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Specifics of nursing care for adolescent with intoxication
MAREŠOVÁ, Daniela
As the number of young people experiencing and experimenting with addictive substances gradually increases, so does the number of hospitilised drugged juveniles. There is also an increase in suicidal attempts undertaken by children using medicaments. Consequently, nurses encounter adolescents whose organisms are intoxicated by alcohol, drugs or medicaments at an increased rate. The purpose of this thesis is to determine nursing specifications which nurses implement when attending to young patients. It focuses on the differences of particular intoxications, the procedures followed, challenges and conventions. Additionally, a comprehensive view of this care is presented of which the recipients are, above all, underaged. This assignment has been compiled using qualitative investigations in the form of semistructured interviews. Conversations with ten nurses from child health departments, children's intensive care and resuscitation units, in addition to detoxication centres for children and youths have been acquired. The research conducted has found that the care for these patients is both physically and mentally demanding for the nurses. No divergence of treatment for underaged patients of any intoxication type has emerged and the most significant feature is coping with frequent aggression expressed on the part of the patients. Conclusions indicate the fact that a patient's age, manifestation, consciousness, vomiting and aggressiveness play a major role as opposed to the initial source of intoxication. This assignment intends to raise nurses' awareness and conversance with nursing care which is provided to intoxicated juveniles. Thereby, this paper contributes to the improvement of the care provided for these young patients.
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Social work with adolescents addicted to psychoactive substances
Malíková, Kristýna ; Krahulcová, Beáta (advisor) ; Nová, Monika (referee)
The aim of this thesis is to draw attention to the serious problem of drug addiction among adolescents who are abusing addictive substances or marijuana. This increasingly important issue is discussed a lot, but very often neglected by the society. This thesis provides definitions and characteristics of individual drugs and their effects on adolescents. The need for prevention and treatment of adolescent clients is emphasized, alongside with the family support, which is often crucial. In the practical part, the author of the thesis focuses on organizations that are critically important in this field. These organizations focus on prevention, counseling services, social inclusion and treatment facilities (inpatient and outpatient services), etc. Their characteristics and methods of client treatment are described. Furthermore, in this work the author presents a survey that confirms the findings of some detailed quantitative research papers. The main findings are that drug abuse is a major problem of this century and also a burden on society, especially on the adolescents themselves. The solution is very complicated and time consuming, but everyone can contribute by not being indifferent to this problem.
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Study of adsorption efficiency of diosmectite and charcoal on selected model compounds causing acute intoxication in the Czech Republic
Mináriková, Michaela ; Martínková, Markéta (advisor) ; Sedláček, Jan (referee)
The first step in treatment of acute intoxications is usually based on a method suitable to eliminate the toxic agent from the poisoned body. The principle of such a method consists of binding the harmful substances to the surface of a suitable adsorbent material. The aim of the present study was to compare the adsorption ability of two adsorbent materials, namely diosmectite and activated charcoal towards selected model compounds which are most commonly involved in acute intoxication in the Czech Republic. The eleven model compounds were selected: acetylsalicylic acid, α-amanitin, amlodipine, digoxin, phenobarbital, ibuprofen, imipramine, carbamazepine, oxazepam, promethazine, and theophylline. Of the tested compounds, promethazine was most effectively adsorbed to diosmectite. Its adsorption to diosmectite (0.191 ± 0.035 mg promethazine/mg diosmectite) was significantly higher than its adsorption to activated charcoal. Amlodipine, imipramine and carbamazepine were adsorbed both to diosmectite and to charcoal, by analogous efficiencies. The effect of temperature and pH on the adsorption efficiencies of these adsorbents was also evaluated. The utilized pH simulated physiological conditions in the various parts of the gastrointestinal tract. Surprisingly, the pH was not found to significantly...
