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Issues of care for a morbidly obese patient in standard beds and intensive care units.
KRÁL, Dominik
This bachelor thesis deals with the issue of care for a morbidly obese patient in standard units and intensive care units. The work is focused on how nurses in standard units and intensive care units care for a morbidly obese patient. The theoretical part consists of the characteristics of obesity, examination methods, treatment, the possibilities of prevention of obesity and selected aspects in the care for a morbidly obese patient in standard units and in the intensive care unit. The research part focuses on the obstacles which nurses perceive in providing care for a morbidly obese patient and on how nurses care for the hygiene, skin, nutrition, excretion and mental needs of a morbidly obese patient. The aim of the thesis is to map the issue of nursing care for a morbidly obese patient. This part was processed in the form of qualitative research survey using semi-structured interviews. Five nurses from the standard ward and four nurses from the intensive care units took part in the interviews. After obtaining the necessary information, it was processed in the form of open coding and the creation of six categories. The results show that the complexity of care is determined by patient's mobility, state of health and his cooperation. Other obstacles are his proportions, lack of staff and the need for more time for overall care. For healthcare professionals, care is more physically demanding when handling the patient during hygiene, after excretion and during positioning. The nurses regularly monitor the skin. They consult patient's nutrition with a dietitian. They use interview with the patient to identify his mental needs. Based on the findings, a brochure for nurses was created, which focuses on the most common problems in the care for obese patients, which nurses may encounter in their practice.
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Nursing care for neurological patients in intensive care units
HRICOVÁ, Kristina
This bachelor thesis deals with problematics of nursing care of neurologically ill patients in intensive care. It´s main objective was to map specifics of nursing care of neurologically ills in Intensive Care Unit. The secondary objective was to find out, how the Intensive Care Unit personal mantains principles of neurologically ill pacients careTo accomplish determinated goals, following research questions were set up: What are the specifics of nursing care of neurologically ill patients in intensive care? How nurses working in Intensive Care Unit, mantain principles of neurogically ill patients care? From a range of neurological diseases, this bachelor thesis focus on strokes in intensive care. Teoretical part deals with different kinds of strokes, their etologie, clinical symptoms, possibility of diagnostic and therapy. Also specifics of nursing care in individual areas. To carry out the research, the method of quantitative research was choosen. Data collection was done by technic of hidden observation and semi-structured interview. Method Pencil - Paper was used to analyse results. Processing researched finding, both research questions were answered. Despite minor shortcomings, mainly of systemic caracter, results of the research are showing great quality of nursing care, provided to patients with neurological diseaseses in observed Intensive Care Unit. It was found out, the most specific area of stroke patient care is nutrition - for reason of dysfagie - and also positioning and rehabilitation. Nurses pointed out, one of the biggest risk of this care is pressure instability and possible lost of conscience. Nurse in Intensive Care Unit must know, how to respond properly and immediately to this situation. The thesis offers complete overview of the nurse care of neurologically ill patients in intensive care and provides recommendation in problematic areas of nurse care.
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Nursing Care for Patients with Peritoneal Dialysis.
HRUŠKOVÁ, Barbora
Peritoneal dialysis, together with hemodialysis, is one of the options for the renal function replacement. These days is the treatment with the help of peritoneal dialysis being used by more and more patients. One of the big advantages of peritoneal dialysis is the ability to care for yourself in the comfort of home, and that the patient doesn´t have to visit the center for dialysis several times a week. Theoretical part of this thesis is dedicated to peritoneal dialysis. Its physiology and types, types of peritoneal catheter and care of the floating tip. All the aids the patient needs for peritoneal dialysis are described here. You can find here description of the possible infectious on non-infectious complications. The last part is devoted to role of nurse in care of patients with peritoneal dialysis. The empirical part of this thesis was processed with help of a qualitative research. Our goal was to find out the most common problems of the peritoneal dialysis patient in their home environment. Based on the objective, there were made semi-structured interviews, that were performed with patients, who have or who used to have peritoneal dialysis. Information received from the patients was analyzed and divided into categories. The results of the research showed the most common problems of the patient with the peritoneal dialysis. The most common problems include the first reconciliation with peritoneal dialysis, fear of infection, but also fear of being able to go to work and others. This bachelor thesis could be helpful to the patients, who already experienced some kidney diseases or are just starting the medical treatment with help of peritoneal dialysis or are being treated by hemodialysis and are considering this option. This thesis may be also helpful to the students or already graduated nurses, who start working in hemodialysis center.
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Issues relating to caring for patients with leukaemia.
