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The Nutrition Day at the standard and intensive care beds in the teaching hospital
Lupoměská, Petra ; Meisnerová, Eva (advisor) ; Novák, František (referee)
The Bachelor thesis consists of two parts - the theoretical and the practical one. The theoretical part is divided into several chapters; the first one is focused on the main information about malnutrition such as its definition, prevalence, classification, causes, impact and the methods of diagnosing. The following chapter describes the algorithm for nutritional care; the rest of the chapters deal with the artificial nutrition, where the indications, contraindications, complications and other essential information related to enteral and parenteral nutrition are described. The practical part is dedicated to the worldwide programme "Nutrition day" and also to the evaluation of the data given by patients of the 4th internal clinic VFN in Prague during the programme. The research part was carried out on grounds of quantitative survey through a standardized questionnaire. There are two aims to the study; the first one was to find out the food intake of all patients of the 4th internal clinic. This goal was not accomplished, because not every patient placed in the standard ward was willing to complete the questionnaire. However, the study showed that only 29 % out of 62 patients who completed the questionnaire ate the whole portion of meal. The second aim was to find out if the daily calorie intake...
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Nasojejunal tube placement techniques
Součková, Veronika ; Novák, František (advisor) ; Paul, Oldřich (referee)
Author's title and name: Bc. Veronika Součková Institute: Charles University, Prague 1. Faculty of medicine Kateřinská 32, 121 08, Prague 2 Study branch: follow-up Master's - intensive care Study programme: specialization in intensive care Title: Nasojejunal tube placement techniques Consultant: MUDr. František Novák, Ph.D. Number of pages: 81 Number of attachments: 3 Number of tables, grafs and pictures: 24 Year of presentation: 2013 Keywords: Nasojejunal tube, placement techniques, enteral nutrition, endoscopy, fluoroscopy, blind bedside technique This dissertation is dedicated to the issue and options in the field of nasojejunal tubes placement technique. Theoretical part aims at the description of methods and procedures of placing the nasojejunal tube and briefly mentions possible complications and principles of enteral nutrition, which is administrated by this method. Empirical part of the dissertation aims at the comparison of placement the nasojejunal tube using the blind bedside technique developed at intensive care unit in General University Hospital in Prague to, endoscopic and fluoroscopic methods. The research brings description and comparison of the most frequently used methods of placement the feeding tube into the small intestine.
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Current possibilities and resources of enteral nutrition
Hrnčířová, Naďa ; Heczková, Jana (advisor) ; Meisnerová, Eva (referee)
0BABSTRACT This thesis is focused on enteral nutrition. This issue is an integral part of intensive and resuscitation care, but it is also a part of standard and follow-up care. There are more and more new resources and the products for enteral nutrition are improving. The theoretical part deals with malnutrition, discusses the different components of nutrition. Much of the thesis forms ways of application of nutrition. The issue is a nasogastric tube, a nasojejunal tube, percutaneous endoscopic gastrostomy, percutaneous endoscopic jejunostomy, feeding button or sipping. There are further expanded the introductions, nursing care, indications and contraindications of these options. The following chapters analyse the modes of enteral feeding, advantages and disadvantages of enteral nutrition compared to parenteral. The practical part is focused on research using anonymous questionnaires in the area of enteral nutrition. The survey was conducted in four departments of three teaching hospitals in Prague. It was focused on nurses and paramedics in medical intensive metabolic care units. The survey had 73 respondents. The aim was to identify the mode of feeding that nurses prefer and how they apply it, analyze the extent to which the nurses actively involve themselves in this, how they are oriented in...
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Evaluation of nitrogen balance with respect to the administered parenteral and enteral nutrition and the composition of the body in critically ill patients
Vaňková, Martina ; Hronek, Miloslav (advisor) ; Havel, Eduard (referee)
The aim of this thesis was to identify and assess the nitrogen balance due to the field of nutritional support, body composition, energy expenditure, utilization of nutritional substrates and their changes during the hospitalization. Nitrogen balance was determined in 12 men and one woman (age 44 ± 16,4 years) with multiple injuries (ISS 40 ± 11) in the ICU based on 2 measurements in the time interval of 1-7 days, as the difference between the received and the ecrected nitrogen. The energy expenditure and nutritional substrate utilization nutritional indirect calorimetry, body composition analysis and blood chemistry laboratory were examined at patients. Correlation analysis revealed dependence between nitrogen balance and other monitored parameters and also dependence on the length of their trauma. Total protein intake averaged 1,40 ± 0,69 g.kg-1 .d-1 . At this dose were recorded negative values of nitrogen balance in the first measurement of the 9-patients and in the second measurement of the whole group. In this work also the results of uptake of parenteral and enteral route were compared. In practice, significant correlations were found between total uptake and energy expenditure (p = 6,31.10-3 ; r = 0,6) in the first measurement, and on the other hand negative correlation during the second...