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Secondary and terciary prevention of addictive substance
Kurz, Roman ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
My final work is about three basic types of prevention, which are used in the field of narcotic's prevention. It's mostly about secondary and tertiary prevention. Besides the basic terminology you can read about the details of differents preventions, who is responsible for it and also about the treatment of addictive behaviours. In my work you can also find the descriptions of legal and illegal narcotics, which excessive using leads to jones. The questions in the questionaire were created with a respect to the respondents - they are the clients of the mental treatment, who decided to help themselves (sometimes not for the first time).
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The crime of habitual drunkenness under s. 360 of the Criminal Code
Velich, Roman ; Říha, Jiří (advisor) ; Vanduchová, Marie (referee)
The crime of habitual drunkenness under s. 360 of the Criminal Code The purpose of this thesis could be summarized as a complex analysis of a crime of habitual drunkenness under s. 360 of the Czech Criminal Code. The described crime (sometimes named 'rauschdelikt᾿) represents one of possible approaches to a problematic question: How to hold a perpetrator who has committed a crime in mental state of insanity (irresponsibility), in which he had induced himself by use of alcohol, narcotics or similar substances, liable? As far as conformity with elementary principles of criminal law (such as 'nullum crimen sine culpa᾿) is concerned, the crime of habitual drunkenness seems to be the most suitable answer to the previous question. The crime of 'rauschdelikt᾿ is an old legal institute that is specific in many aspects. I have chosen the topic within the context of recent recodification of substantive criminal law. A previous regulation of this crime was often criticised for many reasons (e.g. improper title, too stringent penal sanction etc.). Thus we can now review if those criticised deficiencies have been set right. The thesis is divided into ten chapters. Chapter One is introductory and defines basic terminology used in the thesis, such as 'insanity᾿, 'culpability᾿ and so on. The third subchapter...
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The survey of selected parameters of the intervention of Fire Rescue Service of Prague in case of carbon monooxide presence
JOB, Lukáš
The association between intoxication by hazardous chemicals and selected parameters response of the Integrated Rescue System is currently a frequently discussed theme. This connection is especially observed where the main source of carbon monoxide poisoning. Fire and Rescue Service of the Czech Republic in cooperation with the Integrated Rescue System units solves a wide range of events every year just with the leakage of carbon monoxide. This gas was, and today still is the cause of much intoxication, especially when using Karma for water heating. That is the reason why this thesis focuses precisely on the investigation of selected parameters response of the Fire and Rescue Service of the capital City of Prague upon the carbon monoxide occurrence. Important factors influencing the progress of the intervention is i.a., knowledge of the toxic effects of this gas and its effects on the human body, but also adequate quantity and quality of the detection devices and protective equipment. This diploma thesis deals with the investigation of selected parameters mentioned above emergency interventions, be subsequently treated by in the period from 2010 to 2014 under the Fire and Rescue Service of the capital City of Prague. The theoretical part describes the hazardous chemical substance (carbon monoxide) in terms of chemical, physical, biological, and also its use. The important part is the detailed description of the intoxication of carbon monoxide in the organism, the degradation of the organism, consequences of poisoning and medical procedures. Further have been also described respiratory protective devices, which are focused on the protective filters. When processing the diploma thesis is also found all events with the release of carbon monoxide in the capital City of Prague territory. These data are based on the statistical monitoring of events that leads and processes Fire and Rescue Service of the capital City of Prague. From statistic of interventions are subsequently searched data on the number of killed, wounded and rescued persons who are within the statistics registered. As comparative parameters are selected data on average daily temperatures and average daily pressures in the capital City of Prague territory. These data are for the period provided by the Czech Hydrometeorological Institute, Prague subdivision. The diploma thesis is determined and verified hypotheses of influence of the average daily temperature on the frequency of interventions with the presence of carbon monoxide in the capital City of Prague territory in the monitored period, average daily pressures influence on the frequency of interventions with the presence of carbon monoxide in the capital City of Prague territory and affect of the average daily temperature on the average daily pressures. The gained information is comprehensively and detailed processed into tables. The events in tables are divided by years, months. Afterwards it provides a general overview of emergency interventions in the monitored period. The processed data are then statistically examined and evaluated. In the first part is determined statistical unit for the period of five years. The data are also tabulated together with the average temperature and the average pressure and then suitably scaled. Then calculation of the general moments of the first order, standard deviations and correlation analysis follows. The results are compared with prescribed intervals. Based on a comparison of the results with the prescribed intervals is evaluated that the number of events does not correlate with the temperature, so the number of events with a temperature not connected, the number of events is positively correlated with the pressure, which means that the number of events related to the pressure. The temperature correlates positively with the pressure, i.e., these two parameters together, purview within performed examination, related.
