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Educational diagnoses of nursing staff and their practical use
NOVÁČKOVÁ, Klára
This bachelor thesis is focused on the use of educational nursing diagnoses. These often diagnoses often named health improving, educational or wellness are aimed to improve and strengthen health of individual or community and is tailored for the need of a client in question to improve in a certain area (1, 2). Although many nurses are interested in wellness diagnoses and use them, there is an ongoing contradiction regarding their real clinical usefulness (3). The aim of the research part of this thesis was to identify which educational nursing diagnoses are most often used at internal medicine wards for patients medically diagnosed with Type 2 diabetes mellitus or hypertension. Two research questions were posed: Which educational nursing diagnoses are most often used for patients with medically diagnosed Type 2 diabetes mellitus? Second question: Which educational nursing diagnoses are most often used for patients with medically diagnosed hypertension? Qualitative form of research was chosen using the method of secondary data analysis. In this case this involved studying nursing documentation of patients with diagnosed Type 2 diabetes mellitus or hypertension. Studied data was transcribed into answer sheets (see Appendix 1), consequently analysed by coding method and divided into the following categories: Written report on education, Educational diagnosis designation of the problem, Educational plan, Progress of education, Evaluation of education. Studied research group consisted of ten nursing documentation files that belonged to patients then hospitalised at internal medicine wards of hospital Nemocnice Písek a.s. Six clients were diagnosed with Type 2 diabetes mellitus, four with hypertension, with one patient suffering from both. This research showed that educational nursing diagnoses or designation of the patient's educational needs are used by the nurses working at the wards. Educational diagnoses were present in each of the studied files. All were concerned with insufficient knowledge about the illness. In the file containing medical diagnosis of Type 2 diabetes mellitus educational diagnoses were concerned with areas normally defined in literature as desirable for the patient. Similar results were found for patients with hypertension. Interestingly, educational diagnoses were often in discord with educational themes, probably due to education not being always recorded as performed. Further information on the reporting quality about the education was also found, where nurses often omit to report individual components of the educational plan, such as the aim, type or environment. Also, proper evaluation of the education by a nurse is often absent from the report and instead only a short note on the fact that education of the patient was conducted in a certain area is given. On the other hand, evaluation conducted by the client is often reported, although very curtly. Results of this research show that educational nursing diagnoses are in use for patients with both Type 2 diabetes mellitus and hypertension, and are always targeted towards increased knowledge of the patient about the illness. Areas that the diagnoses focus at are in concordance with the medical diagnoses. Educational diagnoses that are concerned with other individually specific areas are also present in some of the education documentation files. With respect to the targeted diagnoses educational plan concerned with insufficient dexterity should also be used. The overall educational reporting is not flawless and its improvement is necessary. The output of this work therefore consists of a model of documentation reporting educational activity. (Appendix 3). This documentation model was evaluated by head nurse Zdeňka Matušicová as well-arranged and practical.
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Alternative components in feeding rations for marmosets and tamarins as prevention of macrosomia, diabetes mellitus and stillborn young
Polívková, Martina ; Svobodová, Ivona (advisor) ; Adéla, Adéla (referee)
This thesis evaluates the suitability of food rations in zoos keeping Callitrichidae considering the prevention of macrosomia, diabetes mellitus and stillborn young, and where needed, suggests a change in feed rations.
The feed rations of Callitrichidae in zoos differ greatly and problems can occur with greater amounts of fat and sugars and often also insufficiency of calcium, which can lead to obesity and further health complications.
When performing this thesis, all food rations of the pygmy marmoset (Cebuella pygmaea), the silvery marmoset (Mico argentatus), the cotton-top tamarin (Saguinus oedipus), the emperor tamarin (Saguinus imperator) and the golden lion tamarin (Leontopithecus rosalia) was weighted during five days in the Olomouc zoo, the Plzeň zoo and the Jihlava zoo. The values of the rations were set based on table rates of the individual components stated in the program ZootritionTM (V2.6) and the final values compared with the recommendations stated in EAZA Husbandry Guidelines 3rd edition (2015).
It was found that changes are needed especially with consideration to the food specialization of the different species, presently all species of Callitrichidae are fed the same rations regardless of their food priorities in the wild.
