Nursing diagnoses and NIC interventions in adult males undergoing radical prostatectomy

Kocaçal, Elem; Karadağ, Ezgi

doi:10.1590/S1980-220X2018038003541

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Original Article • Rev. esc. enferm. USP 54 • 2020 • https://doi.org/10.1590/S1980-220X2018038003541 copy

Nursing diagnoses and NIC interventions in adult males undergoing radical prostatectomy

Diagnósticos de Enfermagem e intervenções NIC em adultos do sexo masculino que passaram por prostatectomia radical

Diagnósticos de Enfermería e intervenciones NIC en adultos del sexo masculino que pasaron por prostatectomía radical

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To determine NANDA-I nursing diagnoses and NIC nursing interventions in patients who underwent radical prostatectomy.

Method:

A cross-sectional and descriptive study was conducted in a research and teaching hospital in western Turkey between June 2016 and June 2017. The sample included adult patients diagnosed with prostate cancer in the immediate postoperative period of radical prostatectomy. Data collection was performed using Gordon’s Functional Health Patterns, NANDA-International and Nursing Interventions Classification Taxonomy Systems.

Results:

Participants were 54 adult patients. The main nursing diagnoses were in the classes of “physical injury”, “self-care”, “hydration” and “physical comfort”. Some nursing diagnoses were identified in all patients, namely: “risk for deficient fluid volume”, “risk for imbalanced fluid volume”, “impaired urinary elimination”. The most selected NIC interventions were in the classes of “risk management”, “elimination management”, “coping assistance”, “tissue perfusion management” and “self-care facilitation”.

Conclusion:

future studies with larger populations are needed to explore the nursing diagnoses and effects of nursing interventions on patients who underwent radical prostatectomy.

Descriptors:
Prostatectomy; Classification; Nursing Process; Nursing Diagnosis; Oncology Nursing

Demographic Variables	n	%
Age groups (years)
43-53 years	9	16.7
54-64 years	35	64.8
65-75 years	10	18.5
Marital status
Single	18	33.3
Married	36	66.7
Education
Primary school level	20	37
High school level	21	38.9
University level	13	24.1
Employment status
Pensioner	27	50
Civil servant	7	13
Employee	8	14.8
Self-employed	12	22.2
Social-security
Social security insurance	43	79.6
Self-employed insurance	11	20.4
Total	54	100

Domain	Class	Code	Nursing diagnoses	n	%
Health promotion	Health management	00099	Ineffective health management	15	27.8
Nutrition	Ingestion	00233	Overweight	15	27.8
	Ingestion	00234	Risk for overweight	7	13
	Metabolism	00179	Risk for unstable blood glucose level	18	33.3
	Metabolism		Risk for electrolyte imbalance
	Hydration	00195	Excess fluid volume	5	9.3
	Hydration		25	11	20.4
Activity	Sleep/rest	00198	Disturbed sleep pattern	28	51.9
	Cardiovascular/pulmonary responses	00239	Risk for impaired cardiovascular function	12	22.2
	Self-care		Bathing self-care deficit
		00108	Dressing self-care deficit	41	75.9
		00109	Feeding self-care deficit	39	72.2
		00102		26	48.1
Perception/Cognition	Cognition	00126	Deficient knowledge	37	68.5
Self- Perception	Self-concept	00124	Hopelessness	6	11
Coping/stress tolerance	Coping responses	00146	Anxiety	9	16.7
		00069	Ineffective coping	9	16.7
		00148	Fear	9	16.7
		00241	Impaired mood regulation	5	9.3
		00125	Powerlessness	7	13.0
Safety/Protection	Physical injury	00155	Risk for falls	25	46.3
	Environmental hazards	00246	Risk for delayed surgical recovery	12	22.2
		00217	Risk for allergy response	11	20.4
	Thermoregulation	00007	Hyperthermia	7	13.0
		00008	Ineffective thermoregulation	10	18.5
Comfort	Physical comfort	00134	Nausea	25	74.1
Comfort	Physical comfort	00132	Acute pain	40	74.1

Domain	Class	Code	NIC Interventions (code)	n	%
1.Physiological: Basic	A. Activity and Exercise Management	0180	Energy management	12	22.2
		0200	Exercise promotion	25	46.3
		0224	Exercise therapy: joint mobility	19	35.2
	D. Nutrition Support			5	9.3
		1020	Diet staging	12	22.2
		1050	Feeding	26	48.1
		1100	Nutrition management	17	31.5

		5246	Nutritional counselling	19	35.2
		1260	Weight management	20	37.0
		1280	Weight reduction assistance	18	33.3
	E. Physical Comfort Promotion
	F. Self-care Facilitation	1400	Pain management	25	46.3

