Authors

Aurora Palacio-Martínez, Iván Prieto-Salvador, María Ángeles Ferradal-García, María Rocío Paniagua-Muñoz, Ana Cristina Mosquera-Varela, María de la Paz Rodríguez-Nicolás

Position

Enfermeras/os. Servicio de Cardiología. Hospital Universitario de León

Contact address

Aurora Palacio Martínez. Carretera Pandorado, 51. 24700 Astorga (León).

Contact email: rory_palacio@hotmail.com

Abstract

Presenting the case of a male 73-year-old patient who, after Internal Cardiac Defibrillator (ICD) implantation, was admitted to hospital due to ICD decubitus with electrode exposure and presence of exudate. After infection was confirmed through different lab and imaging tests, the defibrillator was removed.
Holistic nursing assessment was conducted before the ICD explant surgery, through Marjory Gordon’s Functional Health Patterns, and a plan of care was conducted using the North American Nursing Diagnosis Association (NANDA) diagnostic terminology, describing the expected outcomes according to the Nursing Outcomes Classification (NOC) and stating the necessary interventions according to the Nursing Intervention Classification (NIC). Two nursing diagnoses were identified: [00214] Discomfort and [00161] Readiness for Enhanced Knowledge; and two collaboration problems: [00046] Impairment of skin integrity, and [00146] Anxiety. A series of NOC outcomes was then selected: Personal wellbeing, Skin tissue and mucous membrane integrity, Knowledge of infection control, and Anxiety self-control, with their appropriate indicators these were assigned with an initial score and a target or expected score. Finally, nursing interventions to be carried out were identified with their corresponding activities.
After one month, and before hospital discharge, the indicators were assessed again, and the final score obtained was equal to the target score; and in some indicator, there was a final score higher to the expected one, highlighting the NOC Knowledge of infection control.

Keywords:

Defibrillators; defibrillators implantable; cardiology; Nursing Assessment; nursing care plan; nursing care; standardized nursing terminology; NANDA; NOC; NIC; surgical wound; infection

Versión en Español

Título:

Infección y explante de DAI por decúbito, a propósito de un caso