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Cerebral hypoxia in chronic kidney disease and its relation to cognitive decline
Kalendová, Lucie ; Malík, Jan (advisor) ; Bednářová, Vladimíra (referee) ; Janečková, Jana (referee)
Cerebral hypoxia in chronic kidney disease and its relation to cognitive decline Dissertation abstract - MUDr. Lucie Kalendová Introduction: Patients with chronic kidney disease in need of regular hemodialysis treatment have high rates of cognitive impairment. In its multifactorial etiology, vascular changes, cerebral ischemia and hypoxia play a major role. In our work we first studied the association between low cerebral oxygenation and cognitive impairment in this population. Subsequently, we focused on one of the possible etiological factors in this association - the presence of a vascular shunt for hemodialysis. Methods: Chronic hemodialysis patients without overt cognitive impairment participated in the studies. We used a near-infrared spectroscopy (NIRS) device named INVOS for monitoring cerebral oxygenation (rSO2). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA). To assess the effect of vascular shunt, we performed an interventional study based on short-term ultrasound-confirmed manual compression with continuous monitoring of rSO2. Results: In 39 patients (49 % women, age 64 ± 14 years) we observed a significantly lower rSO2 in the subgroup presenting cognitive decline than in patients without this diagnosis (48 ± 9 vs. 57 ± 10; p = 0.01). The association remained...
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Insertion of a peripheral venous cannula and intravenous injection application - evidence-based practise
Múdrá, Michaela ; Mádlová, Ivana (advisor) ; Tomová, Šárka (referee)
Peripheral venous cannulas are an indispensable part of clinical practice and their insertion is one of the most common nursing interventions. Review Articles show that peripheral vein cannulation is a risky procedure and carries a number of complications. The most common complications in the literature are phlebitis, paravasation, infiltration, and the nurse has an irreplaceable role in the prevention and early detection of these complications. The aim of the bachelor thesis is to present expert knowledge from Czech and foreign literature regarding Evidence-Based Practice in the insertion and care of peripheral venous cannulas. The empirical part uses a questionnaire survey to investigate the knowledge of Registered Nurse and students respondent regarding the introduction, treatment and prevention of complications. The data collected compares the responses in terms of educational attainment and completion of a professional course or training related to peripheral venous catheter insertion. 86 respondents participated in the questionnaire survey at the Motol University Hospital. The questionnaire investigated, for example, the most common complications, the use of protective personal equipment, the duration of cover change and peripheral venous cannula retention, and the prevention of embolism...
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Emergency vascular acces in pediatric patients
Dvořák, Vít ; Sentivanová, Lenka (advisor) ; Hocková, Jana (referee)
Vascular access in pediatric emergency patients is essential with no doubt. This thesis is based on many scientific publications and studies focused on intravenous and intraoseal access and their aplication in pediatric emergency patients undergoing pre-hospital or hospital treatment. First part is theoretical and is concerned about technique of insertion and post-procedure care. The next part is about comparing different techniques and their successful inserting for the first attempt. The last part is aimed at research with predefined goals. The main goal of this thesis is to give a summary of available knowledge about the peripheral intravenous access and intraoseal access in pediatric emergency patients. The research is aimed at selected group of respondents and their knowledge of techniques and treating of intravenous and intraoseal access. The last goal is to find out which access is preferable in sudden cardiac arrest in children. Data obtained from different groups of respondents approved that none of the groups have sufficient knowledge in inserting and carrying the intravenous and intraoseal access in pediatric emergency patients. In an analysis of data the best results gain paramedics. The majority of respondents would prefer intravenous access in case of sudden cardiac arrest. As a...
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Permanent Vascular Access for Haemodialysis with Regard to Diabetes Mellitus Diagnosis
Sajdlová, Zuzana ; Eislerová, Iva (advisor) ; Hocková, Jana (referee)
This bachelor thesis deals with the issue of permanent vascular access for hemodialysis with regard to presence of diabetes mellitus (hereinafter DM). It focuses on peripheral hemodialysis vascular access, which include the arteriovenous fistula (AVF) and arteriovenous fistula created using synthetic material, such as graft (hereinafter AVG). The main objective is to highlight the fact that the vascular system is often affacted by systemic diseases like diabetes or atherosclerosis and creating AVF in such patients is often a complicated matter. By intensive postoperative monitoring imminent complications may be detected and prevented. The research is focused on peripheral HCP (AVF, AVG) and on detecting differences in dependance on their individual representation and their functional characteristics at 40 patients treated in Department of Internal Medicine Strahov, General Teaching Hospital Prague. The average age was 70 years. The first group consisted of 21 patients with DM and a the second group 19 non-diabetic paients. AVF is preferable to AVG even in patients with DM. The actual values of blood flow were measured by a team of nurse and clinical engineer and calculated using special formulas from reagular measurements in both groups of respondents. The obtained values of acutal blood flow have...
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Comparison of the Vascular Access Care in the Intensive Care Unit and Standart Departement
Vašková, Marcela ; Tomanová, Alena (advisor) ; Petrášková, Hana (referee)
Abstaract(thesis) In my thesis, I decided to take the issue of treatment of vascular input in surgical department and surgical intensive care units. This nursing problem can be found practically on every inpatient department and each nurse meets with vascular access dutiny her career. The work is divided into theoretical part and empirical part. The first theoretical part deals with the history of vascular input, a list of basic vascular entries and the educational process. Of the vascular inputs, the work focuses especially on central venous catheter and peripheral venous catheter. The second empirical part focuses on the evaluation of collected data and their statistical analysis. Before the research 4 hypotheses were provided. These hypothesis were confirmed by statistical evaluation of questionnaires. The questionnaires were filled in by sisters from the surgical department and intensive care units. At the end of the thesis is work evaluation. Keywords Vascular access, peripheral venous cannula, central venous cannula, nursing, dressing, asepsis, infections, nurse, patient
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A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
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Invasive techniques comparison at hemodialysis from the nurse's and pacient's view
KUDĚJ, Aleš
This Bachelor degree work deals with the comparison of invasive techniques used at haemodialysis from the nurse´s and patient´s point of view. There are set two main aims. The first aim of the work sets the task to map out the experience of dialysed patients with the particular techniques of cannulation of A-V shunt, their opinion of the standard techniques versus the special ones. The second aim maps out opinions of nurses working in the Haemodialysis Centre of the Písek Hospital a.s. on the techniques of cannulation of A-V shunt, which they prefer. With regards to the research focus there was used the method of the qualitative research. The methodical research procedure involved the questioning method and the technique of the semi-controlled interview. The research was carried out in the Haemodialysis Centre of the Písek Hospital a.s. The research group consisted of 8 clients of the dialysis centre and the second group involved 8 nurses who work at the mentioned department. The research results were processed using the form of the case study and there was carried out the comparative data collection analysis.
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The position of a social worker in a dialysis team
KUDĚJOVÁ, Martina
The diploma work surveys the social impacts of ill people in dependence on dialysis treatment. The whole dialysis team?s interest is the effort to take care of the ill people in a way for them to feel at their best and for the chronic illness to have the least impacts on their common life. The aim of the treatment is not only their stabilized health condition, mental satisfaction and sanity but also the help with solving the social impacts that are brought with by the chronic kidney disease. Work of medical social worker in the dialysis team contributes not only to better understanding the dialysed people?s needs but it also influences mutually cooperation between clients and medical staff and thereby contributes to efficiency of the treatment.
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