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Theory and Practice in the Care of Patients with Percutaneous Endoscopic Gastrostomy
NOVOTNÁ, Štěpánka
The bachelor thesis deals with the care of patients with percutaneous endoscopic gastrostomy. It is divided into theoretical and practical parts. The theoretical part describes enteral nutrition, malnutrition, percutaneous endoscopic gastrostomy, and nursing care. The practical part includes processing and evaluation of the results obtained in the research investigation. Two objectives were set for the bachelor thesis. The first objective was to determine the level of knowledge in nursing care of the PEG patient. The second objective was to determine whether nurse working in the selected wards follow the procedures according to the standards of nursing care when treating PEG. To meet the objectives, a semi-structured interview was chosen which included twenty-three questions. Interviews were conducted with ten nurses in the internal medicine and oncology wards treating patients with PEG. The results support the fact that the level of education and length of experience influence the nursing care of the percutaneous endoscopy gastrostomy patients. It was found that some probands do patient preparation before PEG insertion and patient care on day 1 of PEG insertion. The probands are able to administer nutrition, care for the puncture area and administer medications and fluids into the probe. Problems were encountered in suctioning of gastric contents and rotation of the cannula. Most probands adhere to the department 's standard and continue to educate themselves with the help of seminars, books, or the internet. Afterwards, the interviews revealed that probands mostly encountered complications such as redness around the puncture site or pulling out the PEG probe. It was also investigated how nurses record nursing care in the documentation and how they educate the family or the patient upon discharge to home care.
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The influence of diet on the absence and recovery of the menstrual cycle
MARTINÁSKOVÁ, Markéta
The aim of my Bachelors thesis was to find out what effect diet has on menstrual cycle loss and what effect diet has on menstrual cycle repair. Eating disorders, malnutrition, alternative diets, low body fat, hormonal contraceptives, stress, reduced energy intake and excessive physical activity can have a negative impact on the menstrual system. One of the most common forms of secondary amenorrhea is functional hypothalamic amenorrhea. Low level of estrogen occur, which has a negative effect not only on the reproductive system of women, but also on their overall health. Secondary amenorrhea that lasts 6 months or more results in thinning of the bones (osteoporosis) in postmenopausal age. Early therapy is necessary for the proper function of the female reproductive system. In the practical part, I evaluated a questionnaire of my own design and analyzed the diet records from respondents who have faced or are facing loss of menstrual cycle. The results of my questionnaire investigation confirm the negative impact of the above mentioned factors on menstruation. More than half of the women interviewed have experience of eating disorders. Almost 1/3 of the women are on a reduction diet. The daily energy intake of some of the respondents is below 1500 kcal. The vast majority of the women participate regularly in sports. More than 1/2 of the women experience frequent fatigue, stress and were facing difficult life situation at the time of loss of menstruation. Only less than 1/4 of the respondents use hormonal contraceptives or have an IUD in place. According to the questionnaire survey, more than half of gynaecologists do not deal with loss of menstrual cycle. After evaluating individual diets, it is clear that loss of menstrual periods occurs with low energy intake. By increasing energy intake, menstruation returns.
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The effect of dysphagic diet on the prevencion of malnutrition risk in the elderly
ZEMANOVÁ, Adéla
This thesis, entitled "Effect of dysphagic diet on the prevention of malnutrition risk in the elderly", deals with the dysphagic diet, which is a diet for swallowing disorders. Swallowing disorders are most commonly seen after stroke, in neurodegenerative diseases, head, neck and oesophageal tumours, and in critically ill patients or the elderly. For this thesis, I chose to conduct both quantitative and qualitative research involving two hospitals and one social service facility for the elderly. I divided the practical part into two subchapters. In the first, I discuss the processing of the observational data. Here I describe what kind of diet is served to patients with dysphagia in a particular facility, what technological procedures are used in its preparation and what meals are most frequently served in the facility. In the second part, the five-day menus of each facility are evaluated and compared with the values from the facility's dietary system. The research showed that if the patient consumed all the food given to him, he would not be at risk of malnutrition, as it is energetically sufficient and covers the needs of the elderly. However, in only two facilities did the patients receive a varied diet, and in one facility the meals or individual foods were more often repeated. The aesthetics of the food in none of the facilities corresponded to my idea of an attractive appearance of the prepared food, nor did the technological preparation of the food in any of the facilities correspond to the requirements of a textured diet - pureed. Therefore, it is likely that patients will not tolerate the diet because of the low variety, poor technological preparation, or the way it is served, because, as they say, we eat with our eyes. The intake would then be insufficient and could lead to a risk of malnutrition. It is therefore not possible to say unequivocally whether a dysphagic diet is a prevention of the risk of malnutrition in the elderly, but if the variety of the diet is maintained and the principles of technological preparation are followed, it could be.
