Glicemia instável no paciente submetido à hemodiálise: análise de conceito
Unstable blood glucose levels in patients undergoing hemodialysis: concept análisis
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Objetivo: Analisar o conceito “Glicemia Instável” no contexto do paciente submetido à hemodiálise. Métodos: Análise conceitual, realizada a partir do método proposto por Walker e Avant e operacionalizada por meio de uma Scoping Review. Os dados foram coletados em janeiro de 2023, mediante busca de publicações elegíveis em bases de dados e catálogos de teses e dissertações nacionais e internacionais. Resultados: os atributos críticos identificados foram: variação glicêmica fora do padrão de normalidade e hemodiálise. Os antecedentes identificados foram: Ingesta alimentar insuficiente/ Jejum; Uso inadequado de insulina ou de agente hipoglicemiante; Dialisato sem reposição de glicose; Diabetes Mellitus; e, Idade avançada. Os consequentes foram: Hiperglicemia; Hipoglicemia; Aumento da morbidade; Aumento da mortalidade; Eventos cerebrovasculares; e, Eventos cardiovasculares. Também foi construído um caso modelo e caso contrário e as referências empíricas. Conclusões e implicações para a prática: a análise do conceito “Glicemia Instável” gerou a definição de suscetibilidade à variação glicêmica fora do padrão de normalidade durante e/ou após a hemodiálise. Esse conhecimento contribui para compreensão de forma ampliada do fenômeno e pode apoiar o desenvolvimento de intervenções que fortaleçam a prevenção dos efeitos da variação glicêmica nesta clientela.
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