|
|
Possibilities of physiotherapy in patients with complications after total hip endoprosthesis in
FEREBAUEROVÁ, Martina
There is an increase of number of the total hip joint prosthesis arthroplasties in last years and also the patient age limit is falling down. This leads (for prosthesis determined lifetime) also to the increasing of the number of re-surgeries because of aseptic release. This kind of surgery is for patient more strenuous than primary surgery and so brings higher risks of the possible complications. Complications are not rare even after the primary surgery of the total hip joint prosthesis arthroplasy. Most frequented complication is higher mentioned aseptic release, which results from the organism reaction to the abrasive PE particles, which fall off the worn joint. Next highly frequented complication is the infection in the total prosthesis area, where the cause could be local or global. The next feared complication is the luxation of the prosthesis after total hip arthtroplasty. This luxation is very soring and the nerve damages are possible. The nerve damage is potential also due the surgery. Next complications: thrombosis embolism, different length of the limbs, active scar tissues, lymphedema, heterotopic ossification, periprosthetic fractures, mechanical damage of the artificial hip components. According to the time of complication occurrence may be complications sorted as: pre-surgery, early, late. Target of this work is mapping of the physiotherapeutic procedures used at the patients with the complications after the total hip joint prosthesis arthroplasty. Next target is the processing of casuistries and physiotherapeutic plan forming by chosen complications. As research array were chosen three probands with different complications. The first proband is patient after re-implatation of total hip joint arthroplasty because of infection, second proband is diagnosed different limb length, third is patient with the active scar tissue. Therapy has been treated by every single proband individually and was fitted individually according to patients diagnosis. Due whole therapy was the unit for comprehensive physical training and physiotherapeutic procedures set to contemporary probands condition. This consists of theoretic part and practical part. Theoretic part deals with topics as hip joint anatomy, hip joint aloplastic and complications, which could because of aloplastic occurred, re-implantation of total prosthesis athroplatsty and in meant problematic used physiotherapeutic procedures. The qualitative research was chosen for the practical part of work. Results are worked out as casuistries using the methods of interview, spectating, secondary data analysis and kinesiological testing. The physiotherapeutic plan design is based to initial kinesiological test. Therapy was treated according to this plan. The output kinesiological test was worked out in the end of therapy and after results evaluation was designed long-term physiotherapeutic plan. The therapy was treated 4-5 weeks to every patient. The results say that by all patients came improvement of the movement extent in the operated hip joint, also to the pain reduce or pain elimination, increasing of the muscle power and the walking stereotype. However, some of the pathological movement stereotypes and muscle shorting still remain or were just partially reduced. Altogether, with the total hip joint prosthesis arthroplasty patients with different complications are connected strong muscular dysbalances and disrupted stereotypes of movement and walking. These changes are caused by antalgic position in the joint. Shortly, if the hip joint is long-term affected, then will be the affect evinced on the global deportment.
|
|
|
Problems of nursing care in endoscopic retrograde cholangiopancreatography.
