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Deficit of nurse - educator in nursing profession or patients after amputation of lower limb.
BLAFKOVÁ, Šárka
My thesis deals with the deficit of educating nurses who serve post-amputation patients in nursing practice. Five goals were defined in the thesis. Some of them deal with post-amputation care of the patient and others with post-amputation education of the patient in nursing practice. Goal 1: To map nursing care of the amputation stump from a nurse's perspective. Goal 2: To find out whether nurses educate the patient after leg amputation according to the education plan. Goal 3: To find out whether obstacles exist preventing nurses from educating the patient after leg amputation. Goal 4: To find out the most common post-amputation problems according to patients. Goal 5: To find out how patients view the post-amputation education. All goals were met. Hypotheses and research questions were also defined. Three hypotheses were defined. Hypothesis 1: When caring for the patient after leg amputation, nurses adhere to the rules for amputation stump nursing - Confirmed. Hypothesis 2: When educating the patient after leg amputation, nurses utilize the education plan {--} Confirmed. Hypothesis 3: When educating the patient after leg amputation, the most common obstacle stated by nurses is a time deficit {--} Not confirmed. Three research questions were defined as well. Research question 1: What are the common post-amputation problems according to patients? Answer 1: The most common problems according to patients are movement and learning to walk. Research question 2: When do post-amputation patients require the assistance of nurses? Answer 2: Post-amputation patients require nurse assistance during physical activities, mainly during movement. Research question 3: Do patients view the post-amputation education as a benefit? Answer 3: Patients view the post-amputation education as a benefit. The benefit consists in being taught certain activities or having them explained. The result of this thesis is an education plan specifically tailored for patients after a leg amputation. It describes the individual educational steps for post-amputation patients.
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The Carotid Stump Syndrome
Hrbáč, Tomáš ; Beneš, Vladimír (advisor) ; Přibáň, Vladimír (referee) ; Haninec, Pavel (referee)
Introduction: Internal Carotid Stump Syndrome may be one of the possible causes of ischemic stroke (iCMP), as well as retinal infarction (RI). Syndrome of the occluded internal carotid (ACI) (stump syndrome) is a nosological unit, which is characterized by an onset of ipsilateral iCMP or RI of thromboembolic ethiology in patients with occlusion of ACI via the externa carotid or arteria ophthalmica. In my thesis, I have concentrated upon the specification of the stump syndrome, its diagnostics and treatment; furthermore I have assessed the appropriateness of surgical approach in comparison with conservative approach. Material and methods: A total of 621 patients with occlusion were treated in two centres in the course of five years. In a group of 40 patients, the ACI occlusion was detected sonographically, the length of the occluded ACI being >5 mm, with normal vasoreactivity based upon SPECT CO2 and excluded cardiogenic cause of iCMP. The patients were divided in two groups - surgical and conservative. Patients were monitored in 6-month intervals for the total period of four years. Results: No RI or iCMP were detected in the surgical group; one patient died six months after surgery. We observed one case of amaurosis fugax in the conservative group. Conclusion: Ultrasound examination is a fully sufficient...
