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Nursing care for patient after lung surgery
PECHOVÁ, Lenka
The operation of the lungs is being performed on the base of a variety causes, among which the most common causes are cancer, inflammatory diseases, accidents and a variety of complications of diagnostic and therapeutic procedures. After the surgery, patients are taken to the intensive care unit (ICU). The nurse must meet the patient´s biological, psychological, but also laboratory and medication needs. The attainment on this thesis which is titled as "Nursing care for patients after lung surgery" was to determine the method of nursing care for patients after lung surgery. Three research questions were also asked to achieve this. The necessary information were obtained through qualitative research, semi-structured interviews with nurses from the Department of Surgical Intensive Care Unit, Hospital Czech Budejovice a.s. The research was conducted during March 2015. Three categories were generated from an analysis of data: Specific care for patients after lung surgery, Education, Rehabilitation. This research suggests that nurses meet frequently with this specific care for patients after lung surgery that means several times a month. Further information from this research is that the patient after surgery gets parenteral nutrition first, on the second day starts with a liquid diet and the nurses are following the care with most commond diets as diet no 0, 1, 3, and diet no 9 if the patient is a diabetic. After the surgery, the oxygen is being provided to a patient. The results showed that the nurses must always check to see if the airways are clean, that the patient does not have any mucus in the lungs and that he's able to cough without problems. Nurses are checking the blood gas values by using a Pulse Oximeter. Emphasis is placed on the post-surgery rehabilitation to allow patient to be fully ventilated. For a different lenght of times the indwelling urinary catheter (hereinafter PAK) is fed to patients with respect to the operating performance. It depends on the patient's health condition. The nurses must check the functions of the thoracic drains which are often inserted after surgery. First, the patient has an active suction or active mobile suction, then Bülauov drainage. Frequency of change of the surgical wound dressings is mainly set by the doctor. Postoperative pain is monitored in a verbal way. Prescribed medication is administered also by using the epidural line. Subsequently, the patient receives painkillers IM inj. According to the nurses the post-surgery complications are breathing problems, bleeding from wounds, pain, risk of infection, high waste of chest tubes, the inability of the lungs to maintain a vacuum and subsequent collapse of the lung. The education of the nurses is very multidirectional and each one applies different methods to enrich their knowledge. Physical Therapists are responsible for the rehabilitation of patients after lung surgery. Nurses have a very good knowledge in a nursing care which is applied in their practice. However in some ways the information obtained from the nurses disagree with the procedures set forth in the literature. The conclusion of this work should be aimed to the improvement of nursing care for patients after lung surgery and to correct the shortcomings in the providing of nursing care. This work can be used as educational material for nurses starting job at the Department of Surgical Intensive Care Unit, Hospital Czech Budejovice a.s.
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D. C. Dennett's Approach: on the way to explanation of consciousness
Vraný, Martin ; Peregrin, Jaroslav (advisor) ; Palkoska, Jan (referee)
l'vEnd-Body problem has been a perpetual philosophical issue ever since the dawn of science, and the discussion of Descartes's dualism was the paradigmatic showroom of post:lible solutions for a long time. It wasn't perhaps until the mid-20th century that the debate underwent a considerable conceptual transformation thanks to two impctllses from science: the boom in brainscanning experiments and the boom in computing devices and informatics. The former provided philosophers and scientists with abundance of evidence of correlations between brain activity and mental states. The latter showed how higher mental activities, like pattern recognition Ol' playing chess, could be performed by fast computing machines running a relatively simple programme. Besides these two, there is another important source ať infiuence (only as far as the methodology is concerned) behaviourism. Despite its decline in 1960s marked by renewed interest in the study of mind, theorists were reluctant to rehabilitate the concept of consciousness.
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Rehabilitace po artroskopické operaci ramenního kloubu
Matsangos, Paul ; Jalovcová, Miroslava (advisor) ; El Ali, Zaher (referee)
""Rehabilitation after Shoulder Arthroscopy"" Current Thesis introduces a postoperative state after Arthroscopy of shoulder joint. The operation, was performed on May 2011, due to partial tear of supraspinatus tendon, successfully. In this study I present the therapeutic process that I followed during my practice. Thesis is divided in two parts. In the first part of my study I describe the anatomy and movement complexes of shoulder joint. The enclose muscles and their relation with the outer forces from biomechanical view. In addition, I cite the development of Arthroscopy on Shoulder joint and the differentiation with Arthroplasty in our days. In the second part I review and record all the documents from the past and present state of the patient. I continue with detailed examination taking in mind all the related factors that can be possibly affected after the surgery. Finally, I retell and analyze the therapeutic methods that I applied during post operative state. Key words: Supraspinatus tendon tear, Arthroscopy, Physiotherapy.
