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Novel anticoagulants from the perspective of cardiac patients
KŘÍŽOVÁ, Anna
The bachelor thesis deals with anticoagulant treatment in cardiac patients and their satisfaction with it. Over time, anticoagulant therapy is becoming one of the most widespread areas, which is represented in almost every field of contemporary medicine and nursing. In cardiac patients, anticoagulant treatment plays a very important and irreplaceable role in the prevention and treatment of the disease itself. The aim of this bachelor thesis is to map the awareness, advantages and disadvantages of anticoagulant treatment with warfarin or one of the representatives of NOAK according to the experience of patients with atrial fibrillation and then compare the resulting parameters. A qualitative survey method was chosen for the research survey. Data were obtained through semi-structured interviews with patients. A total of 16 patients were contacted, 8 of whom were taking warfarin and the remaining 8 patients were taking NOAK - 4 Xarelto patients, 3 Pradax patients and 1 Eliquis patient. The results of the research showed that patients are insufficiently informed about their options in the selection of anticoagulants. Another shortcoming in the education of patients about anticoagulant treatment is the insufficient use of an information brochure. The results also showed that patients on NOAK are more satisfied with anticoagulant therapy than on warfarin, as it does not bring them so many limitations. However, side effects were more common in patients with NOAK than with warfarin. Overall, however, both groups of patients evaluate anticoagulant therapy rather positively. Based on the results, an informative brochure for patients with anticoagulant treatment was created as part of the work, which can help them decide between anticoagulant drugs and get acquainted with their options.
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Linking of diet with warfarin in senior age
NOVÁKOVÁ, Tereza
Any diet during the warfarin treatment is a highly discussed topic. The bachelor thesis focuses on the relations between a nutrition and warfarin among elderly population. The thesis itself is divided into a theoretical and a practical part. The theoretical part describes anticoagulation therapy, warfarin, new oral anticoagulation, K vitamin, relations between nutrition and warfarin and seniors. The practical part inquires the general awareness among the seniors of the potential relations between warfarin and anticoagulation therapy and their eating habits. The methodology of qualitative research (semi-structured interviews) was used for gathering the information in the practical part of the thesis. The interviews were realized in a hospital (8 seniors) and also in the houses of the respondents (2 seniors). The thesis also provides the assessment of 5 daily menus of 10 interviewed seniors through the Nutriservis program, the USDA database and the literature (Kohout et al., 2007). As the outputs of the program, the database and the literature all the detected values were compared with estimated vitamin K values among the above 65 years population stated in the "Referenční hodnoty pro příjem ţivin, 2011" publication. The issue of relations between nutrition and the warfarin treatment is accepted basically well. The outputs clearly show that the mistake seniors often do is a vegetable elimination from the menu due to the concerns of a warfarin treatment disorder. The seniors also believe that they shall not consume any green vegetable at all. Concerning the outputs of the thesis it is necessary to focus more on providing correct information to the patients about the importance of including the vegetable in their menu and proposing the appropriate and inappropriate foods. Therefore the professional advice of the nutrition therapist is crucial to discuss deeply the relation between a nutrition and warfarin with the patients. The thesis might be an information source for the seniors using warfarin.
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Problems of anticoagulation therapy in terms of nurses and patients
KLÍMOVÁ, Adéla
This bachelor thesis deals with the use of oral anticoagulant drugs. It focuses primarily on issues of use in terms of patients and nurses. The aim of the work was to find patients' issues in taking oral anticoagulants and the ex-perience of nurses with complications of anticoagulation therapy. To achieve this goal, the empirical section was elaborated through a qualitative research survey conducted through semi-structured interviews with patients using anticoagulant medications and nurses working in outpatient or inpatient cardiology departments. Many surprising results were achieved by the research. The results demonstrated that nurses need to educate themselves about introducing new drugs. Further, nurses are not a primary source of information for the patient. They usually receive questions from pa-tients not explained to the doctor or necessary to repeat to patients. It has been found that nurses often do not encounter complications and have experienced more serious compli-cations only exceptionally. From interviews with patients, it was found that the most common complication they encountered was bleeding from Warfarin. The respondents did not notice any major problems for new oral anticoagulants. In addition, the patients are all informed in the course of the treatment, and each individual receives a variety of informa-tion. The research also demonstrates that patients are also interested in their treatment in-dividually, searching for information on the internet or sharing their experiences with each other. The research was further supplemented by a visit to a special coagulation clinic where the interview was conducted not only with the nurse but with the doctor. The bene-fit the clinic has for patients was presented. Clear material arose thanks to this bachelor thesis, where not only medical staff learned the biggest problems in taking oral anticoagulation therapy.
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The role of nurses in the application of low molecular weight heparin
Kubátová, Lenka ; Křivková, Jana (advisor) ; Tomová, Šárka (referee)
The bachelor thesis "Role of a nurse in application of a low-molecular-weight heparin" focuses on the topic of application of a low-molecular-weight heparin. The aim of the research was to explore the correct technique of a subcutaneous application of a low- molecular-weight heparin and assess the role of nurses in educating patients about the application. The theoretical section provides a basic overview of the low-molecular-weight heparin and explains the principles of antithrombotic therapy. The research section was implemented using a quantitative research technique, interviews using a structured questionnaire. The survey included 130 respondents working at standard surgical, orthopaedic, internal medicine wards and intensive care unit in the University Hospital Motol. The results showed nursing problems in the technique of application of low-molecular-weight heparin. The same number of respondents report a correct application angle (62 %) and do not massage the injection site (63 %). One third of respondents remove air bubbles from a syringe, only 58 % of respondents keep the skin pinch throughout the application. The survey proved that nurses from standard wards and nurses with a University degree apply the correct technique of a low-molecular-weight heparin application better than nurses...