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Attitudes and options of nurses in the care of ethylene glycol poisoned patients. (theretical thesis)
KMETKOVÁ, Monika
Ethylene glycol intoxication, suicidal as well as accidental, belongs to serious, immediately life-threatening poisonings, which can however be cured even in the most severe cases (provided early recognition and correct treatment), including the restoration of renal function to the original state. Ethylene glycol is most notably present in anti-freeze cooling liquids for vehicles (such as Fridex). Consumption of 100-150 ml of such a solution is considered a lethal dose in humans. follows Oral ingestion is followed by rapid absorption. Metabolic decomposition takes place predominantly in the liver by way of alcohol dehydrogenase, to glycoaldehyde, which is further metabolised to glycolic acid and oxalic acid. The clinical aspect is dominated by acute renal failure which is caused by acute tubular necrosis. Toxicological examination including an assessment of ethylene glycol levels in both blood and urine, with prognostic relevance, is indispensable to diagnostics of the poisoning as well as from the standpoint of differential diagnostics. Therapeutic measures include gastric lavage within one hour of ingestion and administration of activated charcoal. Administration of ethanol and fomepizole, compounds that bind alcohol dehydrogenase and thus prevent the conversion of ethylene glycol to its toxic metabolites, is considered valid causal treatment with simultaneous early institution of hemodialysis (even in cases of hitherto intact renal function). As fomepizole is currently not available in the Czech republic, ethanol remains the only antidote. Therapy further includes correction of metabolic acidosis by way of bicarbonates, and intravenous application of thiamine and pyridoxine. Therapy of such a grave condition must entail infirmary care provided by professional nurses as a necessary complement. The nurse serves their function in securing the patient's airways, connecting the patient to mechanical ventilation, monitoring physiological functions, assistance with invasive entry, as well as conducting sample extractions, assuring proper hygiene, the prevention of decubitus ulcers etc. It has been the aim of an extensive effort during my analysis of this topic to collate an up-to-date summary of practical knowledge on ethylene glycol intoxication, as well as subsequent therapeutic options for such patients, based on collected information and available source material. This final thesis, entitled "Approach and Options for Nurses in Therapy of Ethylene Glycol-intoxicated Patients" has been created relying on a body of purely theoretical Czech and foreign sources. To attain awareness of the current state of medical sciences described on the following pages, many professional and scientific publications, books as well as journals and websites of registered professional societies had to be studied. The aim of a detailed inspection of such an extensive body of data has been to provide relevant findings based on the facts determined. The accumulated information is further specified in particular sections. The first deal with intoxication, elimination and first aid in the pre-hospitalization phase from a broader perspective. Without these elementary notes the thesis as a whole would lack in conclusiveness. From this section the thesis fluidly continues with ethylene glycol intoxication itself, its treatment and all the way to the role of the nurse including particular therapeutic measures. These sections contain specific recommendations issuing from news and cutting-edge research on ethylene glycol poisonings.
