Accuracy and prevalence of defining characteristics of the diagnosis Impaired gas exchange in children

Abstract

Objective: to evaluate the accuracy and to determine the prevalence of the defining characteristics of the nursing diagnosis Impaired gas exchange in children with respiratory diseases. Methods: cross-sectional study carried out with 236 children who were in the initial 48 hours of hospital admission. A questionnaire was used with sociodemographic data and physical examination of the respiratory system to identify the defining characteristics of the studied diagnosis. For the analysis of the accuracy, the sensitivity and specificity measures were calculated. Results: the diagnosis Impaired gas exchange was present in 21.6% of the sample and the most prevalent defining characteristics were dyspnea and tachycardia. Regarding the accuracy measures, the characteristics that presented high sensitivity values were dyspnea and abnormal respiratory pattern, while cyanosis, hypoxemia, and restlessness obtained high values of specificity. Conclusion: the characteristics that stood out both for the accuracy measures and for the prevalence were dyspnea and abnormal respiratory pattern. Descriptors: Respiratory Tract Infections; Data Accuracy; Nursing Diagnosis; Child. Objetivo: avaliar a acurácia e determinar a prevalência das características definidoras do diagnóstico de enfermagem Troca de gases prejudicada em crianças com doenças respiratórias. Métodos: estudo transversal realizado com 236 crianças que estavam nas 48 horas iniciais de internação hospitalar. Utilizou-se questionário com dados sociodemográficos e exame físico do sistema respiratório para identificação das características definidoras do diagnóstico estudado. Para análise da acurácia foram calculadas as medidas de sensibilidade e especificidade. Resultados: o diagnóstico Troca de gases prejudicada esteve presente em 21,6% da amostra e as características definidoras mais prevalentes foram Dispneia e Taquicardia. No que se refere às medidas de acurácia, as características que apresentaram altos valores de sensibilidade foram Dispneia e Padrão Respiratório anormal, enquanto Cianose, Hipoxemia e Inquietação obtiveram elevados valores de especificidade. Conclusão: as características que se destacaram tanto pelas medidas de acurácia quanto pela prevalência foram Dispneia e Padrão respiratório anormal. Descritores: Infecções Respiratórias; Acurácia dos Dados; Diagnóstico de Enfermagem; Criança.

Classificação de risco em pediatria realizada por enfermeiros com enfoque nas condições clínicas

“…Children are the most vulnerable and immunologically immature group to pathological processes, consequently, more susceptible to complications and death. It emphasizes the importance of clinical evaluation in the reduction of health damage in children who seek care in the emergency services, since most have non-severe respiratory infections that, if left un-treated, can progress to more serious infections (15)(16) .…”

“…Research indicates the risk of dysentery and bronchitis in the first year of life as a defense mechanism of the organism against allergic respiratory outcome in urbanized environments (17) . Dry cough is related to mechanisms of decreased efficacy of elimination of airway secretions (16) which, according to the Reference Guide used in this study, may appear as mild in children classified as blue (non-urgent), or persistent, in children classified as yellow (in an emergency situation) who require medical attention within 30 minutes, and therefore, should be considered relevant for evaluation of respiratory changes at all ages (6) .…”