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Nursing care of a patient after the first implantation of permanent pacemaker
Benešová, Helena ; Heřmanová, Jana (advisor) ; Hnátek, Tomáš (referee)
The aim of this thesis is a case study of nursing care on patient XY, 95 years, who were acutely admitted to the cardiology department for symptomatic sick sinus syndrome, AV block first degree, and left bundle branch blockage. Thereafter, the patient was implanted permanent pacemaker. The thesis is divided into a clinical and nursing. In the clinical section, I briefly describe the anatomy and physiology of the heart conduction system, arrhythmia on the patient's cardiac types. Particular attention was paid Pacing permanent - its development, indications for implantation according to new guidelines, incentive schemes. I also described the progress of implantation TKS, preparation before and after surgery care, complications of implantation of TKS and permanent cardiac itself. There are also indications of the selected patients and the course of his hospitalization for implantation of TKS. The introduction of the nursing work briefly deal with the description of the nursing process and models of basic nursing care according to Virginia Henderson. According to this model, I am on the day of implantation after surgery made nursing history and assessment of the patient. The information from the patient, his documentation and observations from my observations of other medical personnel, I set the current and...
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není uveden
Bahannan, Abdulrehman ; Slavíček, Aleš (advisor) ; Dlouhá, Olga (referee) ; Slípka, Jaroslav (referee)
Endoscopic laser-assisted cordectomies classified by Remacle and Rudert (typ I-V cordectomies) comprise a vast range of procedures from simple vocal cord stripping or submucosal cordectomy (type I) through more extensive surgery (subligamentous cordectomy- type II, transmuscular chordectomy- type III) to complete (type IV) or extended cordectomies (type V) used when tumour involves the anterior commisure, arytenoid region, subglottic region etc. Endoscopic laser-assisted surgery of the larynx is usually indicated in early stages of infiltrative malignant disease of the glottic region (Tla-b, T2) or in preneoplastic conditions (laryngeal intraepithelial neoplasia - LIN I, II or III). Radiotherapy is also believed to be an equivalent type of oncological therapy for these diseases. Both surgery and radiotherapy can worsen one of the main functions of the human larynx- the human voice. Because the overall survival rates and local control rates are quite similar in both types of therapy, one should always have in mind something that is beyond the main goal of achieving radical removal of the tumour- patients quality of life (QoL) and quality of voice. It is very interesting to compare QoL and voice quality in different types of treatment. The possibility to conserve the radiotherapy for the possible recurrence...
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Nursing home care of the patient with leg ulcer
Střížová, Monika ; Heřmanová, Jana (advisor) ; Ston, Robert (referee)
The aim of my bachelor thesis of nursing care for a patient diagnosed with V.Š venous leg ulcers in home care. Work consists of clinical and nursing section. The clinical part deals with anatomical and physiological description of the skin and the venous system of lower limbs, characteristic of disease, etiology, diagnostic tests, treatment and prognosis. The nursing section briefly describe the nursing process and nursing model Marjory Gordon, which I used as a theoretical basis for processing and evaluation of patient history. I analyze information to determine actual and potential nursing diagnosis, I was effectively planned and implemented nursing home care. Given that Mrs. V.Š in the care of nursing home care for nearly a year, short-term nursing diagnosis, I set the current length of day in a standard manner by treating physician's surgery and one month long. Nursing component of the evaluation of mental status and education of patients and their families. The conclusion is a summary of key information contained in my work and the prognosis of the disease.
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The role of radiology in children hip screening in Pelhřimov Hospital, c. o.