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Nursing care of Pacients after spine surgery
TAKÁCSOVÁ, Alena
The title of my thesis is Nursing care after spinal surgery. The number of patients with problems of different parts of the spine is growing as well as indications to operational solutions. This is due to society trends and a greater load on the body. Therefore operational procedures requiring specific nursing procedures for treatment in the early post-operative period increase. The thesis highlights the issue of specific nursing care for patients with various diseases and parts of spine. It points out that there is no universal measurement of nursing care for different types of operations on the same section of the spine and it is necessary to choose the right procedure in specific nursing care along with subsequent rehabilitation care. The number of people with diseases of the spine indicated for surgery continues to increase. Research mentions modern days numbers compared with the time 20 years ago and I dare say the numbers are disastrous. There is nothing to wonder about. Disproportionate load does not decrease, a sedentary way of life either at work or at home also adds to the risk of developing these diseases. These have resulted in discomfort mainly in personal life of a human, but also threaten their working and social role and disrupt the economic security, which we cannot do without nowadays. In our thesis we deal with already incurred pathological manifestations indicated for a surgery. In other words, what happens to the patient, if they are recommended by our outpatient physician - neurosurgeon for a surgery. The lack of nursing literature on this specific issue was the reason for us to choose this theme. In the theoretical part we will discuss the general structure - spine anatomy and physiology, basic terms related to the basic movements, and curvature of the spine. Since our thesis is focused on nursing care after a surgical treatment of diseases of various sections of the spine at the department of Neurosurgery, Traumatology and the Infectious department in České Budějovice, the theoretical part includes basic theoretical outlines of the most important surgical procedures performed at these departments in the hospital of České Budějovice a.s.. Furthermore, we will get to the specifics of nursing care after these surgeries related to early rehabilitation care and close cooperation with physiotherapists. It should be emphasized that teamwork is the cornerstone in the care of patients after spinal surgery, whose subsequent rehabilitation and education in self-care after being discharged from the hospital care is one of the basic prerequisites for a successful recovery and return to their working and social role. The research part focuses on the following objectives: Aim 1: To determine whether nurses know the correct procedures for early rehabilitation of patients after spinal surgery Aim 2: Find out what is the level of collaboration between nurses and physiotherapists in the specifics of patients after spinal surgery Aim 3: To determine whether the nurse´s education and length of practice has an impact on the provision of specific nursing care for patients after spinal surgery Furthermore, using the research questions related to this issue: Research 1: How do nurses and physiotherapists cooperate in a patient´s care after spinal surgery? Research 2: Is a nurse´s length of practise connected with higher expertise in providing specific nursing care to the patient after a spinal surgery? Research 3: Does the education of nurses affect the knowledge of the specifics of the nursing care to the pacients after a spinal surgery? Research 4: How do nurses extend their knowledge in specifics nursing care for pacients after spinal surgery?
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Case study of physiotherapy treatment of patient after stroke
Šťastná, Johana ; Říha, Michal (advisor) ; Hankovcová, Eva (referee)
CASE STUDY OF PHYSIOTHERAPY TREATMENT OF A PATIENT AFTER STROKE Objectives: Theoretical analysis of after stroke management and elaboration of physiotherapy treatment schedule in the form of an after stroke patient case study. Methods: This work was done with patients consent within an uninterrupted practice at Central Military Hospital in Prague at the Department of Physical Medicine and Rehabilitation. The practice was held from 9th January to 3rd February. The work is divided into two main sections - a general (theoretical) and a special. In the general section is researched the theoretical background for status post hemorrhagic stroke. The general section includes basic characteristics of the illness, etiopathogenesis, incidence, diagnostics, treatment and options of physiotherapy methods concerning the illness. The special section contains the after stroke patient's case study, the review of proposed therapy and the therapy effect evaluation. Results: The patient's condition evolved during the treatment. The patient developed better muscular strength and joint movement, the swelling was reduced, right hand side of his body and limbs was strengthened and his overall stability and gait was improved. The improvement was indicated by functional scales tests as well. Keywords: hemorrhagic stroke,...
