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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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Pick´s disease and the specifics of the nursing care of a patient with this disease
KOPKAŠOVÁ, Lenka
Pick's disease is a degenerative-atrophic process that primarily affects the frontal and temporal lobes of the brain. Besides Alzheimer's disease, it is a lesser known form of dementia which affects people of younger age. Although the exact range of Pick's disease occurrence varies in the literature, the average reported age is between 50-60 years. The disease can change eating habits, cause emotional swings, inappropriate behaviour and sloppy appearance of the patients. The behaviour to others is often selfish, the patients are unable to listen to others and ignore their surroundings. Pick's disease is also characterized by inappropriate sexual behaviour. Globally, the number of dementia patients is still growing and according to expert guesses the increase will continue. Nursing care for patients with dementia is therefore becoming a very actual topic as dementia is called a quiet epidemic of our century. Nurses in their departments quite frequently encounter patients suffering from dementia of various origins at different stages of disability and the staff at healthcare facilities often regard these people as a burden. The aim of this thesis, which is called Pick's Disease and Specifics of Nursing Care for Patients with this Disease, is, based on the theoretical knowledge, to map definitions and diagnosis of Pick's disease, to define the needs of such a patient, and to list the most common problems in the nursing care. It focuses on people with dementia within medical facilities. For proper understanding of the problem, the thesis starts with the anatomy and physiology of the brain and the description of cognitive functions which are affected by the dementia syndrome and the definition of dementia. Based on the studied literature, dementia is divided according to various criteria. It has been found out that dividing dementia is not entirely uniform, but the essential facts and overall opinions of the authors do not diverge. Pick's disease belongs to a group of frontotemporal dementia and its position in this group has changed over time, as it is recorded in the literature. The thesis includes recommendations resulting from the studied literature in the approach to patients with dementia and emphasizes personal communication with the patients and empathetic and humane approach. Although medicine cannot prevent dementia, an early diagnosis of a specific type of dementia and correctly targeted treatment can increase the quality of life not only of the patients but also of their families. I have chosen this topic because I find it very current and interesting. During my nursing practice at the Surgery Department and Aftercare Department, I have met patients suffering from dementia and I did not know how to properly and efficiently communicate with them. For the theoretical part of my work, the methods of explanation, synthesis and induction on the basis of Czech and foreign information sources have been used. The most frequently quoted Czech authors in my thesis are doc. MD. Roman Jirák, PhD., the head of the center for diagnosis and therapy of Alzheimer's disease at the psychiatric clinic of the General University Hospital in Prague, the 1st Medical Faculty of Charles University. This thesis can serve as an informational and educational source both for nurses and the general public who may experience the disease within their families. It would be considered a great success if it helped nurses or family members to diagnose Pick's disease or other dementia at an early stage.
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Nursing process in patiens undergoing endoscopic examination methods.
FORŠTOVÁ, Eliška
In recent decades the endoscopy plays an important role in detection and subsequent treatment of diseases, through which the pathological changes in all hollow organs can be viewed and controlled either by physiological or artificial pathway. A great emphasis is put on care which is provided by the medical personal during the endoscopy. The first aim of the thesis was to find out how patients are prepared for the selected endoscopy and how they tolerate this preparation as well as the course and care after the examination and what information patients have about the steps after the endoscopy. The second aim was to find out how nurses prepare patients for the selected endoscopy and take care of them during and after those examinations. The research part of this thesis was processed as a form of qualitative research, a half-designed interview was chosen as a technique of data collection. There were two groups of researched ? patients who have undergone some of the selected endoscopy and nurses who took care of patients before, during and after the examination. The main results, which are summarized in the tables, include findings about the care which was provided to patients and nurser´s activities associated with the correct preparation before, during and after the examination. These tables are based on results of both reports. The results present that the patients are very well prepared by the nurses for selected endoscopy although these examinations are very stressful for the patients. That relates with their perception of care during the nursing process. Neither patients nor nurses can remember the complete set of acts associated with the preparation, the course and the nursing process after the endoscopy. In conclusion, nothing was neglected during the nursing process, including an information guideline after the endoscopy. Based on these results, an information booklet has been prepared which could have great benefits for patients undergoing selected endoscopy ? especially colonoscopy which is the most common endoscopy. The information booklet contains information about a suitable diet (without any left-overs) and food selection that the patient should follow before colonoscopy.
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Steel structure of a multi-functional sports hall
Valentová, Monika ; Barnat, Jan (referee) ; Štrba, Michal (advisor)
The subject of this dissertation is to design the steel structure of the multipurpose sport hall in Pardubice. The platform dimensions are 50,0 m x 60,0 m. Headroom of the structure is +12,347 m and the total height is +15,026 m. The main frame is created by column on one side and by the spatial truss arc beam.This main frame was chosen duet the evaluation of preliminary design of two variants. The static calculation of main load-bearing elements including joints and specific details was made for the selected option. The technical report and drawings specified by the supervisor. For design of the structure were used valid standards ČSN EN.
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Problems of education of the caregivers of the person with Alzheimer's disease
Jeřábková, Šárka ; Jurašková, Božena (advisor) ; Šlaisová, Ivana (referee) ; Vostrovská, Helena (referee)
The bachelor's thesis reports about problems of Alzheimer's disease. It briefly looks at the history of the illness, introduces diagnostic and therapeutic methods and also mentions alternative options of approach to the patient suffering from this disease. At the last but not least it describes the nursing care about such patient and emphasize the importace of education of the family caregivers. The main part of the thesis is created by quantitative exploratory survey which focuses at three work groups. The first group is represented by family caregivers of the patient with Alzheimer's disease. The survey's main aim is to find out about the amount of the information they have regarding the given problems and the way they deal with their new life situation. The second group is formed by general practicioners and the third group is represented by the home nursing workers. The target of the survey concerning these two groups is to find out about the extent of the education they pursue and eventual obstacles.
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