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Care for the oral cavity in a hospitalized patient
CINCIALOVÁ, Kateřina
The term oral hygiene includes a set of measures to prevent the origination of parodont and hard tissues and their progression. These ailments belong to the most common and frequent ones despite the fact they may be prevented by appropriate care and by the proper choice of oral hygiene aids. The most frequent problems are dental decay, dental plaque, gum disease. For each of us, good oral hygiene practicing daily is essential for preventing troubles mentioned above. During hospitalization patients often alter their habits and modes because of the disease and the stay out of home. In patients who are not self-administering and patients with limited capabilities it is the nurse who is in charge of providing the oral hygiene. Each nurse´s priority should be to meet all the patient´s needs and the proper oral hygiene is one the basic ones. I set four aims in my thesis. The first was to find out patients´view of the oral hygiene level at hospitalization. The second aim was to describe the standards of oral hygiene the particular ward offers the patients. The third aim was to compare opinions of self-administering and non self-administering patients. The fourth aim was to compare the role of a nurse in providing oral hygiene for self-administering and non self-administerin patients. The results of my research confirm the first hypothesis {--} hospitalization brings about changes in oral hygiene. Also the second hypothesis proved to be right {--} during hospitalization oral hygiene worsens in patients because they do not have enough possibilities to carry out all the procedures they are used to. The third hypothesis was confirmed, too. Nurses are familiar with oral hygiene aids and know how to use them. The fourth hypothesis that nurses do not ask patients to tell them what their oral hygiene habits are was true. I conducted the research by the questionnaire method and the method of a stuctured interview. The research samples were nurses and patients in following units - neurological, internal, surgical and orthopaedic - in the České Budějovice hospital, Inc. and in the Tábor hospital. Inc. The results of this research could be used as a feedback for hospital management to help improve patients´oral hygiene. It is necessary to take some measures in this respect. Nurses should be more active in getting information about patients´ oral hygiene aids and their hygienic habits. They should ensure the highest patients´comfort possible. Then their efforts will be rewarding.
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The Role of Nurses in Colorectal Surgeries
ŠULCOVÁ, Jana
Theoretical basis: The problems in rectal and anal diseases have had rising tendency, especially haemorrhoidal diseases, on which we put emphasis in our bachelor thesis. 37% of adult population suffers from this disease so we may line it up to civilization illnesses. Their treatment involves wide range of medical methods, from the conservative therapy to semi invasive ways of treatment. The semi invasive treatment is well withstood by patients and it can help up to 90% of clients. This bachelor thesis is concerned with specifics of nursing duties in a colorectal surgery. It links with topics like taking faecal specimen, basic methods of endoscopy, communication with patients and giving them information about lifestyle. The theoretical basis describes haemorrhoidal disease and gives brief introduction into causes of its developing, most common symptoms and possible treatments. The aim of the thesis: From the practical point of view we set two tasks. The first one is aimed at specifics of nursing job in a colorectal surgery and the second one tries to monitor how nurses in colorectal surgeries inform patients about healthy lifestyle. We asked two research questions regarding these aims. The first research question is: What are the specifics of the nursing job in the colorectal surgery? The second question concerns how nurses in colorectal surgeries provide information to their patients about healthy lifestyle. Methodology: Regarding the bachelor thesis we decided to choose a form of a qualitative research with using semi structural interviews with practical nurses working in colorectal surgeries. The interviews took place from February 28 2014 to March 15 2014 in five colorectal surgeries in following towns: České Budějovice, Písek, Strakonice, Jindřichův Hradec a Třemošná u Plzně. The focus group was created of 6 nurses working in colorectal surgeries. The interviews were performed and recorded with the consent of all practical nurses involved in the research. All extracted data was arranged and categorised into groups that were consequently analysed. The interviewer´s questions were prepared in advance and some extra questions were asked during the interview. The interview was divided into five areas: Identification questions, role of a nurse, examination methods, recommendation and giving information about lifestyle. Results: The results show the specifics of nursing in colorectal surgeries. We found out that nurses working in colorectal surgeries deal mainly with preparing special medical instruments and devices needed for endoscopic examination. Then they assist doctors during a medical examination and with treatment methods of RBL (Barron´s rubber band ligation) and Hemoron, they manipulate with devices in a surgery, check hygiene measures, do administrative work and keep surgery office running. In other conversation areas practical nurses mostly mentioned sampling of biological materials, mainly blood and faecal specimen taking to be given up to histological examination, preparing patients for an endoscopic exam, communication with patients and attending to the intimacy of patients. Consequently we found out that more than half of the practical nurses pay attention to psychological conditioning of the patient before rectoscopy. The research also revealed some weak spots. More than half of the nurses in the focus group do not inform patients about preparations before anoscope exam. Barely one third of the group said that they inform patients about the natural emptying before the exam. Regarding the issue of giving information about lifestyle, we came to the conclusion that practical nurses, even though they do not have enough time, try to inform patients about physical activities, hygiene care and quality of eating and they do it in sufficient rate. But because of the time constrain they put emphasis only on the essential information.
