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Nnursing care for patients with facial injuries
TONCAROVÁ, Lucie
This thesis deals with the nursing care of the patient with facial injuries. Injuries to the face is a synonym for many types of injuries. This term is a soft tissue injury, facial trays, teeth, nose, eye, orbit, burns, frostbite, fractures of the lower and upper jaws, Le Fort fractures and dislocations of the jaw. This, the patient needs nursing care quality, whose sister is a carrier. Sister focuses on the specifics of care and knows how to take care of the sick . The work includes theoretical and practical part. Introduction The theoretical part consists of the types of facial injuries. It builds on the already soft tissue injuries, lower, middle and upper face floor. The thesis continues with information about the causes of disease, diagnostic methods, first aid, treatment, complications and treatment of the orofacial region. Then comes the topic, which includes intervention in a patient with facial injuries within nursing care. Essential topics are dealing with oral hygiene, dressing, pain and nutrition. The following are the communication skills of nurses and rehabilitation of the orofacial region. The practical part consists of a qualitative research using semi-structured interview, which consists of 17 questions. The research sample consisted of nurses traumatology department of the Czech Budějovice Hospital a.s. taking care of patients with facial injuries. Interviews were, after approval of the principal and chief nurse at the appropriate department, where these nurses work. Chats are completely anonymous, a free choice of nurses. After approval of the nurses station to request interviews were sisters recorded in writing on paper. The research took place at the beginning of April 2014.
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Algorithm of imaging methods of injuries of the neck of the femur in the case of seniors
TOČÍKOVÁ, Miluše
The bachelor thesis deals with the incidence of femoral neck injury in the elderly. The work is divided into a theoretical and practical part. As the number of people of retirement age is growing, the rate of injuries associated with this age group has been increasing as well. It is necessary to accept the idea that age is a stage of human life, which every individual must eventually face. A femoral neck fracture is one of the causes of mortality and morbidity in the elderly. The incidence of this injury has been increasing both in developed countries and in the Czech Republic. A femoral neck fracture represents a threat for mobility and independence of seniors. Some people are then permanently dependent on mobility aids, while others remain in institutional care. The most common cause of femoral neck fractures in the elderly is a fall on their side, which is caused by a complex interaction of external and internal factors. The first imaging method used during a medical examination is sciagraphy, which is one of the oldest methods. It allows physicians to assess the preoperative condition of the hip joint and postoperative check-ups during the treatment by alloplasty or perioperative condition with the use of osteosynthesis. It is beneficial for the above-mentioned group of people to carefully assess the bone metabolism. A healthy bone is constantly reconstructed, it continuously breaks down and a new bone replaces it. With age, the degradation of bone prevails over bone formation and the bone begins to "thin". This disease is called osteoporosis. It is a disease that pertains to the civilisation diseases. It is often only diagnosed at an advanced stage, when it is already increasingly susceptible to fracture incidence. The factors of osteoporosis include an unhealthy lifestyle, hormonal changes in women after menopause, when there is a decrease in the level of calcium, a major weight loss etc. A painless, non-invasive method, by means of which a doctor can obtain comprehensive information about the amount of bone mineral in the examined part of the bone, is a densitometry test, or DXA. This test uses x-rays at two energy levels. The DXA method can be measured as a whole-body mineral content as well as any other part of the body. Other causes, which increase the risk of a femoral neck racture, are bone metastases. The proximal portion of the femur, including the femur neck, metastatically affects especially primary lung cancer, kidney cancer, thyroid, breasts in women and prostate in men. At an early stage, bone metastases are asymptomatic. Clinical symptoms such as pain can occur, when the metastatic process penetrates the periosteum and surroundings of the bone, thereby irritating the neural structures. Another symptom is the emergence of pathological fractures. Bone metastases are helping us uncover laboratory tests and diagnostic imaging methods, which include, for example, scintigraphy. Bone scintigraphy can detect a metastatic process much earlier than X-ray examination. The aim of the work was to describe the principles of individual imaging methods, which help doctors to determine the correct diagnosis, to learn more about the femoral neck injury in the elderly and about causes of their ocurence. Moreover, the two hypotheses were established: 1. The most frequently used method in case of a femoral neck injury is skiagraphic examination. 2. That is why more than a half of femoral neck injuries are diagnosed in the elderly. The practical part was elaborated on the basis of a quantitative research. The data needed for the research were obtained from case studies of patients hospitalized in the orthopedic department of the Hospital Tábor a.s., in the period from 1st April 2014 to 31st March 2015.
