Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

Archive Home / Archive

Volume 5, Issue 2-1, March 2016

  • Authors: Rahşan Çam, Havva Yönem, Hatice Özsoy

    Abstract: The fact that surgical procedures and anaesthesia implementation affect thermoregulation, decrease heat production and increase heat loss cause hypothermia in the individual. This situation may create serious physiological problems both during and after the operation especially in risky patients. Surgical operation is a process threatening that body temperature of individual are maintained within required ranges due to the environment it is performed and requiring anesthesia application. Both general and local anesthesia’s suppress afferent and efferent control of thermoregulation. Additionally, surgery environment and exposure to surgical operation generally cause heat loss. Heat loss is a common during surgery. This is because the surgical environment transfers heat from the patient. Anesthesia decreases both heat production and thermoregulation capabilities of patients. Anesthesia also hardens the monitorization of body temperature. Hypothermia may cause complications such as fever, trembling, coldness and paleness in the skin, absent-mindedness, slowing in the metabolic speed, slowing in mental functions, bradycardia and rhythm disturbances, respiration slowing, coma and death. It is important for nurses to appreciate the physiological effects of hypothermia, which can cause complications in surgical patients in these settings. Furthermore accurate and careful monitoring of haemodynamic parameters. In this process the nurse may help maintain the individual’s body temperature by taking protective precautions through various methods before, during and after the operation and especially may protect the patient from various complications that may occur as a result of hypothermia.

    Received: Jul. 8, 2015 Accepted: Dec. 9, 2015 Published: Jan. 20, 2016

    DOI: 10.11648/j.cmr.s.2016050201.11 View: Downloads:

  • Authors: Hossein Asgar Pour, Büşra Tipirdamaz, Dilara Kunter, Havva Yönem, Hatice Özsoy

    Abstract: Introduction: Hospital-acquired infections cause the length of stay in hospital, morbidity, mortality, and increase the cost of treatment. The aim of this study was to determine the incidence of hospital-acquired infections in adult internal-surgical intensive care unit patients, distribution of infections according to the intensive care units, the types, diagnosis and causative microorganisms of infections. Method: In this retrospective study, the archive documents of the patients diagnosed with a hospital-acquired infection and staying in the internal-surgical intensive care units of a university hospital in Turkey between 2013 and 2014 were evalauted. From 9547 patient’s documents that stayed in the adult and pediatrics intensive care units, 448 of them were diagnosed with hospital-acquired infections. From 448 patient’s documents 102 pediatrics intensive care units documents were excluded. In total, 346 adult internal-surgical intensive care unit patients' files were evaluated. Results: The mean age of the patients was 67,91±14,76, 58.9% of them were male, the mean length of stay in intensive care unit was 27,02±25,68 days, 60.7% of the patients stayed in internal intensive care units, and 39.3% of the patients stayed in the surgical intensive care units. The incidence of the hospital-acquired infection in the internal-surgical intensive care units was 4.16%. It was determined that 46% of the patients had a bacteremia infection, 31.8% VIP, 5.8% fungemia, and 4.9% organ-space surgical site infection. 16.8% of the causative microorganisms of the hospital-acquired infections were Acinetobacter SPP, 11.3% had no causative microorganism, 7.2% were E-Coli, 5.8% Acinnobacter Baumanii, 5,5% Stenotrophomanas Maltophilia, 5,2% Psedomanas Spp.IBL+, 4,3% Candida Albicans, 3,8% Klebsialla Pneumoniae, 3,5% Psedomanas Aeriginosa. Conclusion: The incidence of the hospital-acquired infections was low, and most of the infections were associated with blood and respiration. As the rate of the hospital-acquired infections is the most important indicator in the quality of patient care, it becomes important for the intensive care nurses to use their roles as a caregiver and as an educator in the prevention of the hospital-acquired infections. Also, the determination of the agents of the hospital-acquired infections in intensive care units becomes important in the determination of the treatment process.

    Received: Nov. 2, 2015 Accepted: Nov. 2, 2015 Published: Jan. 20, 2016

    DOI: 10.11648/j.cmr.s.2016050201.12 View: Downloads:

  • Authors: Hossein Asgar Pour, Serap Gökçe

    Abstract: Fever following surgery is a common event occurring in 14%-91% of postoperative patients. Fever can occur immediately after surgery and seen to be related directly to the operation or may occur sometime after the surgery as a result of complication related to surgery. Although the list of causes of postoperative fever is extensive, the initial focus for most patients should be on a limited number of the more common infectious and noninfectious causes. The classic W5 of postoperative fever are as follows: Wind: atelectasis on postoperative day 1-2, Water: urinary tract infection on postoperative day 2-3, Wound: wound infection on postoperative day 3-7, Walking: deep venous thrombosis/thrombophlebitis on postoperative day 5-7, and Wonder Drug: drug fever on postoperative day>7. Postoperative fever evaluations should take into account numerous factors including timing, the patient’s own medical, surgical, and social history, as well as details of the procedure including significant events comprising the patient’s preoperative, intraoperative, and postoperative period. A focused physical assessment and any additional symptoms the patient is experiencing should be taken into account in evaluating the clinical significance of a postoperative fever and determining appropriate action. Treatments for the postoperative fever are all dependent on the etiology. Thus, identifying the likely cause through a thorough patient history and physical examination becomes critical.

    Received: Feb. 1, 2016 Accepted: Feb. 13, 2016 Published: Mar. 14, 2016

    DOI: 10.11648/j.cmr.s.2016050201.13 View: Downloads:

All Issues