CHADIMOVÁ, Jana
The topic of this thesis is to compare the use of imaging methods in children hip screening and to find out the presence of developmental dysplasia of the hip (DDH) in Pelhřimov Hospital. DDH is the most common musculoskeletal developmental defect which affects approximately 5% of newborns. It includes an impaired development of acetabulum, femoral head, poor centering into the acetabulum or disproportionate extent of joint movement. DDH is being formed by interaction of genetic factors and external causes. If DDH occurs in the family, the risk neonate increases significantly. The most serious stage of this defect is hip dislocation, but we often meet a lighter form of this defect, which is called shallow acetabulum. The Czech Republic established a system of consecutive check-ups of neonates and infants. It was created on the base of Methodological Sheet of the Ministry of Health from 1996. These examinations are carried out in three stages. During these examinations, ultrasound plays a very important role. The most common method, also used in Pelhřimov Hospital, is the method of Austrian professor Graf. This method evaluates findings and classifies them into groups. After the first year of age, when ossification of structures is nearly completed, the findings cannot be evaluated by this method. X-ray examination is applied in case of diagnostic uncertainties - especially when planning subsequent treatment in children with DDH diagnosis. Imaging methods are applied to determine anatomical reposition obstacles after an unsuccessful primary reposition. We can use ultrasound, magnetic resonance, but we prefer arthrography. Arthrography is more invasive method, but unlike the others, it has got an important advantage: it can also be a therapeutic method. The theoretical part deals with anatomy, development and growth of the hip joint. I also present etiology and history of this developmental defect. The following part deals with a description of the system of clinical check-ups and diagnostics of DDH. Another part of the theoretical work is devoted to individual imaging modalities - ultrasound, X-ray, magnetic resonance and arthrography. Imaging modalities are a very specific part of radiodiagnostic. Paediatric patients are not small adults, their imaging should be restricted to a minimum and it has got its own specifics. The examination must be performed quickly and accurately, in order not to have to be repeated. Options of therapy varies according to the severity of the hip joint. A small damage of the hip joint is solved by a conservative way using various abduction tools like abduction package, Frejk duvet or Pavlík calipers. More serious cases need to be solved by hospitalization, using distraction therapy or surgery. The aim of this work was to analyze the number of paediatric patients, to find out what kind of imaging methods were indicated and performed and to compare the presence of congenital defect of the hip according to sex within Pelhřimov Hospital. The hypothesis of this thesis was formulated as follows: In paediatric hip screening examination in Pelhřimov Hospital presence of congenital defect of the hip is higher in girls than in boys. The purpose of this thesis was to create a comprehensive text dealing with the use of imaging methods in detecting developmental defects of paediatric hip. The theoretical part of this work may serve as information material for professionals and the results can be used as statistical material.
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Usage of NIC and NOC clasifications on patients with complete artificial hip joint.
KULHÁNKOVÁ, Barbora
Abstract The theoretical part of the thesis entitled The Use of NIC and NOC Classifications at Patients with the Total Hip Arthroplasty deals with the problem of the total hip replacement, educating patients before surgery and the regime which must be observed by the patient during the hospitalization and when being discharged from the hospital to home nursing. Further, the nurse has been described as a provider of rehabilitation nursing cooperating with the physiotherapist. The thesis is concerned with the nursing process, it preoccupies with the terminology in the health care, the issue of NANDA, NIC and NOC classifications and the Alliance 3N. Three goals of the thesis were defined: 1. to find out what types of NIC activities are typically used by nurses within the care of patients with total hip replacement. 2. to verify the application of NIC an NOC classifications in the care of patients with total hip replacement. 3. to investigate what sorts of the NOC indicators are typically used by the nurses in the care of patients with total hip replacement. The combination of the quantitative and qualitative research is applied. The four hypotheses were determined in the frame of the quantitative survey: 1. Nursing diagnoses are assessed as not being beneficial by the nurses. 2. Ensuring of tools facilitating the movement is a commonly preferred kind of an intervention by the nurses. 3. The knowledge of NIC and NOC terms is influenced by the previous education. 4. The satisfaction of the nurses with the nursing documentation is influenced by the length of practice. Data was collected by means of the questionnaires. One research query was established for the qualitative research: 1. What is the standpoint of the nurses on the NIC and NOC classifications in the care of the patient with total hip replacement? Data was collected by means of the formed nursing documentation based on the NIC and NOC classifications. The semi-structured interviews were used, as well. H1 remained unconfirmed. H2, H3 and H4 were not statistically validated. The NIC and NOC classifications are generally classified as not being beneficial for the nursing practice by the nurses.
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The pilot project of rotary component production
Toman, Lukáš ; Prokop, Jaroslav (referee) ; Osička, Karel (advisor)
At the begining of the bachelor thesis is a theoretical part that deals with the basic principle of machining. Cutter arbor 40 × 27 ČSN 24 1440 is assessed from technological point of view. Yearly production of the arbor is 17 000 pieces. The main theme is a technological evaluation of the production process from two type sof semi finished product, circular bar hot rolled and forging both made of 14 220.0. For the technological process are chosen machina and tools. Production instruction is elaborated for rough turning operation and the reset is machining time. In the conclusion is chosen semi finished forging according to the technological and economical evaluation of the production process.