MACHOVÁ, Karolina
The theoretical part of my bachelor thesis is primarily focused on nursing care of the patient diagnosed with leukemia and related issues. Purpose of the thesis is to describe this serious disease with an unfavourable prognosis. The theoretical part is built on the basis of analysis of available sources of information concerning the given topic. Two major goals were set for this bachelor thesis. The first objective is to determine the specifics of the nursing care of the patients with leukemia. The second goal was to establish the main issues connected with the nursing care of patients with leukemia. Two research questions were created on grounds of the objectives defined. Those research questions were: What are the specifics of the nursing care of the patients with leukemia? What are the most common issues that nurses have to cope with when treating patients with leukemia? For processing of results acquired in the empirical part of the thesis the form of qualitative research was chosen using the method of semi-structured interviews. The choice of the nurses was intentional, therefore only nurses providing care to the patients with leukemia were addressed. Both research questions were answered and both goals were met. Results from answers received from the nurses were divided into categories and consequently processed. It is necessary for the nurses to comply with the standards in order to avoid complications regarding the patient with leukemia whose immunity is well weakened. Therefore, I would suggest lectures and seminars extension in the hospitals in order to ensure the best quality care for patients with leukemia. This bachelor thesis can be helpful to the students who wish to acquire new information about given disease and provide better understanding of the described issue.
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Conceptual models aimed at the final stage of life
KOHOUTOVÁ, Andrea
The bachelor thesis "Conceptual Models Aimed at the Final Phase of Life" is elaborated on a theoretical basis. The bachelor thesis has an informational character, which logically and intelligibly informs about conceptual models that are aimed at the final phase of life. In this bachelor thesis, we are not only concerned with these conceptual models, but we have also aimed on their development since the beginning of nursing. It was necessary to visit several different libraries and to study or borrow a large number of specialized books from Czech and foreign authors, so that we can get enough information to write this bachelor thesis. The information was also obtained by using Internet search in the EBSCO, SCOPUS and Pub Med databases. Firstly, this bachelor thesis describes the development of nursing, as well as the final phase of life, which is associated with dying and death. Subsequently this bachelor thesis presents conceptual models and their development. Finally, this bachelor thesis deals with conceptual models that are aimed at the final stage of life. From these models, we chose three models, such as Hildegard E. Peplau, Trajectory model, and last but not least the Theory of the End of Life. This bachelor thesis should serve the nurses to improve their work with patients at the final phase of their life. This work can help nurses in their thinking and to learn to treat these patients and to help understand their needs and satisfy them. These conceptual models can serve not only nurses, but also educators as a basis for teaching nursing subjects or as a contribution to professional seminars or conferences that deal with this issue.
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Nursing role in providing care to dying patients at retirement homes
STAŇKOVÁ, Petra
The aim of this thesis is to describe a nurses role in providing care to dying clients at retirement homes. In connection with this goal, were set out five Research questions, which are: What are the specifics of nursing care for a dying client at retirement home? What are the specific needs of a dying client at retirement home? What are the specifics of communication with a dying client at retirement home? How do the nurse ant the family of a dying client cooperate? What is the approach of nurses to the care of the client at retirement home? The empirical part of this bachelor thesis was elaborated by the method of qualitative Research survey, which was realized by the technique od a semi-structured interview. The interview consisted of 24 questions, supplemented in some cases by additional questions. The interview was divided into 6 parts identification, specifics of care, dying client's needs, communication with a dying client, cooperate with the family and nurses approach. Interview were overwritten and processes by open-coding, pencilpaper technique. The research group consisted of nurses working at the time at retirement homes. This bachelor thesis was written in a certain way, to bring basic overview of the nursing role in providing care to dying clients at retirement homes. Based on the findings, supplemented by the knowledge of experts in the fields of thanatology and paliative care, will be create a handbook for nurses ant other staff caring for dying clients at retirement homes.
