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Nursing care of the operation area before and after the operation
KRATOCHVÍLOVÁ, Michaela
Theoretical outcomes The preparation of the operating field is an important part of all preoperative preparation. Preoperative preparation, before surgical intervention, cannot be neglected. In most cases, the doctor will not perform an operation without proper preoperative preparation. The only exception is urgent surgical intervention for which only the most basic preoperative preparation is provided. Preoperative preparation can be categorized as long-term, short-term, or immediate. A thorough and proper preparation of the operating field reduces any development of postoperative wound complications. The aim of thorough preoperative preparation of the operating field is to reduce any risk of developing postoperative wound complications. Postoperative care prevents postoperative complications. It is aimed at controlling the state of a patient's current health after surgical intervention, but also the surgical wound and its dressing. Both nurses and doctors are obliged to perform these controls. In the early postoperative period, the client stays in the ward or in the postoperative room. In the case of arising complications during surgical intervention, the client is moved to the ICU/ARO. The Aims of the Thesis The aim of the thesis is to map the differences in preoperative preparation of the operating field among surgery departments, and to find the differences between preparation in the operating field before a scheduled and an urgent surgical intervention. Furthermore, the aim is to find out if nurses perform preoperative and postoperative care properly. The following questions were chosen: What are the differences in preoperative preparation of the operating field among surgery departments? How do nurses perform preoperative and postoperative care of the operating field? Implemented methods In order to gain the desired information, a qualitative form of research was chosen, namely an in-depth interview method, a method of questioning, and an observational method. Observation was implemented using the hidden observation method. The respondents in the research were the nurses from the urology and the surgery departments at a hospital in Vysočina. Data collection was conducted from February to March, 2014. The acquired data was then analyzed through an open coding method. Results The subsequently transcribed interviews and observations were carefully analyzed using the 'pencil & paper' method and open coding. Eventually, five categories were created: preoperative preparation before a scheduled surgical intervention, preoperative preparation before an acute or urgent surgical intervention, preparation of the operating field, postoperative wound care, medical documentation. Conclusion The research suggests that nurses are well aware of the complete preoperative and postoperative care. What is, however, surprising is how adherence to the principles of barrier care and the client's intimity vary in the course of providing this care.The conclusions in this thesis should aim at an improvement of preoperative and postoperative care of a client and to eliminate any discovered shortcomings in the provided nursing care. The practical outcome of this thesis will be an article in a professional magazine for nurses.
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Is it possible in clinical practice to perform selection of unrelated donors based on KIR genotypes for AML patients?
FRYČOVÁ, Michaela
Acute myeloid leukemia (AML) is an aggressive malignant disease, during which is for most of the patients only possible treatment the curative allogeneic stem cell transplantation. Besides reaction of the graft against the host is a fundamental limiting factor of the successful transplantation the relapse of the disease. According to several recent published studies, the results of transplantation in patients with AML may be influenced except the HLA genes by others so-called non - HLA genes. Especially there is mounting evidence influence of the donors KIR genes (Killer -cell Immunoglobulin - like receptors) in protection against the relapse after transplantation. HLA and KIR genes are coded on different chromosomes (HLA- sixth chromosome and KIR chromosome 19), therefore are segregated independently and HLA identical donors with recipients usually have different compositions of the KIR genes. Cooley et al. (2010) demonstrated that the specific motifs composition of centromeric and telomeric B haplotypes of KIR genes helps to protect against relapse and increases the chances of complete cure AML. In cases where there are multiple HLA identical unrelated donors (UD) then logically the composition KIR genes by the individual donor could be a criterion in selecting the most appropriate donor, therefore, the one with the greatest potential to protect over the relapse . Based on this study and other data the genetic screening of KIR was started with potential donors, if it was possible to choose from several 10/10 or 10/09 HLA identical UD for the patient. Genotyping was performed by PCR-SSP methodology using commercially available kits. It was performed gene classification 160 preferably identical HLA donors for 55 selected patients with AML. The presence of KIR haplotypes A and B as well as their combinations was determined from the type and number of the KIR genes. All genotypes were entered into the calculator, which allows you to enter up to five potential donors and obtain their assigned into one of three categories according to content KIR B. Groups , "neutral" , "better" , "best" , refer to the appropriate protection against relapse. KIR gene classification in the search for donors revealed 43 donors with AA haplotypes, 90 donors with AB haplotypes and 27 donors with BB haplotypes . After assigning state of the presence KIR B was discovered 107 " neutral " donors , 35 "better " donors and the 18 "best " donors . At 40 (~ 73 %) patients were available donors with the different states of the presence of KIR B. These patients represent a group of patients where the selection criterion of the presence B KIR gene at the donor could be used. We confirmed that the additional selection of HLA-matched unrelated donor on the basis of the content B of KIR genes is feasible. Selection such donor for transplantation may improve the outcome of patients with AML.