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Case study of physiotherapeutic care of patient with osteosythesis after subtrochanteric fracture of femur on the left side with consequences complication of ligament rigidity of knee joint
Šťastná, Jana ; Říha, Michal (advisor) ; Hlavičková, Růžena (referee)
Title of bachelor's thesis: Case study of physiotherapeutic care of patient with osteosythesis after subtrochanteric fracture of femur on the left side with consequences complication of ligament rigidity of knee joint. Summary: This bachelor thesis was elaborated during my continuous practice at ÚVN in Prague - Department of rehabilitation and physical medicine in the period from January 10th till February 4th 2012. The thesis includes two main parts: general and special part. In general part is in detail described anatomy and kinesiology of hip and knee joint and also the causes and treatment of subtrochanteric fracture. At the end of the general part you can find physiotherapeutic procedures and approaches used in post-surgery treatment of proximal femur fractures treated by osteosynthesis. Special part includes detailed casuistry of a patient with subtrochanteric fracture of femur. The fracture got subsequently complicated by ligamentary rigidity of knee joint. Key words: fracture, osteosynthesis, knee joint, physiotherapy, case study
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Proximal Femoral Fractures - Nurse Problem with Aging of Population
ŠTECÁKOVÁ, Martina
This bachelor thesis deals with the nursing issue of proximal femoral fracture in the context of aging of population. Recently there has been an increase in the number of cases of proximal femoral fracture in the elderly people above all. Age and general state of health influence significantly the entire postoperative period and self- sufficiency of the patient. The objective of the thesis was to research factors related to proximal femoral fracture, to find out about mobility and at the same time about self-sufficiency of the respondents before and after the trauma. Then, to point out the areas of self-care in which the client has the largest deficit, how the client manages the individual areas and whether his own efforts and efforts of the nursing staff can help him to return to the normal life. These objectives were achieved in the thesis. Four hypotheses were set. Hypothesis 1: Proximal femoral fracture in clients above 65 occurs more with women than with men, was verified. Hypothesis 2: Proximal femoral fracture occurs most frequently with clients living alone after the fall at home, was also verified. Hypothesis 3: Clients who are fully mobile and self-sufficient before the trauma, usually return directly to their original environment immediately after the discharge from the trauma department, was not verified. Hypothesis 4: Self-care in hygiene in the postoperative period is the most difficult task for the respondents, was not verified. The theoretical part deals with anatomic structure, vascular and neurological supply of proximal femur. The other part describes particular types of fractures together with clinical picture and treatment possibilities. Then old age with all its aspects is described. An important area is the nursing part, focused on preoperative preparation and postoperative care. To verify the hypotheses, quantitative research was chosen. A standardized interview was designed for patients. An anonymous questionnaire was designed for nursing staff. Further on, content data analysis was applied. The results of the work point to the deficit in the area of self-care, which influence ability of the elderly to return to the normal life. If nursing staff and physiotherapist were familiarized with these results by means of a workshop initiated by the management of the Clinic of Orthopaedics and Traumatology, it might lead to the improvement of the nursing care and it also might become a stimulus for more intensive rehabilitation. Mapped self-care deficits will be then used to create educational material to facilitate the provision of particular services by home care agencies that will compensate for these deficits when the patient returns to his home.
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problems of seniors accidents - fraktures coli femori
NOVÁK, Zdeněk
Abstract In the thesis, the author focuses on the issue of injuries and specifically on the diagnosis of fractura colli femori. The theoretical part deals with the issue of the cause of injuries themselves and with the question of how to prevent injuries. Moreover, it focuses on circumstances and reasons during which injuries occur. Health problems of neurological character, instability and osteoporosis are analyzed as causes. The theoretical part also presents the types of injuries which are encountered the most during old age. The theoretical part addresses the course of disease during old age as well, the burden of surgery and critical stage of geriatric patients and types of rehabilitation used after injuries during old age (psychosociological rehabilitation). Moreover, the issue of thighbone cervix fracture itself is dealt with herein, what leads to this fracture, risks and types of falls during which thighbone cervix fractures most often occur. Terminology connected to the thighbone cervix fracture is defined herein, picture diagram for how and in which parts fractures occur and also the types of the given fractures. After treatment and the subsequent rehabilitation the work also deals in its theoretical part with the consequences in connection with continuing long-term institutional care. In the research part the author deals with the number of seniors who have been hospitalized for thighbone cervix fractures. The data has been gathered through analysis of secondary data. It has been discovered that in two monitored regions, the number of seniors with this kind of injury has increased. The research has been completed by a survey of 131 seniors with the intent to determine what risks connected to injuries are considered to be the most fundamental by the seniors. It was established that seniors subjectively sense more strongly the risks of health related character rather than risks connected with a safe environment. In the discussion and conclusion the author compares his results with the literature and draws attention to the need to give this issue more attention.
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Nursing care about patient with external fixator
PŘIBYLOVÁ, Martina
The name of this bachelor thesis is: Nursing care of patients with the external fixator. The external fixator is a metal construction above the surface of the skin that connects implants introduced into a bone. The purpose of external fixation is mainly the stabilisation of fractures. The thesis has two main parts: the theoretical and the practical parts. The theoretical part contains basic information on the anatomy of bones, fractures and the therapy of fractures. Further, it deals with the history of external fixation, nursing and rehabilitation care of patients with the external fixator. The practical part includes a research investigation. We set three objectives and posed three research questions within the scope of the investigation. The objective of the thesis was to find out the specifics of nursing care of patients with the external fixator, whether nurses have information about care of patients with the external fixator and how patients perceive the external fixator. We posed the following research questions: What are the specifics of nursing care of patients with the external fixator? Do nurses have information about the care of patients with the external fixator? What problems do patients with the external fixator deal with? The research investigation was conducted in the qualitative method. The research set consisted of the total of 14 respondents - 7 patients and 7 nurses working in the traumatology, orthopaedics and surgery departments. Information was obtained by means of semi-structured interviews and processed into case studies. For reasons of clarity, some data were put into tables. The results formed a basis on which our questions were answered. The specifics of nursing care of patients with the external fixator include the aseptic re-bandaging and additional assistance with care of oneself. Nurses have information about the care of patients with the external fixator, even though that the number of patients with external fixation is in most departments where this research investigation was conducted, rather low. The most serious problems that patients have to deal with are those of comfort. The research investigation forms a framework in which the standard of nursing care of patients with the external fixator was made that surveys the course of the nursing care. I have compiled an information brochure for patients that contains the basic information concerning the therapeutic regime.