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Attitudes and options of nurses in the care of ethylene glycol poisoned patients. (theretical thesis)
KMETKOVÁ, Monika
Ethylene glycol intoxication, suicidal as well as accidental, belongs to serious, immediately life-threatening poisonings, which can however be cured even in the most severe cases (provided early recognition and correct treatment), including the restoration of renal function to the original state. Ethylene glycol is most notably present in anti-freeze cooling liquids for vehicles (such as Fridex). Consumption of 100-150 ml of such a solution is considered a lethal dose in humans. follows Oral ingestion is followed by rapid absorption. Metabolic decomposition takes place predominantly in the liver by way of alcohol dehydrogenase, to glycoaldehyde, which is further metabolised to glycolic acid and oxalic acid. The clinical aspect is dominated by acute renal failure which is caused by acute tubular necrosis. Toxicological examination including an assessment of ethylene glycol levels in both blood and urine, with prognostic relevance, is indispensable to diagnostics of the poisoning as well as from the standpoint of differential diagnostics. Therapeutic measures include gastric lavage within one hour of ingestion and administration of activated charcoal. Administration of ethanol and fomepizole, compounds that bind alcohol dehydrogenase and thus prevent the conversion of ethylene glycol to its toxic metabolites, is considered valid causal treatment with simultaneous early institution of hemodialysis (even in cases of hitherto intact renal function). As fomepizole is currently not available in the Czech republic, ethanol remains the only antidote. Therapy further includes correction of metabolic acidosis by way of bicarbonates, and intravenous application of thiamine and pyridoxine. Therapy of such a grave condition must entail infirmary care provided by professional nurses as a necessary complement. The nurse serves their function in securing the patient's airways, connecting the patient to mechanical ventilation, monitoring physiological functions, assistance with invasive entry, as well as conducting sample extractions, assuring proper hygiene, the prevention of decubitus ulcers etc. It has been the aim of an extensive effort during my analysis of this topic to collate an up-to-date summary of practical knowledge on ethylene glycol intoxication, as well as subsequent therapeutic options for such patients, based on collected information and available source material. This final thesis, entitled "Approach and Options for Nurses in Therapy of Ethylene Glycol-intoxicated Patients" has been created relying on a body of purely theoretical Czech and foreign sources. To attain awareness of the current state of medical sciences described on the following pages, many professional and scientific publications, books as well as journals and websites of registered professional societies had to be studied. The aim of a detailed inspection of such an extensive body of data has been to provide relevant findings based on the facts determined. The accumulated information is further specified in particular sections. The first deal with intoxication, elimination and first aid in the pre-hospitalization phase from a broader perspective. Without these elementary notes the thesis as a whole would lack in conclusiveness. From this section the thesis fluidly continues with ethylene glycol intoxication itself, its treatment and all the way to the role of the nurse including particular therapeutic measures. These sections contain specific recommendations issuing from news and cutting-edge research on ethylene glycol poisonings.
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Differences in nursing care in patients with active and passive thoracic inlet
CHLEBÚCHOVÁ, Eliška
Active and passive chest suction is a treatment method used in surgery. The purpose is to suck liquid, blood or air from the pleural cavity and the restitution effect, i.e. lung unfolding. This method is very efficient in treatment of pneumothorax, hemothorax and other pathologic states in the pleural cavity. Chest suction has been used for a long time, today particularly at surgery departments. Nursing care of patients with chest suction is very important and special, in the instance of nurse's poor knowledge complications may occur, but moreover the patient may be hurt. The thesis called "Differences in Nursing Care of Patients with Active and Passive Chest Suction" is divided into two parts, a theoretical one and an empiric one. The theoretical part describes the mechanism of the active and passive suction, the development of this treatment method, and the indications leading to it. The theoretical part also deals with the nursing care about a patient with chest suction systematically from the chest drain introduction to patient's recovery. Goal was to identify the principles and find out the differences in nursing care of patients with active and passive chest sucking. Three research questions were formulated to achieve the goals. Q1: What are the principles of nursing care of a patient with active chest suction? Q2: What are the principles of nursing care of a patient with passive chest suction? Q3: In what spheres do the theoretical knowledge and practical skills in the care of a patient with active and passive chest sucking differ? Qualitative research was applied to elaboration of this bachelor thesis. The technique of semi-structured interview was used for data collection. A categorization was performed based on the interviews. To improve quality of the results the research was accompanied by the method of involved observation, which either confirmed the findings from the interviews or added facts that the nursed had not mentioned in the interviews. The research was performed at departments where patients with the chest sucking occur. The research has shown that the nurses are aware of the principles of the care of patients with active and passive chest suction. The interviews revealed the principles of the nursing care that should be followed throughout hospitalisation of a patient with chest suction. The nurses point out the differences between the active and passive chest suction in the interviews. The specifics of the system of active and passive chest sucking itself were also identified. The research has also shown that the departments where it was performed often use the active chest suction system called Medela, which gives free movement to the patients and easy handling for both the patient and the staff. Another, not as widespread active suction, compact unit has the same advantages as the Medela system. The research has however shown that the nurses were not sufficiently informed on operation of the compact system and the patient care with the compact active suction unit. The bachelor thesis has brought findings of the care of patients with passive chest suction of conventional type. The principles of the care of patients with active sucking have been found not only for the conventional system, but also those of modern active sucking techniques. The basic differences in nursing care of patients with active and passive suction have also been found out. The nurses concentrate on the differences in the care in the system tightness inspection, water column determination and the differences in handling the systems. This bachelor thesis outlines the principles and differences in the care of patients with active and passive chest suction, the adherence to which is among others a condition of timely recovery of the patient and return to normal life. It will also be written a leaflet on the principles of the nursing care of patients with active and passive chest suction.