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Specific Shape of the Flow-volume Loop in Patients with Sleep Apnea-pypopnea Syndrome Depending on Oropharyngeal Diagnosis
Drobníčková, Martina ; Špunda, Miloslav (advisor) ; Šonka, Karel (referee)
The theme is a testing of dependency of specific shape of the flow-volume loop in patients with sleep apnea-hypopnea syndrome on the oropharyngeal diagnosis. The work consists of 5 parts: introduction, the theoretical part, practical part, discussion and conclusion. The basic group was a group of 45 patients with specific curve. This specific curve is characterized by saw like dents in the aspiration part of the curve. As a control group, I selected 45 patients with the curve, which characterizes obstructive ventilation failure. This curve is flat in both of the respiratory periods. For all 90 patients to assessed anatomical abnormalities in oropharyng. The evaluation is subjective. This data I transferred this data, and I analysed them by the multidimensional statistical method. On the basis of discriminatory analysis, I found that it is not possible to differentiate the patients, that won't have the specific curve or not according to the 18 variables , which monitor the abnormalities of the upper airway. Classification error is 60%. In its application to the original sample of 90 patients, 45 patients would'be wrong classified, which is unacceptable. It can therefore be noted that only the testing of the anatomical abnormalities is not sufficient for making the decision, whether the patients will or won't...
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Education of patient after acute heart attack
Szabová, Iveta ; Schneiderová, Michaela (advisor) ; Švecová, Dagmar (referee) ; Wasyliwová, Vlasta (referee)
The bachelor work concentrates on education after an acute heart attack. The goal of the teoretical part of the work is to give information about education concerning principles, phases of the education proces…, and about an acute heart attack with its associated risk factors, smyptoms, diagnosis and medical treatment. The main work consists of a quantification reaserch method of risks factors related with the acute heart attack. A group of respondents that are observed are patients that suffer from an acute heart attack and were hospitalised at I. Interní klinika in Hradec Králové and a group of healthy respondents from randomly selected participants. One part of empiric part is also an elaboration of the "Proposal of an education plan Protective diet of patients after an acute heart attack with hypercholesterolemia."
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Complications during the hospitalization in patients with acute myocardial infarction treated with primary percutaneous coronary intervention
Kotrč, Martin ; Pěnička, Martin (advisor)
Temu his master's thesis complications during hospitalization in patients with acute myocardial infarction treated with primary percutaneous coronary intervention of (PCI ) I chose on the basis of his great interest in cardiology and more specifically coronary heart disease. The art wants give both professionally in the future and therefore work gave me deepening of information and knowledge , which, as I hope , do I redeem in the future in their medical practice . Coronary heart disease and mortality either directly to consequences of myocardial infarction or its complications is one The forward civilizačných problems currently . In the Czech Republic was the number of hospitalizations for acute MI in 1996 26026 , the mortality rate was 157.6 males / females and 100,000 109,2 / 100 000 inhabitants . In 2000 it was with acute MI 22 042 hospitalized with a decrease in mortality rates among men 18% and 17% of women . Average , treating time was between the years 1994 and 1999 shortened from 12.7 to 8.9 per day , ie about 30 %. but still diseases circulation system in the Czech Republic remain the leading cause of and causing the death of 54.9 % of all deaths ( ÚZIS , 2000). Prehospitalizačná mortality during the past 30 years decreased only slightly , but on the other hand , due to rapid development of...
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