Preoperative Fasting Time and Selected Postoperative Outcomes among Patients Undergoing Abdominal Surgeries: Correlation Study

Background: Prolonged preoperative fasting time had a negative impact on the recovery of the patient in the postoperative period. Aim of the study: was to determine the relationship between the preoperative fasting time and selected postoperative outcomes among patients undergoing abdominal surgeries at one of the University Hospitals Cairo-Egypt. Research question: What is the relationship between the preoperative fasting time and the selected postoperative outcomes (patients' blood glucose levels, blood pressure and vomiting frequency) among patients undergoing abdominal surgeries? Design: Descriptive-correlation design was utilized. Setting: The study was conducted on waiting areas of general surgery operating room at 2nd and 3rd floor in addition to the general surgical wards at one of the University Hospitals. Subjects: A convenience sample of 60 female & male adult patients with the following inclusion criteria: 1- undergoing abdominal surgeries, 2- have no diabetes or hypertension were recruited in the current study Tools: Two tools were utilized to collect data pertinent to the study; I- A semi-structured interview questionnaire, it contained two parts: 1: Demographic data 2: Surgical patient’s clinical data.  II - Postoperative outcomes data sheet: It included measurement of the three selected postoperative outcomes. Results: The current study findings revealed that nearly three quarters of the study sample fasted for longer than required time with a mean+ SD= 11.1 + 2.5 and more than two third of the study sample had waiting time between 3->6 hrs. There was a significance difference between pre-operative & post-operative, post-operative & baseline readings regarding the systolic blood pressure and between the baseline and the pre-operative diastolic blood pressure. There was a positive moderate correlation between the pre-operative fasting time and the post-operative blood glucose results r=0.41. Also, there was a strong correlation between baseline and preoperative blood glucose results r=0.77, while, There was no correlation  between frequency of vomiting post operatively and age, preoperative fasting time, waiting time, blood glucose, and blood pressure.  Conclusion: There was a correlation between preoperative fasting time and blood glucose level followed by blood pressure while no correlation with vomiting frequency postoperatively. Recommendations: Awareness of heath care team regarding updating evidence-based preoperative fasting guidelines, nurse should measure blood glucose level and blood pressure for the non-diabetic as well as the diabetic patients before the surgical procedure and further studies are needed to determine the optimal fasting time and its effect on postoperative outcomes. Keywords: Preoperative fasting time, waiting time, abdominal surgery, blood glucose level, blood pressure, postoperative vomiting

Effect of slow deep breathing exercise on blood pressure and heart rate among newly diagnosed patients with essential hypertension

Background: Essential hypertension is the most prevalent type, affecting most of hypertensive patients. It increases progressively with age. The aim of this study is to examine the effect of slow deep breathing exercise on blood pressure and heart rate among newly diagnosed patients with essential hypertension. Research hypotheses were H1-There will be a statistical significant difference in blood pressure before and after breathing exercises. H 2- There will be a statistical significant difference in heart rate before and after breathing exercises. Design: A quasi-experimental. Setting: The study was conducted in medical and surgical departments at a general governmental Hospital in Cairo, Egypt. Sample: A convenient sample of 120 adult patients. Tools: (a) the Structured Interview Questionnaire. It covers personal and Medical background data (b) Assessment data sheet: designed by the researchers, to record BP and heart rate measurements, (c) Automated digital Sphygmomanometer. Results: A total of 120 adult patients; Most of them was males, their age ranged from 51-60 years and married. There is no statistical significant differences were found in socio-demographic variables in relation to systolic and diastolic BP as well as heart  rate before and after intervention . High statistical significant difference was found in systolic and diastolic BP as well as in heart rate between before and after intervention. Conclusion: practicing slow deep breathing exercise decreased the systolic and diastolic BP as well as heart rate of patients with essential hypertension. Recommendation Replicate this study on a larger population with different medical diagnosis to ensure generalization of results. Key words:  slow deep breathing exercise, systolic blood pressure, diastolic blood pressure, heart rate, newly diagnosed patients, essential hypertension

Correlation between surgical patient supine positioning and the neurovascular injuries: Proposed nursing safety measures

Background:  The surgical supine position is the most common position used in the operating room. Even though, there are many risks to patients under anesthesia that result from supine position on the operating table. The aim was to investigate the relationship between surgical supine positioning and the related neurovascular injuries among patients undergoing elective surgeries. Question: What was the relationship between surgical supine positioning and the related neurovascular injuries among patients undergoing elective surgeries? Descriptive correlational design was utilized. Tools: I- Preoperative Assessment Data Form. II- Risk Assessment Scale for the Development of Injuries Due to Surgical Positioning III- Postoperative Neurovascular Assessment Form and IV- Numerical Pain Rating Scale. A convenience sample of 50 male and female adult patients over a period of 6 months; who had undergone elective surgeries and were positioned on surgical supine position and not suffering from neuropathy and neuromuscular diseases at one of Cairo University Hospitals, Egypt constituted the study sample. Results: There was a positive correlation between supine surgical positioning and postoperative neurovascular injuries among the study sample in relation to tissue perfusion, sensory alteration and postoperative pain as r = .503, .551 & .440 and p value = .000, .000 & .001 respectively.&nbsp

Impact of nursing instructions on selected outcomes among patients with head and neck cancer

Treatment of head and neck cancer with radiotherapy becoming increasingly effective but may result in several undesired complications as oral mucositis, xerostomia, dysphagia, trismus, mucosal infections, and pain. These complications can lead to marked weight loss and  nutrient deficiencies because of decreased oral intake rate. So, it is important to provide patients with nursing instructions through patient education and dietary modifications to prevent or decrease theses complications. Was to evaluate the impact of nursing instructions on selected patients’ outcomes (oral mucositis, oral pain, weight loss and the results of laboratory studies (hemoglobin and albumin) among patients with head and neck cancer receiving radiotherapy. Non-equivalent control group time series qausi-experimental design was used. The study was carried out at the oncology unit in kaser El -Aini Hospital. Cairo University. A convenient sample of 80 patients with head and neck cancer was recruited for this study from the selected oncology unit. Four tools were used to collect data: Demographic and Medical Background Information Form, National Cancer Institute Scoring for Mucositis (NCI-CTC V4), The Pain Numeric Rating Scale (NRS-11) and weight scale. Results supported the stated research hypotheses