Ciencias de la Salud
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Item “Perforación yeyunal producto de lesión deportiva”(Carrera de Medicina, 2019-06-01) Pico Álvarez, Erika Monserrath; Loaiza Merino, Iván Patricio, Dr. Esp.Objective: Give characterize for patients who present traumatic perforation of the jejunum, identifying risk factors, diagnostic and therapeutic processes, to propose diagnostic-therapeutic strategies. Development: Jejunal perforation presents different etiologies, the most common, traumatic cause, in this study we present the case of a male patient to 18-year-old, he has abdominal pain of great intensity after blunt trauma while playing soccer that does not yield with analgesics. It is accompanied by qualm and trew up. Physical examination: conscious, afebrile, painful, abdomen tense in the table, absent hydroaerous noises, painful on palpation, dullness on the flanks and iliac pits. Chest X-ray shows pneumoperitoneum, bilateral subphrenic. Conclusions: The jejunal perforation is of surgical management, due to the complications that occur, death or abdominal sepsis. Doesn´t identify risk factors that are related to the traumatic cause, and its diagnostic is considered in clinic and on image exams, which help to improve therapeutic management. Recommendations: Active management with complementary tests in the shortest possible time would achieve a good forecast in the patient.Item “Paciente con pancreatitis postraumática y la influencia de los cuidados de enfermería.”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Enfermeria, 2017-05-01) Chávez Fajardo, Alexandra Belén; Zabala Montes de Oca, Magali Verónica Lic.Introduction: Traumatic lesions of the pancreas are uncommon but they are accompanied by a great morbidity and mortality, especially if the diagnosis is delayed and consequently the treatment, a relatively common thing given its poor symptomatology. Objective: To analyze the pathogenesis and risk factors involved in the development of pancreatitis in a patient with closed thoracic trauma and the influence of nursing care for its treatment and recovery. Methodology: Descriptive and field, which allowed to establish contact with the patient's reality, conducting direct interviews, surveys that will be supported with bibliographical sources, books, documents, scientific articles. Results: This analysis was carried out with the purpose of identifying the influence of the nursing team in the prevention and promotion of health in nursing care in patients with Posttraumatic Pancreatitis. During the development of this work it was possible to appreciate a patient who does not have a good quality of life, several risk factors and some critical points were identified. Conclusions: Based on the identification of different needs, a Guide to activities aimed at satisfying the needs presented by the patient is proposed. Among the improved aspects we have lifestyles, self-esteem and self-care.Item Recuperación Funcional y Muscular del Dedo Medio, Anular y Meñique tras la Amputación Realizada hace 3 años del dedo Pulgar e Índice de la Mano izquierda, sin haber asistido a Rehabilitación durante este período(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Terapia Física, 2016-10-01) Cadena Vasco, Annabella Stefania; Garcés Gordon, Lida Carmelina Dr. Ft.This analysis of clinical case under the theme "Functional Recovery and Muscular middle finger, ring finger and little finger after amputation performed three years of the thumb and forefinger of his left hand without having attended rehabilitation done during this period" documents and analyzes so detailed visits by the patient from the trauma suffered in his hand by crushing in a work accident at the different nursing homes, collect diagnoses, interventions and treatments prescribed different doctors who had contact in the process recovery, identifies risk factors to which the patient is exposed after amputation these being: biological, environmental, social and related lifestyle of the patient, an analysis of the current situation of the patient that never came is done rehabilitation fruit of this is very strong scar adhesions, lack of functionality and strength in the remaining fingers and a protocol and treatment plan is proposed to improve the functionality in the remaining fingers.Item Intervención de Enfermería en Trauma Craneoencefálico Moderado, Hematoma Epidural en Región Parieto-Temporal Izquierda más Trauma Periorbitario en el Servicio de Pediatría del Hospital Provincial General Latacunga(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Enfermería, 2016-10-01) Mejías Barrera, Jonathan Anderson; Landázuri Troya, Teresa de Jesús Lcda. Mg.This work is done in order to analyze the intervention and application of nursing care in a trauma patient suffering from moderate brain trauma, epidural hematoma in parieto-temporal left periorbitario, which will be aimed at improving the health status and the quality of life of the patient. The epidural hematoma is a collection of blood that occurs between the dura which is the layer surrounding the central nervous system and the skull; This research will be aimed precisely those measures and basic health care for the patient should apply to somehow mitigate the problems and consequences that can cause this pathological involvement. This analysis details the case of a male pediatric patient has a diagnosis of mild traumatic brain injury, epidural hematoma in parieto-temporal left more trauma periorbitario because it showed a drop of about 2 meters, presented loss of consciousness for about 2 hours, accompanied by injury occipito-parietal region left, edema and ecchymosis peri-orbital left, from which the patient begins to exacerbate the box symptoms and complications of the diagnosis as nutritional disorder, skeletal muscle and in the affective domain and psychological. It was taken as a basis for valuation functional patterns of M. Gordon the same as will serve to assess the health status of the patient and identify appropriate interventions that complement medical and drug treatment. In the case analysis