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Care of the diet for pacients in an Anesthesiologic-resuscitation unit
BABIKOVA, Taťána
This Bachelor Thesis is on the problems with care about the nutrition for patients at anesthesiologic-resuscitation unit. The oftenest causes of disability to get meals normally in the acute medicine are: extensive operations, injuries, tumors or infections. From the beginning the patient must be fed only parenterally. After the regeneration of the intestinal passage the intestinal tract is loaded only parenterally. So, it is very important to choose proper methods to make their effect the largest. This thesis is divided into two parts: the theoretical and the empiric. The objective of this work is to map care about the nutrition for patients at anesthesiologic-resuscitation unit. For this aim we determinated the following questions: How do nurses at anesthesiologic-resuscitation unit take care about patients with parenteral nutrition? How do nurses at anesthesiologic-resuscitation unit take care about patients with enteral nutrition? For the realization of the empiric part of the thesis we choose qualitative research investigations. The collection of data was carried out by means of demi-structured dialogues wit nurses. The dialogues were rewrote to Microsoft Word 2016 word for word. Thus, obtained information was coded and then categorizied. The research investigation took place during April 2020. The research showed that nurses have enough knowledge of the problem with nutrition and they will manage to take care about patients with parenteral and enteral nutrition. We found out that at anesthesiologic-resuscitation unit parenteral nutrition is primarily launched and that is mostly through central venous catether or exceptionally through peripheral venous catether. After the stabilization the patient gradually moves on to the enteral nutrition in the form of so-called sipping up to the total applying the enteral nutrition more often through nasogastric tube or oral. The results of the search are realized in the project of the seminary for nurses which will be used for the deepening of their knowledge about these problems.
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Saturation of nutrition needs of seniors in seniors´ homes.
KAHOUNOVÁ, Dagmar
This bachelor thesis deals with the topic of saturation of nutrition of elderly people living in the retirement homes. Nutrition condition in the retirement homes is disturbing. The nutrition condition of elderly people is not rated enough. Insufficient nutrition causes many results and influences overall condition of elderly person organism. Reasons of insufficient nutrition can be influenced. The cornerstone for improving of nutrition condition of elderly people would be implementation of nutrition screenings to everyday care. The nutrition of elderly people has its specifics that should be kept during the elderly persons nutrition care. The bachelor thesis consists of a theoretical part and practical part. In the first part - theory -the main topics are old age, nutrition and malnutrition. The practical part follows on with a research. The aim of bachelor thesis was to find out which obstacles occur during the food intake of elderly people in retirement homes, how nurses satisty the nutrition needs of elderly and how nurses co-operate with other members of nursing care team. For achieving this goal there was used a qualitative research. The research was realized by method of semi-structured dialoques, questioning method. There were 10 nurses working for retiremnet homes who participated in above stated research. The interviews were written down by pencil-paper method and transcribed. As a result was detected that the nutrition condition of elderly people is only minimally rated. In the retirement homes there usually is not implemented any standard, there are only internal procedures. A nutrition specialist usually does not join the nursing care team. If there is neither its own cooking area/kitchen in the retirement home nor the nutrition specialist, there is not served the suitable food for each of the elderly person individual needs. It is neccessary to implement the nutrition screenings to everyday nursing care.
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Nutritional status assessment in patients with hepatopathy
Pirklová, Kristýna ; Novák, František (advisor) ; Ševela, Stanislav (referee)
In patients with liver cirrhosis, a high prevalence of malnutrition should be expected. Although the early diagnosis of malnutrition and well-chosen nutritional support have a positive effect on the patient's prognosis, early diagnosis of malnutrition might be difficult. There is currently no standardized diagnostic protocol for the nutritional status assessment of patients with liver cirrhosis. In patients with liver cirrhosis fluid retention occurs, which distorts the otherwise commonly used diagnostic criteria. The aim of the study: We wanted to evaluate the nutritional status of patients with liver cirrhosis in comparison with a acontrol group without severe comorbidity using anthropometric measurements, electrical bioimpedance, functional tests and laboratory parameters using diagnostic criteria GLIM (Global Leadership Initiative On Malnutrition) and various malnutrition screening tools. The work also focused on evaluating the quality of life of patients with chronic liver disease. Methods: The observational study included 11 patients with Child-Pugh stage cirrhosis A (n = 10) and B (n = 1), who were compared with a control group of 11 study participants without severe comorbidities. An examination panel consisting of anthropometric measurements, indirect calorimetry, electrical bioimpedance,...
