria. The search formula used in the Pubmed database is: "(gene OR SNP OR polymorphism) AND interaction AND (nutrient OR diet OR fat OR carbohydrate OR protein) AND (type 2 diabetes OR insulin resistance OR glucose OR insulin OR HOMA-IR OR HOMA beta OR HbA1C)". Results: After the identification, screening and suitability phases, 25 articles were included in the literature review. Lipids interact with genes related to the metabolism of fatty acids producing effects on DM2, whereas the interaction observed with carbohydrates (HC), are related to the synthesis and regulation of insulin. In the study of gene-nutrient interactions with effect on insulin response (IR), genes have very different functions and the results obtained are very diverse. Conclusion: Different dietary nutrients such as lipids, HC, proteins, fiber and zinc, modify the relationship with TCF7L2, PPAR-γ, ACE, APOA2, SLC30A8, IRS1, ACC2, PPM1K, ELOVL6, PIK3CA-KCNMB3, IRS1, PLIN, S100A9, DHCR7, LPL ADIPOQ and FTO genes with the risk of DM2, insulin resistance or glucose homeostasis markers.