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Nursing care of intoxicated patients
SZTARSICHOVÁ, Barbora
This thesis deal with problems of nursing care of intoxicated patients. Nowadays increasing amounts of toxic substances associated with increasing number of hospitalized people with diagnosis intoxication. Nurse work with intoxicated patients can´t be done without good knowledges about this issue as same as without providing comprehensive nursing care. In theoretical part of this thesis we paid atenttion to general description and to the division of intoxication by journeys into the organism. We mentioned history of toxicology, division of intoxication by the cause of intoxication and drug intoxication. Then we paid attention to the toxicological information center, the diagnostics of intoxication, symptomes of some intoxications, treatment and elimination methods, specific antidotes, nursing care and communication with the intoxicated patient. For this thesis we set two goals. No. 1 : To find out what are problematic areas in nursing care of intoxicated patients from nurse´s point of view. No. 2: To find out specifics of nursing care of intoxicated patients. For this thesis were also set three research questions. Question no. 1 is what are problematic areas of nursing care of intoxicated patient from nurse´s point of view. Second question refers to discovery what role has nurse in taking care of intoxicated patients. And the last research question finds out specifics of nursing care of intoxicated patients. For processing the empirical part of this thesis was used a qualitative research for which we used semi-structured interview. Respondents were 9 nurses work at the internal medicine department, intensive care unit of internal medicine and urgent care department in Hospital of České Budějovice a.s. The data gathered from the interviews were subsequently analyzed and processed into three categories. The first category are the problematic areas in nursing care of the intoxicated patient. Second category is the role of nurses in the care of intoxicated patients and the last category is the specifics of nursing care of intoxicated patient. This survey has provided answers to our research questions. Nurses sees as the biggest problem in taking care of intoxicated patients mainly their lack of cooperation and aggression and also a problem in communication with this patient. Second question, what role has nurse in taking care of intoxicated patients, respondents said that the basic role is to fulfil doctor´s orders, take blood samples for toxicological examination and educated patients. Specifics of nursing care of intoxicated patients constitued of security against further injury and intoxication, prevent further absorption of toxic substances into the organism and elimination of toxic substances from the body of the patient. From the results of this work follows that nursing care of intoxicated patients is mentally challenging for most of the nurses mainly because reasons related to lack of cooperation and aggressive patients.
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Methanol intoxication
PÍCHA, Pavel
This bachelor thesis deals with the theme of methanol intoxication. This issue has been known by people for years. However, it came into the consciousness of people and medias at 2012, thanks to the infamous methanol affair. Methanol is extremely dangerous to people, especially because of its properties and its toxicity. Toxic metabolites are mainly: formic acid and formaldehyde. A man is almost unable to recognize the difference between methanol and ethanol- which is a part of many popular alcoholic beverages. During the methanol intoxication, particularly the basal ganglia and optic nerve are affected. Clinical symptoms of methanol intoxication are ebrieta, gastrointestinal problems such as: abdominal pain and diarrhea. Furthermore: visual disturbances, quantitative disturbance of consciousness, convulsions and acidosis. The severity of poisoning depends mainly on the amount of methanol consumed. Minimal toxic dose is 0.1mg per a kilogram of a body weight. The most efficient way, when providing the first aid, is to provide the patient with some ethanol. The most important steps for hospital treatment include administering antidotes of ethanol or fomepizole and hemodialysis. The aim of the study was to explore the knowledge of paramedics about taking care of a patient who is suspected with methanol poisoning. Qualitative research was conducted through interviews with medical rescuers of the South Bohemian Emergency Medical service. The research sample was given to 10 respondents of different gender, age and length of service. Respondents research group was chosen at random. Respondents were laid a total of 18 questions, which should determine whether paramedics have enough information about the intoxication and ways of how to take care about a patient suspected with methanol intoxication. The results are presented in a box, for better clarity. It showed, during interviews, that only a small part of the respondents have an experience with methanol intoxication. Furthermore, it appeared that the respondents have basic knowledge about methanol intoxication and they should be able to provide the patient, suspected to have intoxication with methanol, with proper first aid and take care of him without hesitation, especially in prehospital emergency care. Further details concerning the research are presented in the discussion. The objective was achieved. We managed, to reply positively on the question: Do paramedics have enough of new knowledge when taking care of patients being suspected with methanol poisoning. Paramedics, employees of the South Bohemian Medical Service have enough knowledge about taking care of a patient, intoxicated by methanol. On the other hand, the rescuers were missing the knowledge about the precise toxic doses of methanol and precise dosage of ethanol as an antidote. Most paramedics also did not know the subsequent exact procedure of hospital treatment, and new types of antidotes. The auxiliary leaflet about metanol intoxication was created on the basis of explored results of practical part of this bachelor thesis to help paramedics. Intoxication with methanol is not so frequent, but it is very dangerous and it is very difficult to diagnose it on the spot. When occured, it is important to know the first aid and the way of how to take care of a patient suspected to be intoxicated with methanol. People should learn from the cases described in the media and also they should stop buying alcoholic products from unknown manufacturers. It would be the prevention of further disaster. We only have one health.