The recommended changes to rations included changing a part of the ration to a ready mixed foodstuff for Callitrichidae to save time and enable a stable ration with good values of calcium and protein, and feed the animals mainly with vegetables rather than fruit, considering the closeness of vegetables to the fruit available in the wild.
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Hypoglycaemia as Acute Complication of Diabetes Mellitus
Krnáčová, Veronika ; Macek, Karel (advisor) ; Rybka, Jaroslav (referee) ; Švihovec, Jan (referee)
Title of thesis: Hypoglycaemia as acute complication of diabetes mellitus Author of thesis: Mgr. Veronika Krnáčová (roz. Vlčková) This thesis was focused on hypoglycaemia as adverse drug reaction of rosiglitazone, pioglitazone, nateglinide and repaglinide, which have been launched to the UK market and on severe hypoglycaemia (SH) requiring the assistance of Emergency medical service (EMS) in region of Hradec Králové. Observed factors were described in two separate sections. Hypoglycaemia as adverse drug reaction of selected oral antidiabetics Aim The aim of this study was to quantify the incidence of hypoglycaemic events during the first nine months of treatment with newly launched oral antidiabetics, rosiglitazone, pioglitazone, nateglinide or repaglinide, prescribed by general practitioners in England, to observe pattern of these events over time, to look for patients' characteristics which could influence the incidence of hypoglycaemia and to analyse the relationship between use of concomitant anti-diabetic therapies and the incidence of hypoglycaemia in patients treated with pioglitazone. Methods We used data collected for prescription-event monitoring (PEM) studies of rosiglitazone, pioglitazone, nateglinide and repaglinide. PEM is an observational, non-interventional, cohort study. Incidence...
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Schizophrenia, diabetes and 2nd generation antipsychotics
Pastucha, Miroslav ; Höschl, Cyril (advisor)
Choosing a theme for a thesis on 3.lékařské UK faculty facilitated by that individual clinics, institutes and departments already offer students the topics more or less established research programs. In addition, of course, there is still a possibility for the student himself devised a problem that will be paid. I was determined to choose topic that will be in the field of psychiatry, because this subject I find interesting and serious I am thinking that my focus after school might be based in this direction. Teaching psychiatry, which I attended in Prague Psychiatric Center, left me very positive impression of this device, both in terms of clinics and research work, and mainly from physicians access to patients as well as science. I was therefore glad that I had the opportunity to working on his thesis on the grounds of the institution. The association of two serious illnesses, schizophrenia and diabetes mellitus, was for me, up until I started to this thesis, virtually unknown. During internship in a psychiatric clinic, but I was surprised observed that many patients with schizophrenia are obese and they themselves admitted that the therapy of certain drugs feel increased appetite. I expected, therefore, that the pathogenesis of this problem will about moving in this direction, which is partly shown. I...
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Three phase bone scintigraphy in diagnostics of neuropathic osteoarthropathy in diabetic patients
Krabcová, Ivana ; Lang, Otto (advisor)
As required by the Centre for Preventive Medicine, 3rd Faculty of Medicine at graduation work is necessary to choose a theme and Prevention. The topic of his thesis Three-phase bone scintigraphy in the diagnosis of diabetic neurogenic arthropathy I chose this as a basic condition very well suited. Diabetes mellitus is a disease with high incidence of serious and complications whose research, particularly in the etiology, prevention and therapy, the emphasis in all developed countries. A common complication of diabetes is called diabetic foot. The main etiologic factors leading to the development of diabetic foot, diabetic neuropathy, and ischemia. Serious consequences Diabetic foot ulcers are, gangrene and amputation. Charcot arthropathy (Choate) is one of the complications of patients with diabetic neuropathy. Diagnosis Choate is problematic primarily because that this diagnosis often thinks of a confused with other diseases, especially with osteomyelitis, phlegmon, arthritis or osteoporosis. Determination correct diagnosis depends mainly on the expression of suspicion for this disease medical history and clinical presentation and exclusion of other possible causes by laboratory and imaging methods. In our work we focus on the method of three-phase bone scintigraphy and the possibility of its use in the...