RYVOLA, Lukáš
Theoretical groundwork Endoscopic Retrograde Cholangiopancreatography (ERCP from now on) is nowadays referred to as the golden standard in diagnostics and treatment of bile duct and pancreas diseases. At the same time it is regarded as the most reliable method of modern medicine in diagnostics of most common oncogenic diseases of pancreas. This examination combines endoscopic diagnostics with X-ray screening and it is unique thanks to the direct display of bile and pancreas ducts. Final picture is made by probing of Vater papillae filled by a contrastive liquid. Other merit consists of completing eventual therapy that follows the diagnostic ERCP. Disadvantages of this examination are complications that may arise already when probing or after a certain period of time. Therefore it is essential to consider each ERCP procedure carefully. Nursering ERCP at the endoscopy section as well as at the ward block of the gastrointestinal department bears its particularities. The priority at the endoscopic section is to employ manually and technically competent nurses skilled in ERCP so they can assist the gastrointestinalist properly. The nurses must be also able to establish contact with the patient to guide him through the examination, using professional skills. Exactly the nurses moderate possible concerns of the examined person. Communication at the ward block is crucial as well ? the nurses explain particularities of the treatment and instruct the patient in basic rules of hospitalisation. They also must be professionally skilled to care for patients after ERCP. Goals of the thesis The aim of this thesis is to monitor particularities of nursing ERCP at the endoscopic section of the gastrointestinal department and to learn how the general treatment of ERCP patients is carried out at the ward block.Qualitative methodology was used for the empirical part of the thesis. Data were collected by interviewing and hidden observations.Results The research survey indicated that ERCP examination nursing treatment bears its particularities that are well known and reflected by nurses at the endoscopy section. Patients confirm that the skills of nurses minimize their stress when undergoing the treatment. The survey indicated that an ERCP examination should be assisted by a nurse with not only technical and manual skills but also empathic and anticipating qualities in order to react appropriately without confusion. Nurses should be able to explain the treatment to the patient properly and to create a comfortable ambience. The survey also indicates that nurses actively seek for courses to keep their knowledge up to date. Particular complications are managed very well by the nurses, they are familiar with specific complications and are always prepared and able to provide the patients adequate nursing. Nursing at the ward block is also at high level in the field of knowledgeableness when informing patients or preparing arrangements and regimes. The patients themselves are satisfied with the overall care after the ERCP examination. The hidden observations show that the nursing after ERCP examination follows the literature properly. Pleasant surprise was that nurses at the ward block of the gastrointestinal department fully implement the five parts of nursing process ? from reviewing the health status of the patient in the beginning to their final evaluation, and that they concurrently create up-to-date nursing diagnoses.
|
|
|
Nursing Procedures of Oxygen Administration to Newborns
STUDÍKOVÁ, Monika
Nursing Procedures of Oxygen Administration to Newborns The diploma thesis is to outline the current perspective of oxygen therapy of newborns who need highly specialized care as early as in the delivery room and subsequently in intensive and resuscitation care units of perinatologic centres. The research in the diploma thesis is focused on the assessment of the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The theoretical part addresses the first treatment and evaluation of a newborn. Then the reasons leading to oxygen administration are discussed as well as the methods of oxygen application in the delivery room and intensive and resuscitation care units. Being at the forefront, oxygen is one of the most often administered medicines. Inadequate use of oxygen as a medicine increases the risk of complications for the newborn. The delivery and the first weeks after the birth rank among the crucial periods of every child. Adherence to the recommended procedures improves the outlooks of premature newborns for leading quality life. The objective of the thesis is to ascertain the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The research was quantitative and used the questionnaire technique. The author created one kind of the questionnaire for the selected research set. The set consisted of nurses working in neonatal wards of selected hospitals. A total of 65 questions were created to ascertain the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The research set consisted of 184 respondents. In order to attain the objective, the following hypotheses were raised: H1: Nurses know the current recommendations for oxygen administration to newborns. H2: Delivery rooms have sufficient technical equipment for oxygen administration to newborns. H3: Nurses are theoretically and practically trained for situations requiring oxygen administration to newborns. H4: Clearly formulated rules of oxygen therapy are available for nurses in a written form in a well visible place in the delivery room. Based on the statistically processed results, the first three hypotheses have been confirmed. The fourth hypothesis was disconfirmed. The objective of the thesis has been attained. The research results may be used for better understanding of the issue of oxygen administration to newborns in a hypoxic condition with regard to the findings of its toxicity. In order to secure adherence to the recommendations for oxygen administration to newborns, it is appropriate to create a nursing procedure and standard and secure its availability in every delivery room and station.