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The history of nursing work before and after the amputation of the lower limb
SVOBODOVÁ, Helena
The aim of this thesis is to map the nursing care of patients with amputated lower limb during the history. This is a theoretical bachelor thesis. Interview with people with experience in the issue were used in the thesis: a general nurse, RNDr. Vítězslav Kuželka, an anthropologist and Mgr. Šimon Krýsl, a historian. A visit to the Medical Museum and Depository in Prague was also necessary for the work. The thesis also contains photographs taken during the visits to the museum or the depository. Preserved historical sources are the most important ones for the thesis. Special literature and literature dealing with these problems nowadays, numerous specialized journals, many history as well as modern books were further important sources. Period textbook and brochures for patients with amputations formed an inseparable part of the information source. The first chapter deals with the prehistoric period. Anthropologist RNDr. Kuželka provided a lot of valuable information. Immersion of a stump into boiling water was a specific feature of nursing care in the prehistoric period. The next chapter deals with the antiquity, when amputation was applied as a punishment. Famous physician Hippocrates belonged to this period. After that a chapter about the middle ages with the strong influence of religion follows. During a visit to the National Medical Library Mgr. Krýsl gave us an interview for this bachelor thesis, in which he mentioned the instruments used for amputation in the history. The fourth chapter deals with the modern times. Jean Louis Petit (1674-1750), a French physician, who was highly regarded for the invention of the screw type tourniquet, was one of the significant persons of this period. Florence Nightingale, the lady with the lamp, meant a real breakthrough as she contributed to introduction of strict cleanliness in hospitals. The modern times also includes the period between 1953 and 1979, which is also a part of this thesis. There is a very much interesting fact that the nursing care of amputees does not much differ from the present. Mgr. Polanová adds her memories of the nursing care in 1979. Further parts of the bachelor thesis focus on the issues of the development of antisepsis and anaesthesia in the history. A chapter dealing with the phantom pain is one of the largest parts. The bachelor thesis is concluded by a chapter dedicated to the nursing care of patients with amputation of a lower limb nowadays. Conclusion This bachelor thesis focuses on the history of nursing care before and after an amputation of a lower limb. It is written chronologically from the prehistoric period up to the present, the 21st century. Each chapter of the thesis contains the trends, interesting points and innovations in the field of interest in the particular period. The whole work summarizes the development of nursing care and healthcare for the amputees. One of great conclusions of the studies of nursing care is the fact that there are periods in the history when hardly any changes were made but also periods when rapid and significant changes were introduced. This thesis also monitors the development of the profession of a general nurse in relation to the care about the amputees. The thesis may serve as a study material for general nurses and also for those who are interested in the history of the nursing care of patients with amputation of a lower limb.
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Design of Transtibial Posthesis With Use of Additive Manufacturing Technology.
Kopecký, Martin ; Náhlík, Luboš (referee) ; Koutný, Daniel (advisor)
The thesis deals with the design of a transtibial prosthesis by additive manufacturing technology. Based on walking biomechanics and the current situation of knowledge a prosthetic foot has been designed for a patient with low level of physical activity. Furthermore, the thesis describes the design of an individual socket for the patient. The socket has been designed by reverse engineer procedure based on the three-dimensional geometry of patient´s stump obtained by 3D scanning. Testing samples of the foot and the socket have been made for the check of functionality of both the devices and then subjected to mechanical tests in accordance to the methodology regulation ISO 10328. Finally, the thesis depicts the FDM technology used for the production of functional samples of the designed devices; assembly of modular transtibial prosthesis and its testing by the patient.
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The options of patients with hind limb amputation for physiotherapy treatments
DÖRNEROVÁ, Nicola
This work elaborates on the problematic of amputation of lower/hind limb and pitfalls associated with it. The theoretical part deals with the amputation from the historical and etiological point of view. I list all types of amputation interventions and their risk factors. A substantial part of the theoretical section is dedicated to physiotherapeutic procedures and possible prosthetic treatments, which are an important part of rehabilitation care for patients with amputations. The practical part of my bachelor work is processed by means of qualitative research. The research was conducted using case studies which, on the basis of anamnesis and examination contain kinesiology input analysis, procedures in physiotherapy and kinesi-ology analysis output. Using case studies I describe the application of theoretical knowledge in practice. The research was conducted at the Center of Technical Orthopedics in Ceske Budejovice. The research sample consisted of three patients with varying height of amputation intervention of the lower limb. All patients were men aged 50-65 years, with the first equipment of the prosthetic device, the first patient after exarticulation in the hip, the other after amputation in his thigh, and the third patient after amputation in his shin. Physiotherapy ran for 10 weeks, 1x a week for 60 minutes. I established an exercise set of five exercises for each patient that they were also supposed to practice at home by themselves. In addition to that, each patient received extra exercises for home practicing to suit their individual needs. I assessed the effectiveness of the therapy based on the results of input and output tests. The aim of this study was to map the practice of physiotherapy with patients after lower limb amputations. Among the most important tasks of a physiotherapist with patients with amputations I consider the care of the stump, the status of which is closely linked with the use of prostheses. During my practice I reassured myself that complications of the amputation stump significantly limit the use of prosthesis. A limited use of prosthesis consequently prolongs the patient's return to the society as its as equivalent as possible member, in accordance with the abilities and possibilities of each individual patient. The effect of locomotion with a prosthesis on the mental aspect of an individual after a leg amputation was in my practice also obvious. The results of the research part of my thesis show that the health state of all probands mentioned in my work improved after 10 weeks of treatment. During my internship, I reaffirmed the importance of early initiation of rehabilitation and awareness of patients about the possibilities of the prosthetic equipment, interdisciplinary cooperation of the nursing staff, age, cooperation and motivation of the patient. This work can serve as an educational material not only for health care workers, but also for the sick or for their family members.