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Educational Activity of a Nurse in an Outpatient Department
HANOUSKOVÁ, Radka
This thesis focuses on educational activity of a nurse in an outpatient department. The introduction to the theoretical part identified educational activities, their types, phases, methods and forms.The aim of the thesis and the research question: The aim of the thesis was to find differences between educational activity of a nurse working in outpatient departments existing in hospitals and those out of hospitals. Methodology: The results of this thesis were obtained by a qualitative research method, namely semi structured interviews. One anonymous South Bohemian hospital was involved in the research, from which three nurses working at specialized outpatient departments were chosen. One anonymous South Bohemian outpatient clinic was another research subject. Three nurses working at specialized outpatient departments were chosen there as well. Results: Four categories, each consisting of several subcategories were based on the obtained data. In the first category called educational activity in an outpatient department we found that the educational activity for nurses in outpatient departments is based on education of a patient in health maintenance and restoration and education in prevention and treatment. In the first established subcategory called the applied educational methods we found that the nurses in the hospital as well as those in the outpatient clinic mostly apply dialogue and demonstration to education. In the second subcategory called the number of educated patients the empiric research showed that in average the number of educated patients is twice as high in the hospital as in the outpatient clinic. We were surprised that nurses in the hospital used an education record sheet to record their educational activity, while the nurses from the outpatient clinic did not keep any records. The second category identifies in what nurses can see the importance of patient education. Upon analyses of the result we can say that they can see it in the information source. This category consists of three subcategories. A subcategory dealing with attracting patient's attention to education showed that nurses gain patients with a smile, a kind word, motivation and commendation. The second subcategory was feedback, which showed that nurses get it orally. And the education topic the nurses meet is always specific for each particular type of department. The finding that various topics are educated in all the departments, but one topic is common, namely diet, where all the nurses educate patients in nourishment, was the result. The third category, education method choice was also established. There was a positive finding that nurses use various education methods, which they choose with regard to patient's state and needs. This category consists of two subcategories. The first subcategory was called the most effective educational method. All the nurses uniformly considered interview to be the most effective method. In subcategory educational material we found that nurses use leaflets or aids for injection application as educational material. The last chapter called influence on education was aimed at things that influence nurses' educational activity. A subcategory time for education was established here. One thing the nurses working in the hospital agreed on was that they did not have enough time for education. On the other hand the finding that the nurses from the outpatient clinic mentioned that they had enough time for education was a surprising result. Another subcategory searched for the proper environment. The answers here differed according to the place the nurses worked at. The nurses working in the hospital replied that they did not have suitable environment for education, while those from the outpatient clinic considered their environment acceptable. The last subcategory examined the obstacles to educational activities. The research showed that the nurses see obstacles in age and in lack of confidence in new technologies. T
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Kompartment syndrome with injuries to the legs and issues from the perspective of patient care
BÁRTOVÁ, Marcela
A complex of clinical symptoms occurring as a consequence of pressure increase in enclosed anatomic space is called the compartment syndrome. We must pay great attention to this diagnostics as local ischemia occurs and sometimes fasciotomy is indicated during compartment syndrome development. This means difficult and log treatment for the affected patients. The aim of the thesis was to find out whether patients are informed on the possibility of surgical solution of compartment syndrome, what information they have on subsequent care of fasciotomy, and to what extent patients fear of possible leg amputation in the instance of compartment syndrome diagnosis. The last aim was to find out to what extent patients fear of consequent functionality limitation of the leg. Interviews were conducted with four patients hospitalized at the traumatology ward of České Budějovice Hospital and with three nurses working at the same ward. The method of non-standardized interview was used in the research. The research has shown that patients are provided with information on the method of surgical solution of compartment syndrome, however sometimes with delay, namely in a situation when a patient learnt the information after the surgery. The patients focused on their injured limbs, the nurses perceive the care of fasciotomy as a complex and inform a patient on all nursing care procedures applicable to the particular patient. The research has also confirmed the fears the patients have of possible amputation of their limbs as well as of subsequent limited functionality of the limb. This influences patient?s mentality, which is very important for the due course of treatment. This thesis outlines the importance of timely provision of information on possible complications and subsequent solution of these complications to the patients. Its lack might increase patient?s overall anxiety of his/her health condition, in our case about an injured limb. The research results will be probably published in journals and lectures may be given at educational events on this topic. A brochure Compartment Syndrome and its Treatment will be issued for patients.
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