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Novel metabolic regulators and proinflammatory factors in the etiopathogenesis of type 2 diabetes mellitus and obesity: the influence of pharmacological and dietary interventions
Mráz, Miloš ; Haluzík, Martin (advisor) ; Šenolt, Ladislav (referee) ; Hainer, Vojtěch (referee)
NOVEL METABOLIC REGULATORS AND PROINFLAMMATORY FACTORS IN THE ETIOPATHOGENESIS OF TYPE 2 DIABETES MELLITUS AND OBESITY: THE INFLUENCE OF PHARMACOLOGICAL AND DIETARY INTERVENTIONS MUDr. Miloš Mráz Doctoral Thesis ABSTRACT (EN) Identifying novel factors involved in the etiopathogenesis of obesity, diabetes mellitus and their complications has become one of the primary scopes of metabolic research in the last years. The aim of the present study was to evaluate the role of recently discovered metabolic and inflammatory regulators including fibroblast growth factors 19 and 21 and chemotactic cytokines in the development of obesity and type 2 diabetes mellitus (DM2). A total number of 182 patients were included into the study. They were divided into 3 groups - patients with obesity but without type 2 diabetes mellitus, individuals with obesity and type 2 diabetes mellitus and healthy control normal-weight subjects. Selected interventions included 2 to 3 weeks of very-low-calorie diet (VLCD - energy content 2500 kJ/day), 3 months of administration of PPARα receptor agonist fenofibrate and acute hyperinsulinemia during hyperinsulinemic isoglycemic clamp. Our results indicate that the increase of circulating FGF-21 levels after VLCD and fenofibrate treatment could contribute to positive metabolic effects of these...
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Laboratory diagnosis of thyroid hormones in clinical medicine
KAVICKÁ, Andrea
Diseases of thyroid gland are the most common endocrine disorders after diabetes mellitus. Laboratory diagnostics has irreplaceable role in the diagnostics of thyroid gland disorders. The first part describes the various thyroid diseases, their causes, symptoms, treatment and diagnostics. The second part this work includes meaning and the principle of individual parameters examinated for monitoring of thyroid gland disorders. Examination of the parameters of the thyroid gland is a very busy immunoassay methods. Methods of the thyroid gland used for determining the functional status of the thyroid gland. Inform us about the etiology, monitoring therapy and based on that choose treatment procedure. Thyreotropin is a very sensitive and specific marker for evaluating the function of thyroid gland and simultaneously appropriate for early detection or exclusion of thyroid disorders. In the case of TSH out of reference limit we set further examination fT4, rarely fT3. TSH and free fraction´s of thyroxine and trijodthyronine performed on the analyzer Roche Modular E, which uses methods ECLIA. Detection of antibodies were determined by using analyzer from Siemens company Immulite XPi, which is based on chemiluminescent immunometric analysis. Examination of anti-Tg and anti-TPO tell us a lot about the etiology of testing in the case of autoimmune disease. I investigated 830 patients, 299 men and 531 women, where on the based TSH out of reference limit diagnostic hypothyroidism and hyperthyroidism. My research, I am allowed to supplement the expertise of the doctors who requested the examination of thyroid hormones In the end this work is graphically represented frequency determination of hormones and thyroid autoantibodies for the year 2013 in our laboratory.
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Labeling of pancreatic islets with superparamagnetic iron oxide nanoparticles for magnetic resonance imaging
Berková, Zuzana ; Saudek, František (advisor) ; Mandys, Václav (referee) ; Haluzík, Martin (referee)
Type I diabetes mellitus is primarily an autoimmune disease resulting from selective destruction of insulin producing pancreatic beta cells. Transplantation of purified pancreatic islets is an alternative method for standard insulin therapy of these patients. Though the islet transplantation represents a promising approach for a selected group of patients, there is still a number of problems to be solved and one of them, perhaps the most important, is the lack of a reliable method of transplanted islets monitoring. (...) The results of this experimental study lead to the improvement of the labeling protocol in experimental transplantation and to its translation into clinical research. While different methods such as PET and SPECT will be soon available for shorttime in vivo followup of transplanted pancreatic islet, magnetic resonance imaging represents so far the only available technique able to provide a direct, longterm and reliable visualization of the transplanted islets with sufficient spatial resolution. At present, is this method ready for clinical application.
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