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Nutritional disorders in patients with Huntington's disease
Procházková, Tereza ; Klempíř, Jiří (advisor) ; Kosheleva, Svetlana (referee)
OF THE BACHELOR THESIS This thesis deals with the issue of nutritional disorders in Huntington's disease. Huntington's disease is an incurable, neurodegenerative, autosomal dominant inherited disease. The prevalence of Huntington's disease in Western society is 10.6-13.7 / 100,000 individuals. The disease is manifested by disorders of free motor control, speech, swallowing, postural instability, cognitive deterioration and various behavioral changes. An integral part of the disease is unwanted weight loss. In the various stages of the disease, the causes of the development of nutritional disorders may differ and combine with each other. In the theoretical part, the chapters are devoted to the etiology and pathogenesis, pathology, clinical manifestations, forms and stages of the disease, nutritional disorders and their classification, methods of nutritional status examination and specific causes of nutritional disorders that occur in each stage of the disease. A special chapter focuses on the classification of nutritional disorders according to the European Society for Clinical Nutrition and Metabolism, which was applied in the research. The practical part aims to examine the nutritional status and evaluate eating habits in a group of patients with Huntington's disease through clinical and...
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Impact of Immunonutrition on the Patients With Cystic Fibrosis
Hloch, Ondřej ; Charvát, Jiří (advisor) ; Kohout, Pavel (referee) ; Rušavý, Zdeněk (referee)
The impact of immunonutrition in patiens with cystic fibrosis Abstract The aim of the study was to evaluate the application of immunonutrition in adults with cystic fibrosis (CF) and malnutrition, who have been receiving enteral nutrition in the form of standard sipping for at least a year. In 30 adult patients, immunonutrice (Impact) was given for 8 weeks. After 8 weeks, patients returned to standard nutritional support. The application of immunonutrition led to a significant reduction in systolic blood pressure and heart rate, to an increase in glomerular filtration and significant changes in the plasma aminoacidogram. Serum amyloid-A (SAA) levels decreased significantly and increased again after the intervention. However, immunonutrition administration was associated with an increase in serum malonyldialdehyde, a decrease in serum glutathione peroxidase and selenium. Thus, administration of immunonutrition led to an increase in oxidative stress, but almost all values remained within physiological limits. At 6-year follow-up, the long- term prognosis in the multivariate analysis depended only on baseline FEV1 and the degree of pulmonary involvement, respectively. The frequency and duration of subsequent hospitalizations and long-term prognosis were significantly associated with plasma fibrinogen levels....
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Evaluation of nutritional status and cardiac risk in patients with anorexia nervosa.
Pálová, Sabina ; Charvát, Jiří (advisor) ; Ošťádal, Petr (referee) ; Zamrazil, Václav (referee)
Anorexia nervosa (MA) is serious psychiatric disease associated with significant mortality. One of the main causes of mortality in these patients is cardiac complications. In 2003 - 2010 we examined 30 patients with established diagnosis of MA. Routinely used nutritional parameters are normal even in severe malnutrition in MA patients and we can ́t use them to diagnose or monitor nutritional status. Therefore we evaluated plasma aminoacids levels to detect minor changes of protein metabolism. According to our results we found mild hyperaminoacidemia and significant elevation of Gly/Val and Phe/Tyr ratio. In the second part of our research we performed non invasive examination s in risky patients with AN to consider possible cardiac complications. Results of ECG and echocardiography confirm results of the previous published studies. Original finding is significant decrease in flow mediated dilatation of brachial artery and its normalization after realimentation. We found also in ambulatory blood pressure monitoring significant decrease in blood pressure during the active period which was the consequence of changes in the heart rate variability. Decrease of the blood pressure in patients with AN in standing position was associated with increase of HF power in supine position and particularly with the lack of...
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