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Nursing Issues in Patients with PEG
Konířová, Lenka ; Pavlíková, Pavla (advisor) ; Škochová, Dagmar (referee)
Bachelor thesis were written on theoretic-empirical bases. The theoretical part is dedicated to general introduction into anatomy and physiology of stomach. The following chapter is about nutrition, the explanation of the terms malnutrioton, nutritional support, enteral nutrition as well as its indications, contraindications, complications, types and forms of artificial nutrition included. The core chapter is about the implementation and treatement of PEG, the psychosocial aspects and specifice of home care included. The aim of the empiric part is to find out to what extend is the issue of PEG familiar to nurses, what are the possibilities in treatement of the patients with PEG, how the patients react to the PEG treatement and nutrition at home. A quantitative method of annonymous questionnaires was used to effectuate this survey. The tested sample formed 111 respondents/nurses and 22 respondents/patients with PEG in home care. The results of the research show that 99% of nurses are familiar with the PEG and 86% are convinced about having enough information how to treat the patient wih PEG. 66% of respondents/nurses are not familiar with any complications during PEG in hospital. The results from patients treated with PEG in home care are following: 21 respondents/patients (95%) are able to treat...
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The role of a nurse in the care of a patient´s nutrition
SKŘÍŠOVSKÁ, Martina
This Master's Thesis "The Role of a Nurse in the Care of a Patient's Nutrition" is written in a purely theoretical plane, deals with the basic pillar of the existence of the human organism the correct and sufficient nutrition of a human, and studies the extent of an involvement of the general nurse in satisfying biological, psychological aspects of patient's nutrition in the nursing process. The topic of nutrition plays an important part of the complete spectrum of each medical expertise. The satisfaction of patient's need for nutrition in all of the stages of his life is a part of a nurse's job in a nursing process not only in Intensive Care Units, Resuscitation Care Units and Standard Care Departments, but even in Geriatric Units and Social Care Institutes. The thesis is methodically divided into separate parts, each logically following its preceding one. In the Introduction we define malnutrition as a global medicinal and social problem, introduce principles and theoretical starting points of an organisation of an optimal nutrition care and introduce international activities, which contribute to creating guidelines using the Evidence Based Practice method, and implementation of effective methods in providing complex care of a patient's nutrition in medical facilities and institutes of social care. We follow with the summarisation of basic nutrients, emphasising their importance for the right function of a human body, and negative effects of their insufficiency in the food intake. The thesis presents an algorithm of an evaluation of a patient's nutrition state in a nursing process, comparing available screening standardised questionnaires, which are usable in detecting sings of a malnutrition. We present the possibilities of food fortification, specify targets of nutritional support in medical facilities, focusing on indications, benefits, risks and paths of application of enteral and parenteral nutrition, and provide complete summary of nutritional interventions in the context of nursing care, which is oriented on ensuring the food intake. In the Conclusion, we identify those aspects of the patient's nutrition care, which are hard to fulfil and realise, and those psychological and social-cultural aspects, which the nurse can in the nursing process satisfy only when using holistic and empathetic approach. The altruistic, but controversial and ethical-philosophical topic represents not initiating or ending the interventions of nutritional support, where this decision respects principles of beneficence and non-maleficence of The Hippocratic Oath, the quality of a patient's life and human dignity.
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Quality of life of selected groups of clients with Crohn's disease
Hejlová, Ivana ; Hlaváčová, Marie (advisor) ; Nikodemová, Hana (referee)
My dissertation work called "The quality of life within selected groups of clients with the Crohn's disease" is analysing the subjective evaluation of the clients' life situation, that describes their day-to-day struggle with this chronic disease. This work is divided into two parts, theoretical and empirical. The objective of the former is to present the current findings about the Crohn's disease, to describe the term "quality of life", defines its various meanings and history and specifies the assessment methods in the clinical practice. In the latter, there are set objectives and working hypotheses for own evaluation. The target of the empirical part is to obtain real life data through questioning methods, partly based on the standardised WHQL-BREF methodology. The obtained data will be subjected to primary analysis in order to create an evaluation result for a selected group of clients. In the last part, this dataset will be compared with the previously measured values on quality of life of clients with Crohn's disease.
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Nutrition of patients in oncology departments
FOUSKOVÁ, Diana
The title of my bachelor thesis is Nutrition of Patients in Oncology Departments. In the theoretical part, I focused on the characteristics of malnutrition cancer, its symptoms, types of tumor malnutrition, its causes and consequences. Then I mentioned and described the various changes in metabolism of an oncology patient and a diagnosis of malnutrition. In the next part I described various types of nutritional support. In the theoretical part, I also focused on cancer therapy, where I described types of cancer treatment, various side effects of cancer therapy associated with intake of food and beverages and for every undesirable side effect I stated dietary recommendations. In the last part I mentioned risk factors and prevention of cancer. The goal of the practical part of my bachelor thesis was to determine the nutritional status of hospitalized patients in oncology departments in the context of anticancer therapy. I responded to three research questions: 1. "How does the antitumor therapy affect quality and quantity of consumed food?" 2. "How often must parenteral and enteral nutrition be applied to these patients?" 3. "How does the antitumor therapy affect the patient's weight?" The method quantitative and qualitative research was used for processing of the research part. The research was conducted by creating a week's records of diet, which were recorded by hospitalized patients in two departments of oncology. The research sample consisted of 50 oncology patients. Week's records of diet were recorded by 30 patients at University Hospital in Olomouc and by 20 patients at the University Hospital in Motol, Prague. The results were processed by Nutriservis software. Values of energy, protein, fat and carbohydrates calculated by Nutriservis software were compared with the recommended values corresponding with weight and age of the patient. I also examined the number of cases of parenteral and enteral nutrition and weight loss during cancer therapy by having records of the patient's weight at the beginning of anticancer treatments and their current weight. All patients were in the second half of anticancer treatment. I learned this information from patient documentation. To be allowed to have a look into the patient's documentation I prepared informed consent form, which I had consequently signed by the patients. The processed data are interpreted using tables and graphs, which are always accompanied by commentary. I have divided patients into groups according to diagnoses for evaluation. The results show that most patients have an inadequate intake of energy and essential nutrients. Food intake of patients has shown to be dependant on the type of tumor. Patients with carcinomas of the upper digestive tract, colon and carcinomas of liver, gall bladder and pancreas have larger deficiency of energy, proteins, fats and carbohydrates in comparison to patients with genital carcinomas. Patients with carcinomas of the kidney and urinary tract have also shown a significant deficit of energy, protein, fat and carbohydrates. The nutritional support was very common, particularly to patients to whom the tumor caused obstruction of some part of their digestive tract. As for carcinomas of the upper digestive tract, PEG is implemented to most patients. Very common was providing of sipping as an addition to their normal diet and in case of major nutrition complications parenteral nutrition was also often applied. The weight loss was apparent on most the patients. How significant was the weight loss depended on the type of tumor. Adequate intake of energy, nutrients and drinks during anticancer treatment is very important for patients. In the case of formation or developement of tumor malnutrition or developement of complications associated with food intake, nutritional support should be ensured timely according to patient's individual condition.