may detail nursing care the patient received, if they were in line with the established management protocol, in addition to analyzing a priority education, training and emotional support to the patient and his mother; which it is of great importance to be able to positively adapt to changes and minimize complications that arise during their hospital stay; to achieve this objective a plan of nursing intervention based on functional patterns of M. Gordon and taxonomy NANDA NIC and NOC which is aimed at the patient and family on a guide behaviors and care to follow for maintenance is made optimal lifestyle.Item Necrosis Intestinal Infantil Post Traumática(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Zurita Mayorga, Lineth Carolina; Sánchez Miño, Jorge Isaac Dr.Femenine patient of 1 year 10 months, born and resides in Ambato (Pasa), product of second poorly, controlled pregnancy feat, well tolerated, domiciliary eutocic birth at nine months gestation, crying immediately after birth, underfed, imunizations complete for the age, adequate psychomotor formation, no personal or family history of pathologic significance. Patient 48 hours ago suffered a fall down steps (aproximately 5 steps) impacting their abdomen on concrete, 24 hours ago displays abdominal distention, refuses to eat, is found hyperactive, so they will lead to the emergency of the Provincial General Teaching Hospital in Ambato, the physical exam FC 100 beats a minute, FR 60 a minute, axillary temperature 36.2 0C, weight 10.3 kg. The examination hyperactive, irritable, oropharynx erithmatous, congestive, abdomen distended, RHA absent, tympanic percusión painful. Placed nasogastric tube being obtained 200 ml of greenish liquid, with a diagnostic of acuto abdomen obstruction and normocytic anemia, recieve hydration, analgesic, antibiotic therapy (Ampicilin and Sulbactam), labaratory exams, alkaline phosphatase: 292u/lm TP:24, 33, HB:8.4, HTC:26.4, leucocytes:22430, neutrophils: 17.59. Evaluated for surgery hyperactive is established patient with respiratory dificulty, abdomen very distented, RHA absent. In the X-ray of abdomen air fluid levels it is noted. Exploratory laparotomy found a heamoperitoneum of aproximately 800 ml in abdominal cavity, ruptura of intestinal meso with active bleeding, intestinal necrosis of aproximately 60 cm of the Treitz angle, rest of intestine with signs of edematous ischemia, spleen and liver of normal characteristics, with ileus anastomosis- ileal, released 60 cm from the angle of treitz and abdominal wash. Continues hospitalized in ICU for postsurgical control during four days displaying good clinical evolution, later it is transferred to Pediatric Services with diagnosis of closed trauma of the abdomen, ruptura of the intestinal meso, intestinal necrosis with ileus anastomosis- ileal, released after 28 days of hospitalization with frank improvement of their situation.Item Ruptura Vesical en Trauma Abdominal Secundario a un Accidente de Tránsito(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Pazmiño Andrade, Roxana Cristina; Yépez Yerovi, Fabián Eduardo Dr. Esp.Abdominal trauma is a common worldwide entity with the main cause traffic accidents. In our country accidents are among the five leading causes of death in the general population, so the trauma is the leading cause of deaths unrelated to an underlying disease. In blunt abdominal trauma, bladder injury is a rare entity and must meet precise physiological characteristics as this is distended that the present conditions it to break up with a soft thump. Bladder rupture may go unnoticed when associated with severe trauma and substances that alter an adequate response as the intake of alcohol. For the above conditions the importance of appropriate initial assessment of the patient with a detailed medical history, a thorough analysis of all risk factors, mechanisms of injury, physical examination and additional tests to reach a true diagnosis is emphasized. The management of intraperitoneal bladder rupture through the years and until now has been considered a surgical emergency; based on a quick scan with repair and bladder drainage this being the mainstay of treatment. So obtaining an excellent prognosis. This clinical case is a 30 year old patient presenting bladder rupture blunt abdominal trauma. The analysis of this case aims to generate scientific basis about the subject.Item Lesión Medular Postraumática(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Proaño Núñez, Jorge Luis; Lana Saavedra, Héctor Enrique Dr.Spinal cord injury is a sudden and debilitating disease with serious repercussions for the patient, family and society. It presents an incidence is increasing, which means to establish and follow protocols in order to improve the prognosis of these patients. This study was conducted in order to establish the clinical picture, course and treatment of a case with spinal cord injury admitted to the Teaching Ambato Regional hospital in 2015 and identify gaps in treatment according to the protocols in these cases. We found that these were not fulfilled and it is very important rehabilitation and psychological support for patients and families. It is suggested to strengthen these aspects for better results in survival and quality of life of these patients. This case corresponds to a male patient 29 years without pathological, personal and family important background, the reason for consultation by entering it suffered a sport, after 8 days of hospitalization due to accident that it was in the middle of a football match, site where a sudden movement exaggerated by neck flexion occurs; the patient starts with loss of sensation in their lower limbs, being transferred to private health-care center without any management or precaution that merits the case. He was treated in that nursing home where on arrival present neurological impairment (Ocular 3 Verbal 1 Motor 1) 5/15 scale GLASGOW, is admitted to intensive care unit for hemodynamic support, mechanical ventilatory support and conduct studies diagnostics. They fail to obtain autonomy for persisting respiratory apnea, given