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Nursing care of patient with coagulopathy.
RŮŽIČKOVÁ, Ivana
Abstract This thesis deals with the nursing care for patients with coagulopathy. Its aim is to monitor the issue and create a summary of information about the disease, its distribution, symptoms, possible treatments used in the diagnosis and subsequent treatment options for patients suffering from this disease. The main point of this work is of course the part about nursing care, where the emphasis is laid on the patient and the problems associated with the disease. After that, dealing with a deficit of needs is described where the nurse plays major role, in removing the deficit. Coagulopathy is a general name for diseases that are characterized by increased bleeding disorder or a lack of clotting factors or their inhibitors. The disease can be divided into two basic groups. The first group refers to the coagulopathy, which have originated based on heredity. Conversely, the second group is called up during the life of a patient and is due to the primary disease; that is most commonly impaired liver function. Congenital coagulopathy is often found in the literature under the name of hemophilia. This disease can be further subdivided according to which coagulation factor is violated. If the disorder relates to coagulation factor VIII, we're talking about the type of hemophilia A. Hemophilia B is then characterized by a lack of factor IX. Hemophilia C, which in our geographical conditions doesn't occur, is reported as a deficiency of coagulation factor number XI. Von Willebrand's disease, which is specific deficiency of von Willebrand factor in the coagulation cascade, can also be included among hemophilic disorders. Acquired coagulopathy arises as a secondary disease. Its cause is the liver diseases, which are mostly liver cirrhosis, hepatitis, obstructive jaundice. Coagulopathy, however, can be caused by poisoning by pharmacological drugs. Most are coumarin-type drugs, among which belong Paralen, Warfarin, Macumar. The difference in the treatment of patients with haemophilia and congenital coagulopathies lies in the realization that congenital coagulopathies are the subsequent diseases resulting from complications of the underlying disease. In this work we will also learn about investigative methods that lead to a subsequent diagnosis. Emphasis is placed on medical history, physical examination and subsequent laboratory methods that are most important for us in this disease. Among the basic laboratory tests there belong a blood count and coagulation tests. After that, imaging methods are important in patients with coagulopathy, because they are considered preventive care, preventing patients suffering from this disease from the occurrence of complications. The main point of this work is nursing, in which it is important for us to know how to manage care for patients with this disease and to deprive them of their current deficits of needs. Most often are these deficits associated with increased risk of bleeding and consequent violation of the integrity of the skin or soft tissues. A frequent problem is also the risk of infection. A major problem in the treatment of such patients are disturbances of mental state, where there is mostly disturbed body image due to hematoma forming on the patient's body or frequent bleeding. Patients with coagulopathy should also be aware of the possibilities of the refilling of vitamin K in the diet. Vitamin K is an integral part of the treatment of patients with acquired coagulopathy. A major problem for patients and for us as a medical staff is, after that, deficit of knowledge about the disease and its subsequent treatment by application of intravenous coagulation factor concentrates. In the Czech Republic there are two associations for this kind of patients. We're talking about Hemojunior association, which is intended for children suffering from hemophilia. Patient with this disease should bbe taken as an individual, and thus we should approach him.
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Cement composite materials with polypropylene fibers
Preisner, Martin ; Hela, Rudolf (referee) ; Bodnárová, Lenka (advisor)
This thesis deals with summarizing the possible effects of the addition of polypropylene fibers, especially low temperature plasma treated on the properties of cement composites and concrete. They are given basic information and distribution of polypropylene fibers. It describes the finish polypropylene fiber low-temperature plasma. The experimental part focuses on the effect of dispersion of polypropylene fibers treated plasma in the cement matrix.
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Methods of the emergency bleeding control and their use in rescue services
MADĚRÁNKOVÁ, Adéla
The theoretical part of this thesis refers to bleeding and the methods that are used to stop it. Descriptions of bleeding, physiological hemostasis, organism changes during hemorrhagic shock, methods of hemostasis, other treatment after temporary hemostasis and complications have all been included. This thesis contains well-known hemostasis methods such as the pressure bandage, but also new tools, for example the hemostatic gauze celox or newly developed tools like the Wound Stasis System. I set two goals for this research. The main goal was to find out which ways of hemostasis are used by ambulance services. The secondary goal was to compare the hemostasis equipment of the previously mentioned services. The research was done in a qualitative style. I used the managed talk method, which I addressed to 13 members of ambulance services. Each respondent belonged to a different organization from South Bohemia and South Moravia, they were all randomly chosen. Each of them answered the same 6 questions. They were asked about their training, equipment and hemostasis experiences. Furthermore, I was interested in their experience with the C-A-T equipment. The 13 subjects attending the survey are able to use all basic methods of hemostasis thanks to their training and equipment. Specifically referring to pressure on the injury, pressing pressure point, pressure bandages and tourniquets. Thanks to the equipment comparison I found out that ambulance services use the same equipment and the only differences concern the C-A-T system, the fixing pelvis belt and hemostasis gauze.