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The role of nurses in the care of chronic wounds by using alternative methods and materials of moist wound healing
SKŘÍŠOVSKÁ, Martina
This bachelor?s thesis deals with the actual classification of wounds and the issue of the chronic wound treatment. In the preface of the theoretical part of the thesis, the term wound is defined and the wounds are subcategorized in the terms of their pathological traumatological origin. In the next chapters, the process of the wound healing is analysed from molecular biological aspect, the terms acute and chronic wound are defined and newly introduces the term non-healing wound for the chronic wound. In the special part, the particular pathological-surgical types of chronic wounds are described from their molecular biological, surgical anatomical and therapeutic point of view. Next, the paper specifies risky factors influencing wound healing process aiming their therapeutic influenceability. These factors are further divided into the system ones and the local ones. The thesis continues with the analysis of the therapeutic and nursing possibilities in the chronic wound treatment describing traditional bandages including sterile pieces of gauze and disinfectant solutions for the materials of the moist wound healing. This is followed by the chapters discussing modern methods of the debridement of the chronic wound such as ultrasonic hydrotherapy, negative-pressure wound therapy or larval therapy. Each chapter describes both the indications and the contraindications for the use of these methods, their advantages and benefits for the patient, aiming the role of the nurse in the chronic wound healing process using these methods. The end of the theoretical part of the thesis is devoted to the nutritional support and the systemic enzymotherapy, which ensures a sufficient energy intake to the organism and both all the macronutrients and micronutrients necessary for building the body tissues. The empirical part of the thesis is in the form of a qualitative research focused on the documentation of the role of the nurse in the care of the patients with a single type of the chronic wound ? more precisely the patient after laparotomy with an extensive resection of the digestive system and a subsequent secondarily healed chronic wound. The method of using case studies was used to accomplish this goal. The record of the chosen group of the patients and the process of the systemic therapy with the support of the cardiovascular, ventilatory and nutritional functions regarding the surgical performance is acquisited and it is completed with the description of the local therapy of the chronic wound, with the description of the role of the nurse in the healing process and with the enclosed photo documentation. Casuistries describe the regression, the stagnation or the progress of the wound healing process; they map the role and the participation rate of the nurse in this process and the use of alternative equipment in this process and the art of improvisation. The summary of the results brings up the conclusion that the scientific and technological progress opens up new possibilities to the patient with the chronic wound and introduces modern technological procedures into the chronic wound therapy though there is a group of patients after laparotomy surgeries with the conducted extensive resection of the digestive system and with the subsequent anastomosis dehiscence, which is contraindicated for the use of these methods. These patients are left to depend on the holistically provided care of a multidisciplinary team with irreplaceable role of the nurse. Biopsychosocial needs of the patient puts great demands on the nurse regarding both the personal and the professional side. The reasoning at the end weighs up and suggests the possibilities of the participation of the nurse in the preoperative preparation of the patient for the planned resection of the digestive system mainly in the form of the education in the support of the nutritive functions and the systemic enzymotherapy.
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The role of the nurse in providing care to patients with short bowel syndrome
BUNDOVÁ, Jana
Short Bowel syndrome characteristically belongs whithin a groop of recognizable symptoms which result from the loss of small intestine or damaged absorption. Because of the advancement of complex medication and intravenous feeding, home patient care is continously increasing. In the year 2008 intravenous feeding was used upon 57 adult patients in 15 health centres. These patients are vulnerable to the full range of complications. Among the most freekvent complications are infections of the location where the needle is injected. The role of the nurse towards the patient is irreplaceable due to the importance of the care resting upon the nurse to ensure no infection can originate. This research deals with the difficulty of the nurse´s role assigned care of the patient with Short Bowel syndrome. The goal of this project is to map out the level of information and experiences which nurses have regarding the care of those patients whit this afliction. A further goal is to discover how careful the patients are regarding the use and care of intravenous catheter to keep infection away. From the analysis obtained, the majority of the nurses have enough informations conserning the care of patients with Short bowel syndrome. These nurses consider the care of these patients to be every bit as demanding as the care required for patients with other condicions. Nurses are now capable of taking control of this care. This viewpoint is supported by even patients who have this condition who have had faverable experiences. Patients are now well enough informed to be able to indepenndently administer intravenuous injections in ther own home envirement, but always in the copany of family members or a home care assistent
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