		1610	Bathing	41	75.9
2. Physiological: Complex	H. Drug Management	2300	Medication administration	31	57.4
	J. Perioperative Care	2210	Analgesic administration	36	66.7
		1450	Nausea management	25	46.3
	M. Thermoregulation	1380	Heat/cold application	22	40.7
3. Behavioural	O. Behaviour Therapy	4350	Behaviour management	19	35.2
		4360	Behaviour modification	19	35.2
	Q. Communication Enhancement	4978	Communication enhancement:	13	24.1
			visual deficit
	R. Coping Assistance
		5230	Coping enhancement	27	50.0
		5820	Anxiety reduction	26	48.1
		5250	Decision-making support	26	48.1
		5330	Mood management	18	33.3
		5380	Security enhancement	19	35.2
		5390	Self -awareness enhancement	26	48.1
		5395	Self-efficacy enhancement	36	66.7
		5440	Support system enhancement	17	31.5
	S. Patient Education
		5602	Teaching: disease process	27	50.0
		5606	Teaching: Individual	19	35.2
		5614	Teaching: prescribed diet	21	38.9
		5616	Teaching: prescribed medication	22	40.7
			Teaching: procedure/treatment
	T. Psychological Comfort		Progressive muscle relaxation
	Promotion	1460		27	50.0
4. Safety	V. Risk Management	4020	Bleeding reduction	24	44.4
6. Health System	Y. Health System Mediation	7040	Caregiver support	22	40.7
		7370	Discharge planning	19	35.2
		7400	Health system guidance	15	27.8

Domain	Class	Code	Nursing Diagnoses
Nutrition	Hydration	00028	Risk for deficient fluid volume
Nutrition	Hydration	00025	Risk for imbalanced fluid volume
Elimination and Exchange	Urinary function	00016	Impaired urinary elimination
Activity/Rest	Self-care	00110	Toileting self-care deficit
Sexuality	Sexual function	00065	Ineffective sexuality pattern
Life principles	Value/belief/action	00184	Readiness for enhanced
Life principles	congruence	00184	decision making
Safety/protection	Infection	00004	Risk for infection
	Physical injury	00206	Risk for bleeding
		00047	Risk for impaired skin integrity
	Thermoregulation	00005	Risk for imbalanced
			body temperature
Comfort	Environmental comfort	00214	Impaired comfort

Domain	Class	Code	NIC interventions
1.Physiological:	B. Elimination management	0550	Bladder irrigation
		1876	Tube care: urinary
		0570	Urinary bladder training
		0600	Urinary habit training
		0560	Pelvic muscle exercise
		0580	Urinary catheterization
		0590	decision making
	D. Nutrition support	1120	Nutrition therapy
	D. Nutrition support	1160	Nutritional monitoring
	E. Physical comfort promotion	6482	Environmental management: comfort
		1710	Oral health maintenance
		1720	Oral health promotion
	F. Self-care facilitation	1730	Oral health restoration
		1804	Self-care assistance/toileting
		1850	Sleep enhancement
		1750	Perineal care
2.Physiological:	G. Electrolyte and acid-base management	2020	Electrolyte monitoring
	G. Electrolyte and acid-base management	2080	Fluid/electrolyte management
	H. Drug management	2380	Medication management
	J. Perioperative care	3902	Temperature regulation: perioperative
	L. Skin/wound management	3440	Incision site care
	M. Thermoregulation	3900	Temperature regulation
		4410	Bleeding precautions
		4190	Intravenous (IV) insertion
	N. Tissue perfusion management	4200	Intravenous therapy
		4130	Fluid monitoring
		4140	Fluid resuscitation
3. Behavioural	O. Behaviour therapy	4470	Self- modification assistance
	Q. Communication enhancement	4920	Active listening
	R. Coping assistance	5248	Sexual counselling
	R. Coping assistance	5240	Counselling
	S. Patient education	5612	Teaching: prescribed exercise
4. Safety	V. Risk management	6550	Infection protection
		6574	Patient identification
		6610	Risk identification
		6650	Surveillance
		6680	Vital signs monitoring
	Y. Health system mediation	7460	Patient rights protection
5. Family	X. Lifespan care	7110	Family involvement promotion
6. Health system	a. Health system management	7610	Point of care testing
6. Health system	b. Information management	7920	Documentation

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[1] Corresponding author
: Elem Kocaçal İzmir Demokrasi University, Faculty of Health Sciences Department of Nursing, Üçkuyular District, Gürsel Aksel St., 14 35140 - Karabağlar, İzmir, Turkey elem.kocacalguler@idu.edu.tr