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Special features of nursing care for the patients after fingers replantation.
KREBSOVÁ, Terezie
Abstract As a relatively high number of amputation injuries of fingers leading to subsequent replantation occur recently, and the nursing care about these patients is very specific in some spheres, I chose the topic ?specifics of nursing care for patients after replantation of fingers? for my bachelor thesis. As duly and professionally provided nursing care is very important and contributes to successful treatment and patient recovery to normal life after replantation I am convinced that it is necessary for nurses caring about the patients affected this way know the correct treatment principles. The goal of the thesis was to identify the specifics of nursing care for patients after finger replantation, and another goal was to find out how nurses cope with nursing care about patients after finger replantation. The research was based on combination of quantitative and qualitative methods and was focused on some fields of the care about these patients on one hand and on the fact whether nurses apply the nursing approach focused on patient needs on the other. The quantitative research was based on an anonymous questionnaire, the qualitative research on observation. The combination was chosen to enable comparison of theoretical knowledge of nurses with the practical activity. The research sample consisted of nurses from the accident and plastic surgery ward. Nurses from the standard treatment section, from the outpatient surgery and from the ICU were asked for cooperation. Hypothesis 1: Nurses know the principles of stump and amputate treatment ? was confirmed. Hypothesis: Nurses know the principles of nursing care about patients after finger replantation ? was confirmed. Hypothesis 3: Nurses plan the care process focused on patient needs after finger replantation ? was not confirmed. Question 1/ What problems do nurses have in providing nursing care for patients after finger replantation? Nurses do not have problems with providing nursing care for patients after finger replantation. Question 2/ To what extent do nurses caring about patients after finger replantation apply the nursing care process? Not all the nurses apply the nursing care process to the full extent. I found during working on the thesis that very few available materials intended for nurses existed on this topic. This is why a brochure including the principles of due nursing care for patients after finger replantation was issued upon the thesis for nurses caring for patients with this problem. A nursing standard, which is still unavailable, could also be elaborated.
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Transtibial prosthesis for recreational swimming
Křemen, Jan ; Mazůrek, Ivan (referee) ; Paloušek, David (advisor)
This thesis deals with the construction of an active transtibial prosthesis for recreational swimming. Its aim is to create a working sample of such a prosthesis. The device will primarily serve the patient to move in water - it will be attached to the stump and it will be driven forward. Secondarily, the prosthesis can be used for walking, in the sense that the patient attaches the prosthesis near to a water surface (pool, lake, ocean) and comes with it to the shore. As part of the design and electronics it will be necessary to determine the characteristics of the human resistance in water depending on speed and to determine the necessary propulsion (thrust) strength of the propeller, which will serve as the driving force. Subsequently there will be formed structural variants and selected the best one. This will become default for design and construction of simplified testing device, which will be tested for static thrust. After verifying the functionality and reliability, the final functional sample will be manufactured and tested too.
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Prevention of venus thromboembolic disease
Šichtařová, Daniela ; Fanta, Jan (advisor)
Deep vein thrombosis and pulmonary embolism are part of the same process , venous thromboembolic nemoci.Žilní thrombosis and pulmonary embolism is a serious complication in the postoperative period and thromboembolism is often the cause of death not only in patients surgical or orthopedic surgery , after injuries , but also in gynecology and obstetrics or in connection with an internal disease . More recently, complicates this episode and modern performance transplant surgery, vascular surgery and laparoscopic operace.TEN is one of the most common diseases endangering the patient in terms of long-term morbidity, disability , mortality as well . Epidemiologically important is deep vein thrombosis of the lower limbs , distal and proximal . The potential of pulmonary embolism in a lesser degree also contribute venous thrombosis upper extremities , axillary vein , pelvic and brain . Since the latter is difficult to diagnose , has a relatively high prevalent in hospitalized patients , high treatment costs diagnosed events , and sometimes in spite of treatment ends fatal disease , is devoted to its prevention tremendous effort . Wait for the diagnosis means to expose vulnerable patients unacceptable risk .
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