Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
Residente Medicina Interna Hospital Universitario Virgen de la Victoria, Málaga, España.
Enferm Intensiva (Engl Ed). 2021 Jan-Mar;32(1):48-53. doi: 10.1016/j.enfi.2020.02.006. Epub 2020 May 4.
McArdle's disease or glycogenosis type V is a rare disease due to deficiency of muscle myophosphorylase leading to inability to degrade glycogen at this level. Patients have fatigue, pain, and cramps on a regular basis. In addition, after intense exercise or stressful situation, they are exposed to cellular lysis. This can occur in the form of rhabdomyolysis and myoglobinuria, a potentially serious clinical syndrome if not treated quickly.
We present the care plan of a 38-year-old man with McArdle's disease and secondary rhabdomyolysis on physical exercise, which required attention in the Emergency Department for 24 hours, as well as his subsequent admission to the ward. A nursing evaluation was performed following the care model of Virginia Henderson.
Priority was given to nurse diagnoses: (00016) deterioration of urinary elimination, (00092) activity intolerance, (00093) fatigue and (00132) acute pain; and potential complication: risk of acute renal failure.
The Care Plan is developed following the NANDA-NIC-NOC methodology, with special attention to alterations in the elimination and musculoskeletal system. The diuresis is monitored. Fluid replenishment is performed, and analgesic medication is given.
There is little literature on the nursing care of patients with McArdle's disease, which has limited the comparison of our results with those of other authors. However, given the good response of the subject through fluid replacement, optimal pain control and rest, they made a rapid recovery.
McArdle 病或糖原贮积症 V 型是一种罕见的疾病,由于肌肉磷酸化酶缺乏,导致无法在此水平降解糖原。患者经常出现疲劳、疼痛和痉挛。此外,在剧烈运动或紧张情况下,他们会发生细胞溶解。这种情况可能表现为横纹肌溶解症和肌红蛋白尿,如果不及时治疗,这是一种潜在的严重临床综合征。
我们介绍了一位 38 岁男性的护理计划,该患者患有 McArdle 病和继发性横纹肌溶解症,这是由于体力活动引起的,需要在急诊室接受 24 小时的治疗,随后还需要住院治疗。我们按照弗吉尼亚·亨德森的护理模式进行了护理评估。
优先考虑护士诊断:(00016)尿排泄恶化、(00092)活动不耐受、(00093)疲劳和(00132)急性疼痛;以及潜在并发症:急性肾衰竭风险。
根据 NANDA-NIC-NOC 方法制定护理计划,特别关注排泄和肌肉骨骼系统的改变。监测利尿情况。进行液体补充,并给予镇痛药物。
关于 McArdle 病患者的护理,文献很少,这限制了我们的结果与其他作者的结果进行比较。然而,考虑到患者通过液体替代、最佳疼痛控制和休息,病情得到了迅速恢复,情况良好。