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Specifics of nursing care of patients with hemophilia
HOUSKOVÁ, Tereza
This bachelor thesis is divided into two parts. The topic is the specificities of nursing care of patients with hemophilia. The aim of theoretical part is to sum up in detail the issues connected to inherited coagulopathy, in this case hemophilia. It provides and discusses the definition, severity, causes, manifestations, diagnosis, complications, and therapy of the given disorder. Nursing care is an area not to be omitted when discussing hemophilia, especially due to the character of the disorder, which is highly specific and includes complex care. The empirical part of this bachelor thesis is based on the results of conducted qualitative research. The main goal of this research is to identify the specificities of nursing care of patients with hemophilia, including their specific needs. Further, this research sets to identify in what way are people diagnosed with hemophilia affected by this disorder. For this purpose, three targets were selected. First target is connected to the specific needs of the hemophiliacs. Second target is to map which parts of daily life of the patients are most influenced by hemophilia. Third and the last target cover the specificities connected directly to the nursing care of patients with hemophilia. The research questions were devised according to the aforementioned targets. Semi-structured interviews were used as the qualitative research method in order to fulfill the set targets. Semi-structured interviews were conducted with two peer groups, first group chosen for the purpose of this research were five nurses with experience in care of patients with hemophilia. Second group interviewed comprised of five hemophiliacs. The semi-structured interviews with the nurses aimed to identify the specificities of nursing care of patients with hemophilia, including their needs. The interviewees with hemophilia were asked mostly about their activity in daily life. The interviews were recorded and afterwards manually transcribed. Interviews were properly coded and categorized into specially devised categories. The results of the conducted research show that all the nurses identified as the most important specificity in nursing care of patients with hemophilia regular application of coagulation factor, which is usually done twice a week. However, they further note that during hospitalization, in most cases the time interval is shorter between individual applications. This is due to the planned procedures. The research concludes that due to the character of the disorder such as hemophilia, it is necessary to check on the patient more frequently in his room and monitor bleedingand last but not least the pain. All the nurses further stated that pain is one of the most important factors connected to fatigue. Therefore, heighten need for sleep can be observed in patients with hemophilia. A significant specificity in nursing care of patients with hemophilia, pointed out by the nurses, is that no intermuscular injection can be applied to such patients due to the high risk of bleeding into the muscle. Another contradiction is administration of drugs containing acetylsalicylic acid, which has a negative impact on aggregation of blood cells. All the nurses agreed that in terms of hygiene it is crucial to consider joint stiffness and their swelling, which are often accompanied by strong pain. Pain was also noted by many respondents as a factor that most often have a negative influence on their daily life activities. Contact sports or extreme sports are unsuitable for such patients, as they involve high risk of injury and consequent open or inner bleeding. Further, the respondents felt limited in terms of possible career choices, affected by their bleeding disorders. Based on this research an informational pamphlet was created. This pamphlet can be used as a source of basic information for patients with hemophilia and people close to them as well as for students of medical courses.
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KNOWLEDGE OF PREMEDICAL FIRST AID REQUIRMENTS FOR TEACHERS IN NURSERY SCHOOL
KOVÁŘÍK, Ondřej
Bachelor thesis ?Premedical First Aid Knowledge Requirements for Teachers in Nursery Schools? summarises urgent conditions and diseases occurring primarily among preschool children. The theoretical part deals with selected injuries, from the most serious injuries (resuscitation, disorders of consciousness, suffocation) to the less serious ones (eg fractures). Pathophysiology, symptoms and finally providing of first aid is briefly described for each of the injuries. This part was described mandatory legislation for teachers regarding first aid education in this section. I used a content analysis of professional publications in this part of my thesis. The second part is practical and related to my research. The aim of the research was to find out level of first aid knowledge among teachers in nursery schools. I used a quantitative method in the form of questionnaires in my research. The questionnaire consisted of fourteen questions. These questionnaires were filled mostly by teachers during personal meetings in nursery schools near my residence in Brno. The research is processed with the charts and descriptions. The results of the answers are given as a percentage in each graph. The hypothesis, established at the beginning of the research, was not confirmed. Teaching staff have sufficient knowledge of first aid. However, they have lacks in innovations piece of knowledge first aid (CPR, choking). In these cases, most teachers would act based on outdated standards. Primarily right answers dominated in further points of the questionnaire. My surprising finding was that half of those surveyed teachers had never undergone any first aid training.