|
|
|
Informedness about lifestyle of patients with diagnosis Diabetes mellitus
BEČKOVÁ, Věra
This thesis aims to depict the contemporary situation in diabetes patients{\crq} awareness of healthy life style and to determine whether the information on healthy life style is reasonably accessible and comprehensible to patients or not and whether they abide by the rules. I set four assumptions for this thesis: 1. The diabetes mellitus patients feel that the information on healthy life style within the frame of their illness is sufficient and accessible. 2. One third of the informants feels that the information on healthy life style in terms of their disease is not accessible. 3. One third of the informants has difficulties with apprehension of the information on healthy life style in terms of their illness. 4. More than half of the informants abides by the information on healthy life style in terms of their illness. The selected group of informants consisted of diabetes mellitus patients. The data were extracted from anonymous questionnaire intended for the patients of two diabetology clinics in Znojmo regardless their age, sex or diabetes type. 150 questionnaires were distributed. The finite number of questionnaires used for data compilation after elimination of erroneously or incompletely filled items was 118. The results of the research revealed that most of the patients feel sufficiently informed and that the information on healthy life style is reasonably accessible. Nevertheless only 22,9% of informants abide by the information on healthy style, the rest of the informants is not able to manage all the rules they should be conformant with or cannot change their life styles in accordance with the advices of professionals. I would like to emphasize the importance of information on healthy life style in the frame of diabetes mellitus that can help the patients to prevent the unfavourable complications of this disease and therefore improve the quality of their lives. Nevertheless also the patient must feel the consciousness and need to abide the rules of healthy life style. That is why I consider the distributing information on healthy life style of diabetics very important and hope that my thesis will also serve this purpose.
|
|
|
Interruption problems in the view of student of the secondeay schools for healt workers.
ŠÍMOVÁ, Michaela
The dispute over interruption is one of the most intensive and most controversial political and ethical discussions in today{\crq}s modern civilization. It includes a great number of opposed, controversial opinions and attitudes both in the sphere of medicine and on the political or ethical ground. I have selected the topic of this work on the base of personal interest in the issue of termination of pregnancy, because this issue bears the basic questions and attitudes of man to the existence of the individual. Today the issue of interruption is sharply polarized into two controversial rivalling groups, i.e. the ``pro-life{\crqq} movement and the ``pro-choice{\crqq} movement. The dispute over termination of pregnancy has been becoming more and more topical issue not only in the Czech Republic but also in the world. The aim of this work was to map the attitudes of students not only of graduation classes of selected sanitary secondary schools to the issue of interruption and to compare the mapped attitudes of students of the Faculty of Health and Social Studies and of the Theological Faculty of the University of South Bohemia with the attitudes of respondents of graduation classes of the selected sanitary secondary schools to the issue of interruption. On the base of this aim, two hypotheses were stated in the research part of the work. After that, the questionnaire investigation was performed, for which a structured questionnaire had been elaborated. The questionnaire was filled out by fifty respondents of the Faculty of Health and Social Studies and fifty respondents of the theological Faculty of the University of South Bohemia of České Budějovice. On the base of that investigation, one of the hypotheses was not confirmed. Available literature and current Internet sources were used for the theoretical and for the practical part of the work. The work should serve primarily to the students themselves and to other readers as a modest data source for this extensive issue, and the research part of this work could be used as a small summary both for laymen and for professionals teaching at universities and high schools, so that they have the possibility to look at the issue of interruption from the point of view of the students, future professionals and workers of different areas.
