Description of the constraints of health of a patient registered the family health unit

Description of the constraints of health of a patient registered the family health unit of alto do maracanã in recife in 2014


University of Pernambuco (UPE)1

Research Journal of Pharmacology and Pharmacy-2d CodeHuman health should be seen as a whole, and analyzed in all its aspects: physical, social, cultural and spiritual. Understand the individual in all its complexity is essential for the development of actions that aim to improve health conditions of the entire population. In the context of nursing care, for the care occurs in the best possible way, the professional uses a work process for the effective assistance to each person. This process of work we call the Sistematização da Assistência de Enfermagem (Systematization of Nursing Care) – SAE. The SAE is a method made by stages that will give the nurse knowledge of the problem and will make him planning assistance for the solution of the problem of the individual. These steps are called: nursing history, nursing diagnosis, care planning, nursing prescription, evolution of nursing and nursing prognosis, this method allows the nurse to observe the specific needs of each patient, as well as his family; and through such observation the nursing professional prescribes specific care for the health problem. The objective of this study was to use and apply the steps of SAE to describe the health conditions of a patient user of a Family Health Unit (FHU) of Recife, PE, as a method of learning the content. It is an academic work developed as consolidation of curriculum content during the II period of nursing course. Initially it was chosen a family answered by the USF of higher risk according to the scale of Coelho&Savassi. The head of the family was interviewed for collection of health history, anamnesis and physical examination as a basis for the nursing diagnosis and draw a care plan. M.Z.N, 69 years old, woman, widow, evangelical and black race has the nuclear family composed by two sons, E.M.Z.N, 38 years and F.Z.N, 32 years. The genogram showed that the external structure of the family is composed of six children, 10 grandchildren and 2 great-granddaughters. Your children are present and show concern for her health. Has Problems of locomotion and depends on family and neighbors to bring her to any location outside the home. Their main complaint is numbness and pain in the lower limbs. Has difficulty of access to Basic Health Unit (BHU) due to mobility, requiring home visits frequently. Had multibacillary leprosy around two years ago, having completed the treatment recommended for one year. Recently had erysipelas and is under treatment with Benzetacyl. Reported hypertension and renal problems besides disc herniation (confirmed in the medical chart). In abdominal palpation was identified, in the right hipocondrial region, a hepatomegaly confirming the diagnosis of hepatic steatosis accentuated annotated on the chalkboard and confirmed by imaging examinations. After anamnesis and physical examination. The main nursing diagnoses raised were feeling of impotence, disorder of self-esteem due to signal of depression, hypertension and impaired physical mobility, for the reversal of these diagnoses were indicated, respectively: Assist the identification of strengths and the personal advantage, highlight the positive changes in the condition of the person; it was reported to the nurse to the Family Health Unit (FHU) a need of build up a trustable relashionship between nurse and pacient, estimulating the pacient to express her feelings and promove the social interaction through suppoting groups e visit of religous intitutions; Avoid prolonged periods sitting or lying in the same position, stimulate ambulation in short hikes and frequent (at least three times per day) with support in the event of instability, consult the physiotherapist for evaluation and a care plan; low sodium diet, and healthy daily practices. The diagnostics and measures to minimize them were discussed with the nurse site and presented and discussed in the classroom. The application of knowledge acquired in the classroom in care practice the community has enabled the students a significant experience of systematization of nursing care. The methods used for the family and social diagnosis, such as the Calgary Family Assessment Model through the genogram and ecomap, allowed an approximation with the history of life of the patient and understanding of the warp of determinants and constraints of her health-disease process. The application of connector A of the SIAB allowed know how was the life style of the chosen family and the scale of Coelho & Savassi allows you to evaluate the family in full, because they are reputable health problems, social and environmental. When the score is high this family is considered of risk and needs greater monitoring the USF, already the achievement of anamnesis, physical examination and the drafting of the SAE enabled a better learning theoretical-practical as well as the exchange of experiences with the services professionals. The practical experience in the community of content administered in the classroom is of utmost importance to the student grow as nurse committed with the health of people, since it enables you to interact in the context of the patient understanding it in your space and in their relations as a human being and not just as a patient or a pathology. In addition to providing a grounding practical that will be perpetuated through the whole graduation, as well as in professional life. This first contact with the family enables students see the subject hospitalized in a way integral, seeing the person beyond that moment not only at that time synchronic cutout.

Keywords: Public Health; Nursing Care; Physical Examination

Free Full-text PDF

1. Silva. EGC, Oliveira. VC De, Neves. GBC, Guimarães. TMR. O conhecimento do enfermeiro sobre a Sistematização da Assistência de Enfermagem: da teoria à prática. Rev Esc Enferm da USP. 2011;1380–61.
2. Santos N, Veiga P, Andrade R. REBEn exame físico para o cuidado do enfermeiro. 2011;64(2):355–8.
3. Alves KYA, Dantas CN, Salvador PTCDO, Dantas RAN. Vivenciando a classificação internacional de práticas de enfermagem em saúde coletiva: relato de experiência. Esc Anna Nery [Internet]. 2013; 17(2):381–8. Available from:
4. The FOR, Of P, In I. Extended nursing consultation: education possibilities for the practice of integrality in health. 2013;34(4):53–60.
5. HORTA, W.A. Processo de enfermagem. São Paulo: EPU; 1979.
6. Brunner & Suddarth: Tratado de Enfermagem Médico- Cirúrgica. 12ª ed. Rio de Janeiro: Guanabara Koogan, 2011. Vol. 2.
7. Carpenito-Moyet, Lynda Juall. Manual de Diagnósticos de Enfermagem. 13ª Ed. Porto Alegre: Artmed, 2011.
8. NANDA. Diagnósticos de enfermagem da NANDA: definições e classificação (2012-2014). Porto Alegre: Artmed, 2013.
9. Carpenitto, L J. Diagnósticos de enfermagem: aplicação à prática clínica. 8ª.ed., Porto Alegre: Artes Médicas, 2002.
10. Castro, C; Aguiar CCT; Blay, SL. A diferenciação entre os quadros depressivos com comprometimento cognitivo e demência nos idosos. Revista debates em psiquiatria, v. 1, n. 4, julho – agosto, 2011.
11. Fernandes, S; Rodrigues, E; Vianna, DL. Efeito da hidroterapia no edema de membros inferiores. Revista Mackenzie de Educação Física e Esporte, v. 10, n. 1, 2011.
12. Longo, MAT; Martelli, A; Zimmermann, A. Hipertensão Arterial Sistêmica: aspectos clínicos e análise farmacológica no tratamento dos pacientes de um setor de Psicogeriatria do Instituto Bairral de Psiquiatria, no Município de Itapira, SP. Revista Brasileira de Geriatria e Gerontologia, v. 14, n. 2, Rio de Janeiro, 2011.
13.BRASIL. Constituição Federal da República. Brasília: Governo Federal, 1988.
14.BRASIL. Ministério da Saúde. VIII Conferência Nacional de Saúde. Brasília: Ministério da Saúde, 1986 (Anais).