Caso clínico: Isquemia aguda tras retirada de balón intraaórtico de contrapulsación

Resumo

The Intra-Aortic Balloon Pump (IABP) has become the most widely used device nowadays in patients with severe cardiovascular diseases. The nursing staff must have the necessary knowledge to handle hemodynamic values and be able to relate them to the signs and symptoms, which, if overlooked or misinterpreted, could lead to serious consequences for the patient. We are concerned with the case of a 56-year-old woman with an inferior and lateral acute myocardial infarction who, after a percutaneous coronary intervention, requires implantation of an intra-aortic balloon pump. After a good response to the treatment and a rapid hemodynamic stabilization, the device is removed 72 hours later, to develop immediately signs of acute ischemia in the right lower limb requiring urgent intervention. An individualized nursing care plan was developed using the evaluation of the 14 needs according to Virginia Henderson’s model, emphasizing as the most relevant nursing diagnoses the following: inefficient peripheral tissue perfusion, acute pain, risk of infection and personal resilience deterioration, it being a priority to address emotional and psychological coping problems before this event for her unexpected and with the aim to reduce her level of anxiety so that she regained confidence in her capacity to overcome the new situation. Thanks to the development of the individualized care plan, the record of activities allowed to organize the work methodologically so as to provide a quality care in problem solving