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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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Nursing care in a hygienic and epidemiological regime from the patient's perspective.
KŘEPELOVÁ, Lenka
Considering contemporary lifestyle and possibility of travelling imported infections accrued and some illnesses come back that have not occurred nearly at us more. Not only haemorrhagic fevers and other highly infectious illnesses but also hospital multiresistant bacterial strains that mean high risk for patients constitute a threat. The number of nosocomial infectious grows still. The patient is in the case of suspicion or already diagnosed infectious illness isolated and treated in the infectious department or in the tribal department in the room with increased hygienic-epidemiologic regime. The patient is saved in a single room, the possibility of visits is reduced and the staff uses personal protective equipment. The man is holistic being and it can come due to isolation to lack of satisfaction of his/her bio-psycho-social needs. The aim of this thesis is to identify unsatisfied bio-psycho-social needs of patients in increased hygienic-epidemiologic regime and to describe changes in needs of the patient depending on the time of hospitalisation. The theoretic part describes the problematics of infectious illnesses, system of the care for the patient with infectious illness and changes in human needs in the period of the illness. The empiric part of the thesis deals with unsatisfied bio-psycho-social needs of isolated individual through quantitative research. The research suite was made up of 10 patients who were hospitalised in the room with increased hygienic-epidemiologic regime. The survey was carried out in the Hospital Jihlava by semistructured interview and the results of the survey were processed by opened coding by method paper and pencil. It is emphasized that the most needs of the patient have biological, psychical, social and even spiritual aspects. The rate of satisfaction with caregiving depends on the health condition and personality of the patient. Not small influence has the length of the hospitalisation, too. It was found out during the survey that the patients have not enough information about specifics of the care in the infectious department and that is why there is often a misunderstanding of necessity of barrier measures. It is possible to avoid useless misunderstanding through timely and suitable education. It was created an educational material with the title "Guide for patients hospitalised in the infectious department of Hospital Jihlava" for this purpose. Employees of the infectious department of Hospital Jihlava were informed with results of the research during a workshop, too.
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Work of a nurse in an osteology out-patient ward
KAŠPAROVÁ, Iveta
Osteoporosis is defined as a metabolic system bone disease, which is characterised by reduced content of bone matter. This disease is considered the most frequent disease. Osteology departments are mostly visited by older clients, but younger clients are nowadays not exceptional either. The nurse plays an important role in the osteology outpatient department / clinic. In addition to nurse duties such as administrative or treatment work, the nurse should be able to communicate, listen, or possibly give advice to clients. Thus she becomes a consultant, assistant as well as a defence counsel. The thesis was aimed to determine the nurse job specification in an osteology outpatient clinic. The research was carried out using the qualitative method and data were collected from semi-structured interviews with 7 respondents in selected osteology outpatient clinics, of which 5 nurses are from the osteology outpatient clinic in České Budějovice and the remaining two nurses are from the osteology outpatient clinic in Prague. The interviews were consequently processed into case reports. Those case reports became the basis for evaluation of the results sorted in categorization tables. The most significant results of the research proved that nurses must only be trained in a specialized course if their job sheet includes densitometric examination. This densitometric examination, or sampling of biological material for bone markers and education with respect to application of medication using a fosteon pen are ranked amongst special activities not performed in other special outpatient departments. Some osteology nurses confirmed that their job sheet also includes to educate clients, most often verbally, and provide reference materials or practical demonstration. This bachelor thesis can primarily be used for nurses who are interested to work in an osteology outpatient department in the future.