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Rheology of the Knee Joint before and after the Surgical Treatment of the Rupture of the Anterior Cruciate Ligament
Strážnická, Lucie ; Jelen, Karel (advisor) ; Tlapáková, Eva (referee)
Název: Reologie kolenn~ho kloubu před a po chirurgickém řešení ruptury přednfuo zkříženého vazu Název v anglickém jazyce: Rheology of the Knee Joint before and after the Surgical Treatment of the Rupture of the Anterior Cruciate Ligament Cíl práce: Shrnout a analyzovat problematiku kolenního kloubu a získané poznatky využít při detekci změn reologických vlastností kolene po ruptuře předního zkříženého vazu před operací a v průběhu rekonvalescence. Srovnáill se zdravou končetinou a hodnocení změn průběhů hysterezních křivek v průběhu rekonvalescence. Navržení hodnot~cích parametrů pro popis stavu kolenního kloubu a jeho vývoje v průběhu rekonvalescence. Metoda: Bylo použito několik dostupných literárních zdrojů, ze kterých byly čerpány informace pro získání teoretického přehledu o problematice kolenního kloubu. Zároveň probíhala experimentální studie, která potvrdila či vyvrátila předem dané hypotézy. Výsledky: Výsledky poukazují na možnost detekce změn reologických vlastností kolenrubo kloubu po ruptuře předního zkříženého vazu. Bylo navrženo několik parametrů pro hodnocení vlastního experimentu, obecně lze ale říci, že bude ještě potřeba mnoha dalších studií, než bude zcela zřejmý výklad těchto parametrů a bude možné tyto parametry považovat za hodnotící standard. Dále je důležitá skutečnost...
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Manufacturing of biscuit pan
Pešava, Josef ; Císařová, Michaela (referee) ; Podaný, Kamil (advisor)
The solved part – the „cookie cutter“ is made of tin material TH 370 0,24 mm thick. It will be used for baking cookies at temperatures up to 250°C. Estimated annual series is 100 000 pieces. The most optimal method from the variant solution of the production of the part was chosen. In the first operation the circular rondel is cut from the sheet and there is the conventional campaign in the second operation. Based on calculations the nearest suitable press LEN 25 C is selected for the production. The price of 2,58 CZK per mold was calculated in, the technical-economic evalution. The pull tool is designed from technological and design calculations.
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Comparison of the results of basic coagulation tests carried out in three different laboratories on the same sample of blood
FÁLOVÁ, Alena
Basic coagulation tests are carried out in every laboratory of hematology. Every patient who is about to undergo a surgery, or is treated with anticoagulants, should be examined this way. Coagulation tests allows to find out, if the patient is suffering from outer or from inner coagulation cascade disorder. Final diagnosis is carried out using specialized tests. The basic tests include protrombin time, activated parcial tromboplastin time, and fibrinogene. The principle of coagulation tests is determination of the time needed for detection of fibrin fiber after addition of reagent to the sample of tested plasma. Tests used in hemostasis can be global, group and specific. For the test, test tubes with an antikoagulant are used. In hemostasis, the antikoagulant used is trisodium citrate. It is always necessary to keep the same blood/citrate ratio. The preanalytical part, which consists of specific actions the sample undergoes from its obtaining to the analysis itself, is also very important. Nowadays, the coagulation tests are run in laboratories using multifunctional analysators. Blood samples are obtained from a vein. Small, portable coagulometers are used for measuring protrombin time for patients treated with anticoagulants. Blood for this test can be obtained from the fingertip. This thesis is focused on comparing the measurment of a sample on three different coagulometers. Different tromboplastins with different ISI (International Sensitivity Index) were used. Reagents for activated parcial tromboplastin time were also purchased from different producers. In this bachelor thesis, fifty randomly chosen samples were tested, because not every application form has the patients diagnosis stated. Every sample was tested that very day, within four hours from taking the blood. Samples were primarily tested in laboratory Synlab czech s.r.o., using coagulometer Sysmex CA. Other measurments were carried out in laboratory Stafila s.r.o. using coaguometer ACL Elite PRO and in laboratory Medipont s.r.o. using coagulometer START 4. All measurments were statisticaly evaluated. Average values and standard deviation were calculated, and shows, that the values does not differ significantly. Level of significance in INR test (international normalised ratio) and in activated parcial tromboplastin time was evaluated as statisticaly significant, yet without bigger clinical importance. Only in protrombine time, measured in seconds, results from coagulometers does not differ. The same can be applied when comparing coagulometers with each other. Based on my findings, it is recomended for the doctors to use the same laboratory for testing the protrombin time and activated parcial tromboplastin time. At the same time, it is necessary to say, that the differences measured in this thesis are so minor, that they have no practical clinical importance.
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