|
|
Ensuring intravenous lines in children.
BENEŠOVÁ, Nikola
Intravenous cannulation ranks among the basic nursing procedures performed by nurses on everyday basis. The indications for cannulation include particularly infusion therapies, administration of replacement fluids in case of blood loss, anesthesia, long-term administration of antibiotics, parenteral nutrition or monitoring of central venous pressure. In case of children the method prevents frequent unpleasant and painful punctures. Intravenous cannulation is used for peripheral catheterization, central catheterization, umbilical catheterization and PICC. The most frequent is application of peripheral catheters. In absolute majority of cases the procedure is performed by two nurses, while one introduces a catheter and the other holds the child. It should be always made possible for the mother/accompanying person to be present during the procedure. Apart from observation of disinfection, sterility and correct procedure by nurses/ physician, it is very essential to ensure good mental preparation of the child which depends on how much the child is able to understand the provided information. The parent or another accompanying person must be sufficiently instructed in advance about the procedure. In case of introduction of a peripheral catheter in newborns and nurslings no rubber or other tourniquets are used on the limb and the limb is only pressed by the assisting nurse with adequate force. Equally as in adults, visible veins of upper and lower limbs are used for intravenous cannulation but also veins on the child´s head which is a specific place used in little children. Umbilical catheter introduced immediately after the birth is also characteristic for newborns and this procedure can be performed only by a physician, similarly as it is the case with the central catheter. PICC is different in this respect as it can be also introduced by a professionally trained nurse. Aseptic approach is always applied. All catheters must be firmly fixed to prevent their undesired extraction. After the procedure the patient and the puncture area are regularly checked to prevent complications.
|
|
|
The issue of mentoring patients with degenerative diseases of the spine for autotherapy for long-term kinezioterapeutical plan
KADERA, Jan
This bachelor thesis focuses on instructing the patients with a degenerative disease of the spine for autotherapy from the kinesiotherapeutic long-term plan point of view. The right instruction for autotherapy is one of the most fundamental elements not only due to its correct understanding, but most importantly for the right home exercising. Unless the exercises are done correctly, a patient's conditions may worsen, which we need to avoid. In the theoretical part individual anatomic structures of the axial system are described, including vertebrae and their interconnection and of course the spinal muscular components, greatly contributing to both the static and dynamic stability necessary for all forms of motion. Then, there are the most frequently occurring degenerative diseases of the spine and their diagnosis possibilities mentioned here. In the next part different ways of treatment are described. The main treatment for the degenerative diseases of the spine is a conservative treatment involving variety of methods and concepts in terms of physiotherapy. In case this treatment is not successful, a surgical treatment comes into effect, which does not yet guarantee a 100% positive result beforehand. In that case we are talking about the so-called failed back surgery syndrom caused by a number of factors, and thus the treatment is not clearly defined. Apart from its therapy the main aim of the thesis is to evaluate the efficiency of the variety of ways of instructing patients because there are many approaches through which it is possible to instruct patients on dong exercises at home. For my thesis I chose three options, which are a verbal instruction, an instruction according to pictures and a video instruction. To achieve the aim, the qualitative method of data collection was used. The sample group consists of three patients with a generative disease of the spine. In the practical part based on the initial kinesiology examination I, besides the therapy, deal with the patients instructions on autotherapy and I assess their efficiency. During the therapy each patient was informed about a few possibilities of the instructions which they should subsequently follow when exercising at home. During the first visit an initial kinesiology analysis was conducted. The second visit included the therapy and an oral instruction on how to do the exercises. These instructions and exercises were the same at the third visit. The fourth as well as the fifth session was finished with the instructions for autotherapy through pictures. The sixth and the seventh session involved video instructions. At the end of each session every patient demonstrated the assigned exercises which were being corrected at the same time. During the final therapy session the output kinesiology analysis was performed and the success of the therapy was assessed. Simultaneously an uninstructed interview was conducted with each patient in which the patients expressed their subjective opinion on the executed therapy and the ways of the instructions. All the patients state the most appropriate instruction was the audio instruction because of its simplicity and clarity.
|
guest ::