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Hygienic-Epidemiological Measures in Healthcare for Patients Colonized with MRSA
Janík, Martin ; Nováková, Jana (advisor) ; Tomšová, Hana (referee) ; Míčková, Eva (referee)
This bachelor's thesis is focus on evidence based medicine and healthcare for patients with MRSA infection or colonization. The main aim of theoretical part was to collect current regional and foreign information about topič and their comparison. The main aim of research part was pilot study to compare knowledge of nursing sisters from selected medical institutions. Respondents were nursing sisters (n=761) from teaching hospitals, lst and 2nd type hospitals, social care centers and specialized centers.
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The modification of spasticity and functional abilities of patients with infantile cerebral palsy by selective dorsal rhisotomy
Vašíčková, Hana ; Kraus, Josef (advisor) ; Zounková, Irena (referee)
Selective dorsal rhizotomy is a neurosurgical procedure for treating carefully selected patients with cerebral palsy. The aims of this thesis are to assess the influence of this treatment on changes in spasticity, functional abilities, locomotion and activities of daily living of these patients and also to assess the changes in these parameters in patients who were treated using this method at the neurosurgical department in University Hospital Motol in previous years. Six patients with CP diagnosis were tested - five 6 to 21 years old boys and one 35 years old woman. Ashworth and modified Ashworth scales were used to assess spasticity, goniometry was used to measure the range of passive movements. The Barthel index and Global care impairment scale by Dressler tested activities of daily living. Penn Spasm Frequency Score and Peacock's scale of locomotion were also used. The results showed a reduction in spasticity in lower as well as upper extremities, an increased range of passive movement of lower extremities, reduction of clonus the tendon of Achilles and an improvement of speech. Decreased pain and improved ability to perform activities of daily living were noted and hygienic care of a child was made easier thanks to this treatment. Powered by TCPDF (www.tcpdf.org)
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Periodontal Disease of Dogs
Škutová, Šárka ; Barták, Miroslav (advisor) ; Olekšáková, Tereza (referee)
Periodontal disease (PD) affects periodontium and thanks to its prevalence it is considered to be one of the most occurred diseases in small animals and even in human. The uppermost etiological agens presents bacterial plaque. Bacterial plaque strongly accumulate if it is not eliminated and it might be the cause of development of gingivitis or even periodontitis over time.
The anatomy itself is relatively large, since the oral cavity is comprised of many kinds of tissues and a detailed description thereof would cover 70 pages at least. That is why the main aim of this work was to attempt to select the most basic information only.
Due to dividing of anatomical structures into bones, soft tissues, salivary glands and teeth, the individual components of supporting apparatus (periodontium) are not described in chapter called ,,periodontium,,. Here is explained its purpose and a description and function of periodontal ligament, which has not been included above. Particular attention was paid to the teeth. Determining the type and the number of individual teeth, the knowledge of their structure and the number of roots, all of that is important when it comes to a tooth extraction. The knowledge of tooth marking, dental formulas, identification systems and odontogenesis itself is equally important.
As for each disease, the etiology is the essential part for understanding the formation of disease. Bacterial plaque, which adheres to enamel of teeth is regarded (as already mentioned) as initial etiological agens. It can mineralize in tartar in varying degrees depending on every individual subject (animal). There are involved other risk factors at onset of the disease such as age, breed, number and line-up of the teeth, their pathology, diet, but also some diseases.
PD can be classified in two basic forms (gingivitis, periodontitis). Gum inflammation, or gingivitis, is often denoted as initial and totally reversible stage of disease. It is possible that there may not be present any symptoms or just slight redness at the beginning. Later stage leads to swelling, pain and significant bleeding, whereas it can manifest in periodontitis if therapy is absent.