the conditions radiological studies column starts, but family transfer request which is authorized diagnosed with neurocysticercosis + Spinal Cord Injury (a rule) + polyneuropathy (a rule). Once transferred arrives at Ambato Teaching Hospital where the study of this case starts, Emergency patient presents Blood Pressure: 110/60 mmHg, heart rate: 62 beats per minute, respiratory rate 18 breaths per minute, on the scale of GLASGOW 11/15 (Ocular 4 Verbal 1 Motor 6), rhythmic heart, preserved breath sounds. Neurological examination Elemental: sensitivity preserved, quadriplegia, which suggests a diagnosis of: polyneuritis Guillain Barre type (a rule).Item Síndrome de Embolia Grasa Secundaria a Fractura de Fémur(2016-10-01) Moreira Granda, Edison Javier; Guerrero Sierra, Alfonso Bolívar Dr. Esp.For those who manage major trauma victims, the topic of fat embolism weighs heavily on the mind. The incidence of this problem can approach 90% in patients who have sustained major injuries. If it progresses to the rare clinical entity known as fat embolism syndrome (FES), a systemic inflammatory cascade affecting multiple organ systems, morbidity and mortality are high. Accordingly, swift diagnosis and treatment of fat embolism are paramount for ensuring the survival of this patient population. (1) Here, we present a case of a 25-year-old previously healthy who was admitted to our hospital after suffering a traffic accident with front right latero impaction against a trailer to go as copilot. The patient's injuries include a fractured right femur subtrochanteric fracture and contusions. The patient went on to develop fat embolism syndrome twelve hours after the accident. Its symptoms include poor respiratory mechanics with desaturation, tachycardia, tachypnea, irritability disorientation. Based on the clinical presentation and imaging support, the patient was transferred to the intensive care unit for hospital management. During the development of this clinical case we specify in detail the clinical, diagnostic methods, treatment and evolution that had the patient during their hospital stay.Item Trauma Ocular(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2015-03-01) Kelly Chico, Diana Carolina; Pérez Padilla, Carlos Alberto Dr.In emergency, there are countless emergency eye care, including eye injuries represent a considerable proportion, this condition requires a very cautious appropriate initial management and especially since the minimum possible manipulation of the eyeball is recommended until there is a specialist. Ocular trauma is a disease with important psyco social and economic connotation, fear that produces the fact of losing the sense of vision is invaluable, and more so if this is lost suddenly after trauma. In this work, the case of a young male patient is presents without importance background, he suffered a traffic accident that causes corneal scleral puncture wounds on both eyeballs, by the severity of the same evisceration decide left eyeball, the right eye was surgically repaired successfully although as post traumatic complications the patient has a cataract. Most data were extracted from medical records but to revise many things left unfinished, so it was very helpful interview with the treating physician. Detailed treatment given and compared with recommendations for management protocols and guidelines, mainly failures in emergency treatment carried find a situation that is quite common for the general practitioner is often not prepared for the initial management of this type of trauma, especially in the case of a severe trauma, besides the patient risk factors are analyzed and recommendations are given to prevent them. The patient in the postoperative period is post traumatic it is decided corrected in a second intervention waterfall, there is a delay in processing this surgery, the patient had a visual acuity of light perception. The literature recommends that the correction of a cataract should preferably be done in the first 10-14 days following the first surgery and that this period should not exceed one year.Item Análisis de caso clínico promoción Octubre 2014-Marzo 2015(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2015-03-01) Kelly Chico, Diana Carolina; Pérez Padilla, Carlos Alberto Dr.In emergency, there are countless emergency eye care, including eye injuries represent a considerable proportion, this condition requires a very cautious appropriate initial management and especially since the minimum possible manipulation of the eyeball is recommended until there is a specialist. Ocular trauma is a disease with important psyco social and economic connotation, fear that produces the fact of losing the sense of vision is invaluable, and more so if this is lost suddenly after trauma. In this work, the case of a young male patient is presents without importance background, he suffered a traffic accident that causes corneal scleral puncture wounds on both eyeballs, by the severity of the same evisceration decide left eyeball, the right eye was surgically repaired successfully although as post traumatic complications the patient has a cataract. Most data were extracted from medical records but to revise many things left unfinished, so it was very helpful interview with the treating physician. Detailed treatment given and compared with recommendations for management protocols and guidelines, mainly failures in emergency treatment carried find a situation that is quite common for the general practitioner is often not prepared for the initial management of this type of trauma, especially in the case of a severe trauma, besides the patient risk factors are analyzed and recommendations are given to prevent them. The patient in the postoperative period is post traumatic it is decided corrected in a second intervention waterfall, there is a delay in processing this surgery, the patient had a visual acuity of light perception. The literature recommends that the correction of a cataract should preferably be done in the first 10-14 days following the first surgery and that this period should not exceed one year.