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The issue of nursing care in patients with Clostridium difficile
ŠEDIVÁ, Ilona
Nosocomial infections, which do not often relate to the diseases are increasing nowadays. Clostridium difficile belongs to the frequent nosocomial infections and it is known as post-antibiotic colitis. The main reason of colitis is the usage of antibiotics, especially broad-spectrum antibiotics. The thesis is divided into the theoretical part and practical, as well. Theoretical part describes the division of the nosocomial infections, infection of the intestinal tract, anatomy, physiology of the intestines and infectious diarrhoeal diseases. The thesis is subsequently aimed to the clostridial infections and precautions against the spread of the disease. Practical part is aimed to the knowledge of the nurses, skills and attitude towards this issue.The thesis uses quantitative investigation and technique of the questionnaires, hidden observation of the nurses working on the selected wards and additional interviews with head nurses. The research was conducted in hospital in Tábor, a.s. The questionnaires were distributed on the surgery, orthopaedics, surgical JIP, ARO, ONP, infective ward, rehabilitative ward, TRN, cardio JIP, internal ward-cardio, internal ward-gastro. The thesis was formed from 143 questionnaires and 171 questionnaires were distributed. Hidden observation was made by head nurses from individual wards and it was logged to the relevant observation sheets.From existing findings we can say that there exist specifics of nursing care at the patient with the clostridium difficile. Among to these specifics we can cite the barrier nursing care where we can include the isolation of the patient, disinfection and hygiene of hands,using protectors, appropriate usage of laundries and infectious waste, location of the patient according to the epidemiological perpective and individualization of the tools for the patients. From another investigation ensue that the nurses keep barrier nursing care, superficial disinfecion, decontamination of the tools. From the results is evident that the nurses do not know the methods of the transmission of the clostridial infection. On the base of another investigations we have found out that the nurses do not know principles of the barrier nursing care. In conclusion is it possible to say that the nurses do not have so extensive information, that are essential for care for the patiens with clotridium difficile. In order to care for these patients in right way is neccessary to know principles of the barrier nursing care and keep them all. Keeping the principles of the barrier nursing care is crucial step in preventing the transmission nosocomial infections. The results will be provided to the officials of the individual hospital´s wards as an option of improvement in caring for the patiens with clostridial infection. The results were partially presented at a conference in Tabor´s hospital in May 2014. We recommend to re-train the staff of the hospital, which would be specifically aimed towards the principles of the barrier nursing care and towards the disinfection and decontamination in related to the nosocomial infections. On the base of these findings was made a proposal of the nursing care standard, which would specify and unite the care for the patiens with clostride infection. Subsequently, it would be apropriate to repeat the research in 1 2 years and than both researches compare together.
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Case study: Physiotherapy treatment of a patient with diagnosis of disc herniation and spondylolisthesis of L5-S1
Krokou, Anastasia ; Dudová, Agnieszka (advisor) ; Pavlů, Dagmar (referee)
Case study: Physiotherapy treatment of a patient with diagnosis of disc herniation and spondylolisthesis of L5-S1. Nazev: Fyzioterapie léčba pacienta s diagnózou herniace disku a spondylolistéza z L5-S1. Author: Anastasia Krokou Summary In this case study I negotiate the topic mentioned above and I quote the two main approaches. The theoretical approach with a close aspection to the functional and structural mechanism of the spinal column, combined to the biomechanical and kinesiological approach, focused more on lumbar spine, and the pathological disturbances that may arise in this region, in this case it will be about disc herniation. The other approach that completes my study work is the practical one and it concerns the application of rehabilitation and physiotherapy principles in order to treat the post-operative sequences that follow and how the treatment plan of short and long term of rehabilitation will look like. My bachelor's thesis practice took place in Ustředni Vojenská Nemocnice Praha during the period of 16.1-27.1 at the department of neurosurgery and also at the department of out coming patients. I used my knowledge that I gained these years while studying at Charles University at the department of Physiotherapy and applied for the best results according to the patients' situation....
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Case study of physiotherapy treatment of a patient with Psoriatic Arthritis after Total hip arthroplasty
Enstad, Christian ; Maršáková, Kateřina (advisor) ; Jarošová, Hana (referee)
Title: EN: Case study of physiotherapy treatment of a patient with Psoriatic Arthritis after Total hip arthroplasty. CZ: Případová studie fyzioterapie léčby pacienta s psoriatické artritidy po totální endoprotézy kyčelního kloubu. Thesis aim: In this thesis I will aim to discuss the rehabilitation after a total hip arthroplasty in a patient with psoriatic arthritis. The thesis is divided into two parts, one theoretical where the aim will be to explain some of the current research concerning psoriatic arthritis and total hip replacement. It will be focused on the anatomical, bio-mechanical and kinesiological properties of the lower extremities as well as the surgical procedure of total hip arthroplasty and following rehabilitation. I will also briefly look at the epidemiology and etiology of psoriatic arthritis and associated symptoms. The second part will focus on a 67 year old woman with the mentioned diagnosis in the post-operative state 2 weeks after surgery. The practical part aim to describe examination, therapeutical approach and conclusions after one week of examination and therapy. 4
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