Kalp Cerrahisinde Kırılgan Hastaların Hemşirelik Bakımı

Kırılganlığın standartlaştırılmış bir tanımı olmamasına rağmen yaşlanmaya bağlı fizyolojik rezervlerin azalması olarak kavramsallaştırılmış bir geriatrik sendromdur. Kırılganlık kardiyovasküler hastalıklar sonucu ortaya çıkabildiği gibi kardiyovasküler hastalıkların gelişmesi ve ilerlemesi açısından da öngördürücü bir göstergedir. Epidemiyolojik çalışmalarda kırılganlık prevelansının diğer cerrahi hastalara oranla kalp cerrahisi hastalarında daha yüksek oranda olduğu saptanmıştır. Ayrıca kırılganlık kalp cerrahisi sonrası delirium, mortalite ve morbidite gibi birçok olumsuz sağlık sonuçları ile ilişkilendirilmiştir. Kalp cerrahisi adayı hastalarda ameliyat öncesi kırılganlığın değerlendirildiği ileri değerlendirmeler ile ameliyat sonrası ortaya çıkabilecek istenmeyen olaylar öngörülebilir ve gerekli önlemler alınabilir. Kırılganlığın yönetimi multidisipliner ve çok boyutludur. Kırılgan kalp cerrahisi hastalarının yönetimi için kırılganlık kavramının, ölçüm araçlarının, patofizyolojisinin anlaşılması önemlidir. Bu derlemede kırılganlık kavramı, kırılganlığın değerlendirilmesi, patofizyolojisi, kalp cerrahisinde kırılganlığın epidemiyolojisi, hasta sonuçları üzerine etkisi, kırılganlığın değerlendirilmesinin önemi ve hemşirelik bakımına yer verilmiştir.

Anahtar Kelimeler:

Kalp Cerrahisi Ameliyatları, Kırılganlık, Hemşirelik Bakımı

Nursing Care of Frail Patients in Cardiac Surgery

Although there is no standardized definition of frailty, it is a geriatric syndrome conceptualized as a decrease in physiological reserves due to aging. Frailty may occur as a result of cardiovascular diseases, and it is also a predictive indicator for the development and progression of cardiovascular diseases. In epidemiological studies, the prevalence of frailty was determined to be higher in cardiac surgery patients than in other surgical patients. In addition, frailty has been associated with many adverse health outcomes such as delirium, mortality, and morbidity following cardiac surgery. With advanced evaluations to determine preoperative frailty in patients who are candidates for cardiac surgery, adverse events that might occur following surgery could be predicted, and necessary measures could be taken. Management of frailty is multidisciplinary and multidimensional. It is significant to recognise the concept of frailty, its assesment tools, and its pathophysiology for the management of frail patients with frailty and proposed to undergo cardiac surgery. This review discusses the concept of frailty, its evaluation, pathophysiology, epidemiology in cardiac surgery, effect on patient outcomes, importance of its evaluation, and nursing care for this condition.

Keywords:

Cardiac Surgical Procedures, Frailty, Nursing Care,

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