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Enteral nutrition in oncology patients
Šulcová, Jana ; Křížová, Jarmila (advisor) ; Mráz, Miloš (referee)
This bachelor thesis considers possibilities of enteral nutrition and its influence on life quality of oncological patients. The thesis consists of a theoretical and an experimental part. The theoretical part compiles the issue of malnutrition and nutritional support with emphasis on enteral nutrition. It deals with malnutrition in oncology and its solution. In the experimental part, a study of influence of enteral nutrition on life quality of oncological patients was conducted. A question was, how health condition, life quality and energy intake of patients are changed after one month of enteral nutrition use. The survey includes a physical examination, measuring patients with a machine Bodystat Quadscan 4000, filling up a questionnaire, evaluation of laboratory tests, and analysis of the patient's diet. The results of the study prove positive influence of enteral nutrition on health condition of patients with respect to laboratory tests. According to the questionnaire, the life quality of patients increased and the diet report shows increased energy intake. The physical examination results and Bodystat measurements did not prove positive influence of enteral nutrition.
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Specifics of nursing care for a patient with nutritional stoma.
MUSILOVÁ, Klára
Main goal of the thesis was to map out the specifics of nursing care for a patient with a nutritious stoma. Three research questions have been identified in connection to this goal. First research question was focused on mapping out the nursing care for a patient prior applying the nutritious stoma. Second research question was focusing on nursing care for a patient while the nutritious stoma is being applied, and the last third question researches the nursing care for a patient after applying of the nutritious stoma. The empirical part of the bachelor's thesis was processed through a qualitative research analysis, which was carried out by a form of semi-structured interview. The semi-structured interview was divided into three parts. First part focused on basic identification data, second part focused on percutaneous endoscopic gastrostomy and third part on percutaneous endoscopic jejunostomy. Collected data was processed with an open coding method "pencil paper". Research file consists of general nurses working at a neurological, gastroenterological, standard internal department and intensive care department at Hospital České Budějovice and at the department of long term intensive care for patients at Hospital Třebíč. The results of the thesis are divided into a separate categories which are: establishment of nutritious stoma, immediate nursing care about nutritious stoma after establishment, nursing of nutritious stoma, applying of fluids into nutritious stoma, applying of nourishments into nutritious stoma, applying of medicine into nutritious stoma, recording of care into documentation and education of the patient about nutritious stoma. The thesis provides an overview of the problematics of nursing care for a patient with nutritious stoma. Based on the results a brochure will be written containing basic information about care for a patient with nutritious stoma, which will be addressed mainly to nurses.
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Patients' education by enteral nutrition
Argaláčová, Tereza ; Novotný, Aleš (advisor) ; Meisnerová, Eva (referee)
Enteral nutrition is a form of a nutritional support which should be considered for malnourished patients or those at risk of a malnutrition who have a functioning gastrointestinal tract but are unable or unwilling to maintain adequate oral intake. This bachelor thesis discusses issues of the enteral nutrition - it's indications, contraindications, methods of delivering and possible complications. A big part of the thesis is dedicated to a percutaneous endoscopic gastrostomy which became the technique of choice to provide long-term enteral nutrition support and is nowadays one of the most popular approaches to the gastrointestinal tract for long term home enteral nutrition. The last part of the thesis shows the importance of the education of patients on a long- term enteral nutrition and provides a short guideline on how to properly educate them. Keywords: malnutrition, enteral nutrition, percutaneous endoscopic gastrostomy, education
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Nurse's role in the nutrition of patients in intensive care
VACKOVÁ, Veronika
This bachelor thesis is divided into two parts theoretical and empirical and the purpose of this thesis is to deal with the topic of the nurse´s role in the nutrition of patients in intensive care. In the theoretical part of the thesis, complex issue of the nutrition ensure of intensive care patients is summarized. We have been dealing not only with the common concept of the nutrition on the intensive care units and the role of the nutrition therapist but also with the characteristics, causes and diagnosis of the malnutrition as the most serious issue in the nutrition field. In the thesis, the types of a nutrition support in the intensive care have been also defined as well as the indication, contraindication, types of serving, complications, types of medicines, monitoring and the related role of the nurses. The practical part provides with the results of the research, which have been found by using a qualitative research method. The main purpose of this bachelor thesis was to emphasize the role of the nurse by the handing enteral and parenteral nutrition and also a description of the cooperation with the nutritional therapist on the associated intern and neurological unit of intensive care at České Budějovice hospital. At the basis of above mentioned, two objectives have been stated. At first, our task is to find out the way how is the right handing of the nutrition to the intensive care patient by the nurse secured. The second task is finding out the way of cooperation of the nurse and the patient while securing the nutrition of the patients in the intensive care unit. For the first task, four research questions have been established, for the second task have been established one research question. For the high-quality data network, the method of hidden monitoring for keeping authenticity has been used. As a consequence of the insufficient amount of data to the reaching of the second task, half-structured interview has been chosen instead. Research dataset consisted of thirteen records of sighting and one interview on the above mentioned intensive care unit. As a basis for analyses, three observation sheets were made, into these sheets were then during the observation information assigned. Each sheet consisted of single points planned in accordance to theoretical part. The nurse follows these points when securing the patient´s nutrition. Remaining information, not included in observation sheet were written into the notes section or were included into the information about the performing of the particular point. The results were analyzed by using an open-coding. There are six categories coming out from the analyses, which are connected with securing the education, information providing, keeping an obstacle-free approach complications preventing, using tools, nurse´s cooperation with the patient and deciding processes during work performance. In the results, there is a conclusion of the analysis with illustrative examples to find. The sequence of the results is presented according to sequence of categories during performing. In each category, the results are evaluated according to research tasks stated. We believe, that the obtained information, which map the activities of the nurses when securing the nutrition at the intensive care unit patients and the acquainting the cooperation with the nutrition therapist helps in the future to the awareness of the potential weaknesses and following correction. The results may become inspiration for more detailed analysis of this topic.