Periodontitis affects the entire periodontium and it is often called as an irreversible stage. Although thanks to guided tissue and bone regeneration it is possible to achieve at least slight improvement these days. In most patients disease passes into chronic form, causes them not only pain during eating, but may also result in various systemic diseases. A special form which affects younger individuals is called ,,juvenile periodontitis,,. Diagnosis is primarily based on the medical history and examination of the oral cavity. Tartar index, gingivitis index, grades of tooth mobility and other parameters, which helps to determine the extension of disease and stage can be obtained using the intraoral radiographic, visual examination and measurement by periodontal probe. All collected information can be used to devise recommended therapy.
The sole therapy depends on the state of the patient and the requirements of the owner. It consists of several steps. The essence is especially removal of any deposits of bacterial plaque and tartar, correction of teeth pathologies (smoothing rough surfaces) and tissues pathologies to eventual tooth extraction. As part of the therapy may also be chosen application of antibiotics and other preparations supporting wound healing. Many specialists have been developing new treatments over the past 10 years, but most of them are still not fully finished. These include the development of vaccines, photodynamic therapy, or guided tissue and bone regeneration, which were already mentioned.
An integral part of therapy is home dental care. Without consistent home care there is a high probability of relapse.
An important weapon against the rise of PD are various preventive measures. The most effective method of prevention is probably regular tooth brushing using a brush and a special paste made for animals. However, many owners prefer to avoid this method. They rather elect to feed dry diets, dental treats and other products which help to reduce the amount of plaque and tartar. Another option is a professional teeth cleaning performed by a veterinarian.
A survey via questionnaire consisted of 16 questions, which were aimed at awareness of the disease, age, sex, breed, size, diet, preparations which help to control amount of plaque and tartar, systemic diseases and especially the presence of PD, age at first hit by disease, the circumstances of diagnosis, stage, treatment and relapse.
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Condition of Patients with the Diagnosis of Spina Bifida Cystika with Myelomeningocele and Subsequent Rehabilitation Intervention
Gajdová, Magda ; Dylevský, Ivan (advisor) ; Kučera, Miroslav (referee)
Name of the diploma thesis: Condition of patients with the diagnosis of spina bifida cystica with myelomeningocele and subsequent rehabilitation intervention Goal of the work: Spina bifida (cleft spine) is a congenital defect resulting from failure of fusion of embryologie halves of vertebral arches. Spina bifida belongs to the group of congenital abnormalities ofthe central nervous system, which manifest themselves through neural tissue anomalies and bony changes of the spine. Since there is not a single Czech publication dedicated to the diagnosis of spina bifida, the first goal of this diploma thesis was to thoroughly describe the diagnosis of spina bifida, with special emphasis on cystical spina bifida, and to introduce opinions of the Czech and mainly intemational experts on this issue. In the second part ofthis diploma thesis, based on a case study ofthree patients with the diagnosis of congenital spina bifida cystica with myelomeningocele, the goal was to compare the historically, as well as currently applied rehabilitation treatment of these patients and to confirm that the rehabilitation procedures differed, depending on the height ofthe lesion and the availability ofqualified rehabilitation care. Solution method: To process the gathered information about spina bifida from specialized...
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The palate shape and growth variability of patients with cleft palate
Plíhalová, Petra ; Strnadel, Tomáš (advisor)
Cleft lip and / or palate is one of the most common congenital defects ( CR 1 in 500 newborns) with significant involvement of genetic component in the etiology. They represent a serious disability face the consequences of aesthetic , functional and psychological . Anomalous growth and development of the facial skeleton causes the development of jaw and dental disorders. Orthodontic therapy , sometimes combined with Maxillofacial orthopedic lasts into adulthood and often ends prosthetic dořešením . Severe dysfunction is a speech disorder requiring intensive speech therapy and speech therapy . Comprehensive treatment of clefts is therefore necessarily multidisciplinary , long-term and costly , which also participates in programs focusing on prevention (genetics, teratology, epidemiology) and Research " ( Šmahel et al . , 2000). An important role is played by the analysis of origin of morphological changes ; the extent of the affected Primary growth insufficiency tissues , to what extent are the result of surgical procedures and when it is a result of the effect of altered functional relations. The findings are then confronted with the knowledge of the etiology and mechanisms of defects ( Tomanová , 1993). Anthropometric monitoring could also contribute to the estimation of genetic predispositions for the...
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