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General knowledge of first aid for teachers of primary schools
JEŘÁBKOVÁ, Iva
The introductory section of the Bachelor paper describes non-professional First Aid as needed to manage the most frequently encountered health problems. Besides, the section lists the acts of law related to the First Aid that the teaching staff members are expected to study. The second section of the paper covers a research conducted at several randomly chosen Basic Schools in the Regions of Pilsen and South Bohemia. The paper aimed (1) to explore the level of competence that the teaching staff at Basic Schools are able to demonstrate in providing the non-professional First Aid; (2) to map the frequency and characteristics of First Aid extended at the Schools. The required data were gathered with reliance on the quantitative form of research, using the method of inquiry applied through the questionnaire technique. The questionnaires were distributed among the Basic School teaching staff. As the research results indicated, the teaching staff members are poorly oriented in the latest advances (in resuscitation, in treatment of snakebites and epilepsy). In these cases the teachers were found inclined to apply obsolete methods. Concerning the other questions, the correct answers prevailed. As a matter of some interest comes the fact that almost all of the teachers questioned were keen to take a First Aid course.
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Specific aspects of nursing care of a child with hemophilia.
RENDL, Lukáš
This thesis deals with care nursing for children with haemophilia. Haemophilia is a bleeding disorder that is classified as congenital coagulopathy. In the Czech Republic there are about 780 hemophiliacs, about 230 of them are hemophiliacs aged 0-18 years. Bleeding episodes are caused by the lack or the complete absence of one of coagulation factors VIII, IX and XI, each of which plays an important role in the process of coagulation and its deficiency or complete absence interferes with the clotting cascade. In the theoretical part, the classification of haemophilia according to types and stages, all types of the disease manifestations, the distinctive inheritance pattern of the disease, which causes the disease occurrence only in boys, are mentioned. From a nursing perspective, this thesis deals with psychological and social problems in these patients, the specific needs of haemophilia patients and the resulting specific nursing care. The thesis also presents a very specific haemophilia treatment according to the most modern methods and the comparison of approaches and treatment of hemophilia with other states. To conduct the practical part of this qualitative study, a quantitative survey was used, which was divided into two parts and was carried out in the period from January to April 2011. The aim was to determine how the cooperation between medical institutions and families of children with hemophilia is materialized. The research survey was carried out by using anonymous non-standardized interviews with four families with a child suffering from haemophilia and two nurses caring for heamophylic patients. Another objective was to identify the specifics of nursing care for a child with haemophilia. To meet this objective, anonymous standardized interviews with four nurses working in the children's ward of haematooncology were conducted and questionnaires for nurses and students of non medical fields were used. 12 nurses and 49 students took part in the questionnaire survey. The information received from the questionnaires has been processed into graphs. In the practical part of this thesis it has been identified how the cooperation between a medical facility and a family with a child who suffers from haemophilia works, the importance of a good approach taken by professional medical personnel especially in the early stages, when a family is confronted with the disease the first time, is referred to, and it has been found out that the health care workers´ approach influences the disease acceptance. Specific features of nursing care for a child with haemophilia have been identified, the most specific is considered dealing with coagulation factors preparates that are used to treat the disease. It includes dilution and the subsequent intravenous administration of the preparate, but also the hemophiliac´s family education on this issue. Structured education in this area contributes to the quality improvement of the life of haemophyliacs and their families so that the patients could be shifted to home treatment. The results of this thesis may contribute to the improvement of nursing care for children with haemophilia. The practical outcome is a booklet designed for children with haemophilia which can be used to teaching how to dilute coagulation factors preparates and the subsequent self-administration of the preparates.
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First aid´s Knowledge of Emergency Units
MORAVCOVÁ, Marta
Increasing number of life and health threatening emergency events causes significant financial and environmental damage. With their large range and destructiveness these events compel an effective communication of the available rescue capacities. This increase was the crucial moment for commencement of a development of such system which would join all the necessary establishments predetermined for dealing with a specific emergency situation and concurrently which would become an effective tool for its handling. Such system nowadays is the Joint Rescue Service. The basic establishments within the Joint Rescue Service are the Fire Brigade of the Czech Republic, the Medical Rescue Service and Police of the Czech Republic. Mutual collaboration during actions is co-ordinated and requires permanent co-operation, especially when securing personal safety of rescue groups of the Fire Brigade and Police. It is beneficial when members of these establishments are educated in the area of first aid application as also during the actions lives of these people are often threatened and only the immediate first aid in place may be the crucial prognostic factor. The objective of my Bachelor Thesis was to map the knowledge of first aid application at the basic emergency establishments within the Joint Rescue (Police of the Czech Republic and the Fire Brigade of the Czech Republic). The research group consisted of members of police and fire brigade of the South Bohemian Region. Data collection was in form of a questionnaire provided to be filled in. I distributed the questionnaires personally as I wanted to discuss the relevant topic with the police and fire brigade members and to know their opinion. The research proved that both the members of the Fire Brigade and Police of the Czech Republic are very well prepared in terms of the theory of first aid application to an injured person. The established system of education of policemen and fire brigade men rescuing people in need of first aid is probably functional and provides policemen and fire brigade men with enough information on fist aid basics. Although policemen have less practical experience it does not mean that they would not be able to apply first aid to an injured person. Both rescue services are well prepared for helping an injured person.
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