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New antithrombotics and laboratory tests for monitoring their effect
Hadravová, Jiřina ; Bártů, Iva (advisor) ; Neupauerová, Jana (referee)
This bachelor work follows up the comparison of new antithrombotics with the existing commonly used drugs. The theoretical part describes the individual drugs, their characteristics, indications, advantages and disadvantages. The work presents a comparison of the need for routine laboratory monitoring of individual drugs. The practical part of this work describes methods for the determination of the existing and new drugs and compare them. The work contains the results of measurements of new antithrombotics by the individual methods of determination. I compared the measured results of the commonly used methods with methods designed directly for the determination of new antithrombotics and I evaluate which routine methods can be used to approximate assessment of new preparations. The samples from patients treated with anticoagulant therapy and healthy persons provided the Department of Clinical Hematology, University Hospital Motol in Prague. Powered by TCPDF (www.tcpdf.org)
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D-dimers in pregnancy. Influence Leiden mutation and anticoagulation therapy.
FELIXOVÁ, Veronika
In my work D-dimers in pregnancy, influence of Leiden mutation and anticoagulant therapy, I study the D-dimer concentration in pregnant women with Leiden mutation and the potential influence of anticoagulant therapy. In the first part I deal with theory. I describe here the process of fibrinolysis, including its activators and inhibitors that influence the process of fibrinolysis, and in which D-dimers are being created. . I deal with the division of thrombophilia, on the condition congenital, acquired and mixed. .Among congenital thrombophilic states belongs resistance to activated protein C, which in most cases is caused by mutation factor V Leiden. I describe here the emergence of this mutation, the occurrence and the risks with which this mutation is linked. The most discussed risk factor for me was pregnancy, which I mention in my work. Another part deals with anticoagulation therapy. In the methodical part I describe the quantitative determination of the D-dimer level by an immunoturbidimetric test in the Laboratory of Hematology of the Hospital České Budějovice. I split the whole process into a preanalytical, analytical, and postanalytical part. The principle of analysis is the addition of polystyrene particles covalently coated with monoclonal antibodies, where D-dimers are bound together with particles to clump and increase cloudiness. The haze intensity is measured by optical density and is directly proportional to the concentration of D-dimers. In the fourth part of my work I processed the data provided by the Hematology Outpatient Hospital of České Budějovice. These are the investigated levels of D-dimers in women with Leiden mutation and in women without the Leiden mutation. Leiden mutation is a thrombophilic condition with a negative personal history of thromboembolism. This mutation results in a breakdown of the coagulation system, which is manifested by frequent thrombotic complications. The risk of thromboembolism is higher in these patients than in the other population. In pregnancy, it is necessary to check with a hematologist. In the charts and tables I have attempted to confirm the aim of the work that D-dimers in pregnant women with Leiden mutation are higher than in pregnant women without the Leiden mutation. I have also looked at anticoagulant therapy that is recommended to patients to prevent and treat thromboembolic disease. The aim of the work that the level of D-dimers in pregnant women with the Leiden mutation is higher, compared to women without the Leiden mutation, was confirmed to me. The effect of anticoagulant therapy on the level of D-dimers is that pregnant women without anticoagulant therapy achieve higher levels of D-dimers than pregnant patients with anticoagulant therapy.
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Anticoagulant therapy focusing on patients with atrial fibrillation
VANÍČKOVÁ, Martina
Thrombosis has recently become a widely discussed issue due to an increasing number of cases and problematic treatment. Once developed, thrombosis cannot be cured completely. Currently used anticoagulant treatment is limited to avoid complications such a hemorrhage or stroke. INR value checks (Quick tests) and monitoring covering at least 70% of the treatment period within the therapeutic range are necessary (2-3), but could be rather difficult to maintain in some patients. So-called new anticoagulants could prove themselves as an appropriate solution.
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The issue of compensation of a heart valve from the perspective of the patient
MUNDLOVÁ, Anna
A heart valve replacement is one of the most technically difficult cardiac surgeries. For the patient, it means a mental and physical health intervention. Heart valve surgery is currently the second most common cardiac surgery - accounting for up to 20% of the total number of cardiac surgeries. The goals and objectives of a heart valve replacement are to improve patients' quality of life and their medical prognosis. The heart valve replacement is carried out only in cases when we cannot perform the heart valve plastic surgery and thereby replace the entire heart valve with an artificial one. Heart valve prosthetics can be mechanical - patients with this kind of prosthetics are then warfarinized for life or they can also be made of biological material (bioprosthetics). Patients with bioprostehtics require only a three month long anticoagulant therapy. Temporary postoperative complications may occur such as dyspnoea, gastric and intestinal atony or aggravation of pulmonary functions. Among the rarer complications are rhythm disorders, thrombosis of prosthetic heart valve, and last but not least infective endocarditis. The patients, after the heart valve replacement, are at a greater risk of complications, therefore they are obliged to always have their patient at risk of infection endocarditis card with them (see appendix 4). After the operation the patients are informed about the lifestyle changes they are to follow within their daily routine, the information is delivered by doctors and nurses. The task of the nurses is to inform the patient about the lifestyle changes together with doctors. Good understanding and observance of these lifestyle changes help to improve patients' life after the heart valve replacement. This bachelor thesis is divided into an empirical and theoretical part. The theoretical part focussing on the problems connected with the heart valve replacement, valvular imperfections, perioperative nursing, patients' lifestyle changes and their quality of life.
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