|
|
|
Specifications of nursering care of patiens with complications after direct SKG/PTCA
BLÁHOVÁ, Ilona
Abstract In the Czech Republic there is no doubt about the tendency of gradual increase in median life expectancy, which is significantly affected by the fact that mortality from cardiovascular diseases, especially from acute coronary syndromes, has been decreasing. Besides the provable effect of a healthy lifestyle, diet and, by all means, a quality and effective pharmacotherapy, a significant development in the field of interventional cardiology contributes to this accomplishment. The number of coronographies, coronary angioplasties and implanted stents have multiplied, and today the invasive coronarographic diagnostics and percutaneous myocardial revascularization belong to the the most common diagnostic and therapeutic methods in treatment of acute forms of ischemic heart diseases. An obvious prerequisite for such a rapid development in the field of intervention coronary angiography was the establishment of a sufficiently dense network of catheter laboratories and specialized facilities, which provide a highly professional and intensive care for patients. This thesis is focused on three basic objectives: ? To survey and characterize differences in nursing care concerning various complications in patients after SKG / PCI ? To survey bio / psycho / social impacts of complications after SKG / PCI on a patient ? To identify and summarize personal and material prerequisites and requirements to ensure quality nursing care for these complicated conditions The research was conducted by using a qualitative methodology. The methods used were observation, non-standardized interviews and medical and nursing records analyses. The research survey samples on which the investigation was focused were patients with the acute coronary syndrome hospitalized in the coronary care unit in the Cardio Center in České Budějovice, their family members and also the nursing staff providing the comprehensive nursing care. The outcomes of this survey were eleven descriptive case reports characterizing the occurrence of the most frequent complications in patients with ACS after SKG / PCI. To ensure clarity, each case study is complemented by a thought map with an account of the most important nursing interventions in the management of specific acute conditions. The paper also contains a framework analysis of bio / psycho / social impacts of complicated situations on patients. It is interesting to compare this matter from the perspective of nurses and patients, which is seen in correlation graphs. The section describing the organizational and personnel provision is introduced with the characteristics of the medical process and it also contains the list of medical personnel with their qualifications and the length of experience in the Coronary care unit in České Budějovice. Summarization of the instrumental medical equipment is also based on the analysis of previous cases and is accompanied by photographs of the equipment typical and indispensable for the care of patients in the Coronary care unit, which primarily has an informative and complementary character to get an integrated view of the Coronary care unit running and the nursing staff work.
|
|
|
Kinesiotherapy of diabetes mellitus
CHALUPSKÁ, Tereza
My bachelor thesis is focused on kinesiotherapy in diabetes mellitus with focus on type 2 of the disease. Diabetes mellitus is a chronic whole-life disease leading to high morbidity, disability and mortality. A patient with high glycaemia level fluctuation and variable inadequate body mass (and further decompensation indicators) overburdens his/her organism and does not contribute to postponement of occurrence of cardiovascular, neuropathic, nephropathic, retinopathic and other problems. Adequately selected kinesiotherapy help people with diabetes mellitus compensate this disease. The theoretical part deals with diabetes mellitus in general and discusses physical activities focused on diabetes mellitus. The practical parts processes four case reports (women with diabetes mellitus type 2 diagnose) in the form of qualitative research. The first three respondents take regular exercises in groups divided according to physical and mental ability. The fourth respondent does not participate in any physical activity in the groups. Anamneses were found out through semi controlled interviews. Check-up results (dynamic examination of spine, anthropometrical examination, goniometrical examination, examination of shortened muscle groups, examination of weakened muscle groups, hypermobility examination, neurological examination, measurement of heart rate and blood pressure, determination of glucose concentration and HbA1c) were collected by direct observation. The aim of the work was to provide a theoretical outline of kinesiotherapy possibilities in diabetics, to map the forms of physical activities among diabetics and to evaluate efficiency of the individual physical activities of diabetics. Personal interest and active approach to physical activity regime are the main preconditions to successful kinesiotherapy in individuals suffering from diabetes mellitus. In the instance of individual and purely personal goal a suitable form of physical activities can be found for diabetics and thus contribute to compensation of the disease.
|
|
|
Laboratory methods for diagnostic infections total prosthesis articulations
HRONÍČKOVÁ, Lenka
Prosthesis articulations and their infectious complications are currently a much discussed problem among orthopaedists and microbiologists. The most operations are performed especially at hip and knee joints. The main reason for their most frequent damage is secondly the fact that endoprostheses of these joints have a good possibility of fixing of plastic materials into the bone and a long lifetime. Endoprostheses are used also in joints of shoulders, elbows etc. Despite of all aseptic procedures infection development sometimes appears. This complication is the most common cause of endoprostheses damage and it is often the reason for re-operation. The development of infection depends on interactions between a micro-organism, prosthesis articulations and a host. Bacterial agents causing infections of prosthesis articulations include gram-positive cocci, especially Staphylococcus aureus and Staphylococcus epidermidis, sometimes even streptococci. Further they could be gram-negative bars, especially Escherichia coli, Proteus species, Pseudomonas aeruginosa, Enterobacter species a Serratia marcescens etc. In mixed infections there can also appear anaerobic bacteria, especially Propionibacterium acnes and anaerobic streptococci. Most of bacterial agents are a part of so called bio film, which is important for bacteria and their survival. Bacteria in bio film acquire matrix protection against the effect of antibodies and phagocytes and also against the effects of antibiotics. Implementation of new laboratory procedures and methods, when among others ultrasound is used to destroy bio film, and making further cultivation and identification of infectious agents easier proved as a contribution. It leads to significantly higher capture of etiological agents of infectious complications of prosthesis articulations and this way it contributes to better securing of re-implantations. Procedures and methods presented in this thesis can be used in other modifications at examination of other inorganic materials and implantations and at examination of tissues taken out of patient ´s body at various infectious complications. Presented thesis compares laboratory procedures and methods used so far at OLM (Department of Medical Microbiology) in Nemocnice Jindřichův Hradec, a.s. (Hospital in Jindřichův Hradec, Ltd.) with laboratory procedures newly implemented for this purpose to examine infections of prosthesis articulations in cooperation with the author of presented thesis in spring months of 2008.