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Nursing care about a patient under the influence of alcohol
TOMAŠÁKOVÁ, Zuzana
Abstract- Nursing Care for a Patient under the Influence of Alcohol This bachelor's thesis deals with the topic of nursing care for patients who are under the influence of alcohol. "Alcohol is the most spread and widely used psychoactive drug that is greatly accepted within our socio-cultural environment" (Fišer S., J. Škoda, 2009, p. 99). Today's hurried times influence greatly both the psychological and economic aspects of our lives. Therefore, there are many people who, when suffering from a stressful situation, decide to reach after alcohol as a crutch that should mitigate all negative impacts of today's times. But only a handful of them realize that alcohol does not solve any of these problems but rather worsens the situation, whether in the family or in the job. Alcohol causes serious health problems to manypeople and consequently they are forced to seek help in health-care facilities. In a worstcase scenario, it can happen that they end up on the streets and become homeless.Frequently, especially during winter, they have to be taken to a hospital. After the examination they are either hospitalized or, if not seriously injured, referred to a sobering-up centre. Of course, this situation also concerns other people who are under the influence of alcohol, not only the homeless. The nursing care of these patients has to face many problems, whether in terms of communication or aggressiveness. In the theoretical part of the thesis we discussed the terms alcohol, its history, its influence on our organism, the problematic of alcohol drinking among young people, blood and breath alcohol testing, origins and development of the alcohol addiction and its consequences. Moreover, we have examined the impact of alcohol on an individual's social environment, communication, aggression, the patient - nurse relationship, professional deformation and burn-out syndrome. Two objectives were created to comply with the plan. Objective No.1: To describe the approach of nurses to patients who are under the influence of alcohol. Objective No.2: To find out what issues have to face the nurses who take care of patients under the influence of alcohol. Consequently, two research questions were framed. Research question No.1: What are the specifics of the nursing care of a patient affected by alcohol. Research question No.2: What is the approach of nurses to patients who are under the influence of alcohol. The practical part of this thesis contains the results of a qualitative research that is based on an in-depth semi-structured interview conducted with nurses from the hospital Nemocnice České Budějovice a.s. We have approached twelve nurses to take part in this research; the only condition was their work in a ward where they frequently meet with patients under the influence of alcohol. Therefore, we have cooperated with nurses working in emergency department, in intensive care unit and in internal intensive unit. Subsequently, based on the open coding method, every nurse was assigned with a number (from one to twelve). The lines in the thesis mentioning the nurses' answers were numbered in order to refer to them. Using the method of "paper and pencil" important information was highlighted in the text and subsequently, the "showdown" technique was used to divide the gained data into five categories that were then divided into subcategories. The research investigation has provided answers to both research questions. The interviewed nurses stated that the main problems concerning the work with patients under the influence of alcohol are communication, as they have to communicate with these patients very carefully, calmly, to inform them in most cases only about the most important steps, and aggression which is a very common consequence of drunkenness. The cooperation with the police also becomes an integral part of the nursing care of patients under the influence of alcohol, because the saf.
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