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Nursing process in patients with hemodialysis
STACHOVÁ, Klára
Chronic kidney disease is often symptomless and painless. It is often late for some patients when they realize that there is something wrong with their bodies, namely the kidney function. Kidney failure causes a complex metabolic failure and water and electrolyte imbalance. Unfortunately this phenomenon is irreversible and a lot of the patients have to undergo hemodialytic therapy, which only substitutes the function of the kidneys but does not treat the kidneys. However dialytic technology is nearly at the perfection level at present. Nevertheless dialysis brings the risk of numerous complications for the patient. The dialysis principle is based on blood cleaning by means of a dialytic apparatus. Life rescue is the patient's priority so he/she has to visit a hemodialysis centre several times a week. The hemodialytic therapy is particularly physically and psychically demanding for the patient and his/her close relatives. This therapy significantly affects the patient's life. It has a substantial influence on patient's lifestyle and values. The therapy is accompanied by various treatment and nursing recommendations adherence to a diet with significant limitation of liquids, regular intake of medicines, stress regulation etc. from physicians and the healthcare staff. The aim of the bachelor thesis called "Nursing Process in Patients with Hemodialysis" was to map the problems of the nursing process in a hemodialysed patient on the base of specialized literature. The topic is elaborated theoretically by the review and synthesis method. The information was obtained from Czech and foreign specialized literature as well as from journals specialized in this issue. Hemodialysis is one of the most demanding elimination treatment methods of long-term character. Nursing care plays a very important role on hemodialysis. It must be effective, of high quality and particularly continuous as the patient only visits the hemodialysis centre on some days of a week. The nursing care has an irreplaceable role in healthcare. The patient before, during and after hemodialysis depends on quality nursing care provided by a nurse. Nursing process based on knowing the patient and active identification of his/her needs is a characteristic feature of modern nursing care. It stresses elaborate continuity, complexity and individuality of the patient, the sequence of the care and satisfaction of needs in partial steps of the nursing process. The nursing process requires continuous interaction between the nurse and the patient. Flexibility, currency, modification and repeated evaluation of the process are advantageous not only for nurses but also for the patients and often leads to timely solution of problems and satisfaction of patient's needs. The theoretical work reveals that hemodialysis is very closely related to the nursing process and contributes to patient's substantial satisfaction. It points out the importance of planning and preparation of nursing diagnoses. A feedback, not only for a nurse, but also for the patient for possible changes or preparation of a new care plan is also an important aspect of preparation of the nursing care plan. The obtained information on the nursing process in a hemodialysed patient are dealt with by the individual chapters of this bachelor thesis. This bachelor thesis is a guide in planning the nursing process and focusing on the most important problems during hemodialytic therapy not only for experienced nurses but also for tertiary school students. It also contributes to recognition of the necessity to create and apply the nursing process in the care of hemodialysed patients. A comprehensive view of the issue in question is the result. This study material for tertiary school students is the result of careful and thorough study of specialized literature.
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Intraoseal approach - an alternative to peripheral venous entry
TUROŇ, Jiří
The intraoseal approach is an alternative method how to ensure bloodstream in cases when it is difficult or impossible to use venous entry. It is used mostly in children, but it is possible to apply it to adults too. This bachelor?s thesis called ?Intraoseal approach - an alternative to peripheral venous entry? deals with theory of using intraoseal approach in conditions of pre-hospital urgent care. The practical part of this thesis surveys the frequency of using intraoseal implant and screens the knowledge of rescuers working in Salvage and rescue service of Moravian-Silesian district. The method of quantitative research was used to validate the hypothesis. Obtained data were collected by method of anonymous questionaires. These questionaires were distributed to Salvage and rescue service of Moravian-Silesian district, to resorts of Ostrava, Opava, Havířov, Karviná, Krnov, Třinec and Frýdek ? Místek in the concrete. The results of this work showed practical and theoretical knowledge of paramedics of Moravian-Silesian district. Their orientation in the problematics of using alternative venous entry in conditions of pre-hospital urgent care is mostly correct even if there was few wrong answers. Nevertheless the results of research were excellent. These are hypotheses defined ? H1: Paramedics know the process of using intraoseal approach, and H2: The intraoseal approach is used less than venous cannulation in life endangering cases. Both of these hypotheses were verified. The frequency of using this entry is not so high, but I believe it becomes more common with increasing knowledge of rescuers, especially in cases of immediate threat of life with impossibility of using peripheral venous entry.
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