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Nursing Care of Klients with Fractured Distal Femur
VOPÁLKOVÁ, Milena
The name of this Bachelors thesis is "Nursery Care of Patients with Fractured Distal Femur". With view to the lengthening of the populations age, increasing popularity of adrenalin sports and development of traffic we can expect an increasing number of this serious type of injury, and therefore it is time to address the issues of nursery care of the clients with this type of fracture. Fracture of the distal part of femur often happens suddenly and unexpectedly and the client has to deal with a health problem, which brings about a lot of changes as regards his/her health, psychic and social situation. The purpose of this thesis is to map the nursing specifics and nursing problems experienced by clients with a fractured distal femur from the nurses point of view. Through an analysis of a research survey we will summarize the thesis outcomes and determine the specifics of possible complications under the nursery care of such clients. Hence, the thesis contains two fundamental parts: theoretical and empirical. The theoretical part deals with the historical development of nursing and care provided as regards these fractures, the anatomy of lower limbs and causes of such fractures. It also addresses the basic classification of such fractures, principles of an osteosynthesis therapy, education, nursing and rehabilitation care. The empirical part includes a research survey with two predetermined goals mapping the specifics and complications within the nursing care of clients with a distal femur fracture. With view to the fact that various specifics and complications within the nursing care in the period before and after surgery were ascertained, they were categorized as pre-surgery and post-surgery specifics and complications. The research survey found out that one specific is differing pre-surgery nursing care of the clients with a fractured distal femur, mainly provided that stabilisation of the fractured part is executed by means of a skeletal traction or a patch traction or through a knee brace. The ascertained nursing complications are related to such immobilization interventions. According to the interviewed nurses the nursing procedure is even more diverse, mainly as regards the injured clients mobility and the nursing care. Other specifics of the nursing care are monitoring of locomotion and sensitivity of the traumatized lower limb, antidecubitus care, aself-care deficit and a possible risk of the lever action impact on the distal femur when moving on the bed. Specifics of the post-surgery nursing care regarding clients with a knee brace are: monitoring of locomotion and sensitiveness of the lower limb, correct manipulation with the knee brace, care of the locomotion, a risk of the lever action impact on the osteosynthesis area mainly when the client is sitting on the bed with lowered limbs or doing exercise on the motor splint. Nursing complications ascertained during the post-surgery period are mainly an oedema and a haematoma of the surgical wound place, urine and faeces emptying disorders, inadequate relief of acute pain, decubites under the knee brace or on the heels, long-term deficit of the clients self-care due to the traumatic consequences and other possible complications as described in this thesis. Outcomes of this thesis are two simple mind maps, which are a part of this thesis. The first mind map shows the nursing care specifics as regards a client with a fractured distal femur and the second describes the most frequent complications and interventions of a nurse within the nursing care as regards a client with a fractured distal femur. The outcomes of this thesis can serve as an information material for traumatology unit nurses and also for nurses working in other complements.
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Case study of physiotheraeutic care of a patient with the diagnosis of dislocated comminuted fracture of femoral diaphysis in its middle third.
Schovancová, Veronika ; Neuwirthová, Svatava (advisor) ; Hulvová, Petra (referee)
Title: Case study of physiotherapeutic care of a patient with the diagnosis of dislocated comminuted fracture of femoral diaphysis in its middle third Author: Veronika Schovancová This baccalaureate thesis was designed as a case study at the Rehabilitation Clinic Malvazinky during my continuous specialized practice from Jan 23 - Feb 17, 2012. The thesis deals with the issues of physiotherapy for dislocated comminuted fracture of femoral diaphysis in its middle third after spongioplasty; reposition and stabilization of the fracture using a splinting technique. The thesis is divided in two parts, general and special. The general part focuses on literature search-based description of fractures, their classification, conservative and surgical treatments, and healing of fractures. The fractures of femoral diaphysis are described in more detail - clinical image of this trauma, its prognosis, therapeutic approaches to the problem, and particularly physiotherapeutic and rehabilitation approaches. The special part is devoted to the case study of a patient with dislocated comminuted fracture of femoral diaphysis in its middle third suffered after falling off a horse, to complex kinesiological analysis of the patient, course of physiotherapeutic treatment using physiotherapeutic devices, and evaluation of the...
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