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Early enteral nutrition in neonates with low birth weight under 1500 g
KOVANDOVÁ, Klára
This diploma thesis should sketch quantitative research of early enteral nutrition at newborns with low birth weight under 1500 grams at specialized department - neonatology in České Budějovice. Research in this diploma thesis is focused on evaluating of implemetation level according to current recommendations neonatology for the start of early enteral nutrition at premature babies. In the theoretical part of the diploma thesis we try to describe all things that include the issue of premature babies care. Next chapters deal with differences of premature baby in relation to nutrition. The nutrition of the newborn with very low birth weight is provided immediately after parenteral delivery. Quantitative research definately prefers the start of enteral nutrition in the first few hours after delivery. Goal of this strategy is to completely replace the parenteral nutrition as soon as possible. Goal of this diploma thesis is to descibe quantitative research with implementing of the enteral nutrition at newborns with birth weight under 1500 grams at specialized neonatology departments and to identify the most important differences from current recommendations for this field of care. Considering the set goal there was used the quantitative research for this diploma thesis. To get the data to create the research, secundar analysis of the data from nursing documentation of our research team was used. Through the quantitative research we try to demonstrate lack of starts with early enteral nutrition at premature babies with birth weight under 1500 grams in the 2012 and 2013. Secundar analysis of the date was made during my working experience at neonatology department in České Budějovice. Data needed for this research were systematically written into prepared chart created in Microsoft Excel. After entering all necessary data in the table, they were subsequently created graphs that reflect the real situation examined issues. After identifying the most significant differences from the current recommendations for this area of care deficiencies are subsequently provided to the department of neonatology in the České Budějovice for future improvement strategy early initiation of enteral nutrition in premature infants in this weight category, was written Decalogue of practical recommendations for optimization of enteral nutrition for preterm infants nurses working in the neonatal intensive care. The research file was created by 139 respondents (newborns with low birth weight under 1500 grams). This file is created by newborns born from 1 January 2012 to 31 December 2013 which means during two years.
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Nursing Specifics in Paediatric Patients with Gastrostomy
POHLOVÁ, Světlana
Gastrostomy is one of the access routes enabling enteral nutrition support to children with eating disorders. It is a method of choice in situations where real assumption of enteral feeding by a nasogastric probe longer than six weeks exists and with undamaged functional digestive system. The possibility to perform enteral feeding outside health care facilities is the most advantageous aspect of gastrostomy for children and their parents. Optimum nursing care is one of the main preconditions of long term functional gastrostomy. This why suitable education of parents and their children in the nutrition support method is necessary. The aim of the work was to map awareness of the issues of gastrostomy in children patients among parents and to propose a unified educational programme aimed at easier insight into the issues. Qualitative research method was applied to the problems. The techniques of study of healthcare documentation and semi standardized interviews with respondents in their home environment were used for data collection. The results of the healthcare documentation studies, which defined the sample of the children with applied gastrostomy, were processed into graphic form for better transparency. The interviews with the respondents in the form of audio recording were transposed into written form and quantified by means of tables enabling the research conclusion to be drawn. The research results showed that practical training of gastrostomy treatment and awareness of possible complications and their solution was the weak point of the education. The above results have confirmed the necessity to elaborate a unique educational programme related to the issues of feeding tube insertion, the care for gastrostomy, support of food, medicines, and possible related complications in terms of learning the ability to prevent complications, identify and solve them.
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