Care for the postoperative adult in the administration of insulin

Abstract

Introduction: Postoperative adult patients with cardiac surgery (POCC) with or without type 2 diabetes mellitus (T2DM) commonly present glycemic uncontrol, favoring the presence of complications that increase morbimortality.

Objective: To describe nursing care for adult POCC patients with or without T2DM in insulin administration.

Methodology: Systematized review with integrative methodology. Evidence-based nursing steps: clinical question; descriptors in health sciences: nursing care, administration and dosing, regular human insulin and human isoform insulin; search for scientific evidence (SciELO, CINAHL, PubMed, LILACS, CUIDEN), full text articles published from January 1, 2012 to March 31, 2017 in Spanish, English and Portuguese; reading and evaluation of scientific evidence with evidence table; and in-depth content analysis for evidence integration.

Results: 20 articles were found that met the inclusion criteria. Prevailing studies with level of observational evidence III / C, published in English in Anglo-Saxon countries of the medical area. Five dimensions were identified: nursing assessment, blood glucose measurement, glycemic control, complications due to hypoglycemia or hyperglycemia and recommendations or follow-ups for nursing.

Conclusions: Evidence-based nursing care can improve metabolic control and prevent complications from hypoglycemia and hyperglycemia.