|
|
|
Exercise sister in prevention and treatment recurrent and chronic rhinitis and possible complication near puppy fat
OSADČÍ, Jana
Abstract The thesis examines the role of a nurse in prevention and treatment of recurrent and chronic rhinitis and possible complications in children. Rhinitis belongs to the most frequent diseases with chronic course in the group of children and adolescents. The number of affected people, particularly among children living in towns and cities is still rising, so sufficient and suitable education of children and parents provided by nurses is very important. Four goals were set in this thesis. The first goal was to examine the role of a nurse in prevention of recurrent and chronic rhinitis. The second goal was to examine the role of a nurse in treatment of recurrent and chronic rhinitis. The third goal focused on examination of the complications nurses most frequently face. The fourth goal was to elaborate an educational standard for nurses working at paediatric wards of hospitals and in surgeries of practitioners for children and adolescents. Three hypotheses were linked to the goals. The first hypothesis assumed that nurses educated parents in prevention of recurrent and chronic rhinitis. The second hypothesis asked whether nurses educated parents and children in treatment and possible complications of recurrent and chronic rhinitis. The third hypothesis said that otitis media, sinusitis and conjunctivitis were the most frequent complications of recurrent and chronic rhinitis. Quantitative research performed by the questionnaire method was used to achieve the goals. An anonymous questionnaire was designed for nurses and parents. The questionnaire for nurses and parents contained 24 questions. 70 questionnaires were distributed among nurses from paediatric wards and 50 returned. The return was 71 %. 60 questionnaires were distributed among nurses in surgeries of practitioners for children and adolescents, 40 returned. The return was 66 %. 50 questionnaires were distributed among parents and 30 returned. The return was 60 %. The data collection was performed in March 2011. The research results showed that most of the nurses educate parents in prevention and treatment of recurrent and chronic rhinitis. The parents confirm the benefit of the education. They consider a talk with a nurse in a surgery the most suitable education form. Education by a nurse has strong influence on parents and children suffering from recurrent and chronic rhinitis. A nurse helps them learn and understand the disease, teaches them how to find a new lifestyle, informs them about prevention and provides information on treatment. We also found that no educational standard dealing with care about children suffering from recurrent and chronic rhinitis existed. We have elaborated the standard and provided it to nurses in surgeries of practitioners for children and adolescents and paediatric wards.
|
|
|
Problems of Bulimia Nervosa
POMYJOVÁ, Daniela
The work deals with the problem of mental bulimia and its description. It is worked out in a theoretical way. There are disease definitions and its possible causes. It characterizes concomitant symptoms, it explains the development and potential effects of mental bulimia. Furthermore it focuses on might-be complications and it suggests potential treatment. It also describes therapies and work with affected ones. The work describes in detail the treatment which uses cognitive behavioural therapy (CBT). CBT belongs among the most effective therapies and it is a highly developed method. It is a therapy used with food intake failures, specifically with mental bulimia in this work. The treatment is also about a high quality and professional help. The result depends on three crucial facts {--} patient´s attitude to CBT, effort to return to the reality of daily life and ensuring of individual social functioning.
|
guest ::
