Pljučna embolija pri nosečnici in vloga medicinske sestre : diplomsko delo

Alijagić, Aida (author), Mlinar, Suzana (mentor), Cotič-Anderle, Majda (comentor)

Uvod: Tekom nosečnosti se v ženskem telesu pojavijo različne spremembe, tako fiziološke kot anatomske. V času nosečnosti v razvitem svetu največ žensk umre zaradi pljučne embolije. V tem življenjskem obdobju so ženske petkrat bolj ogrožene kot sicer. Obstajajo številni dejavniki tveganja, ki lahko privedejo do bolezni, znaki pa so lahko nespecifični. Namen: Namen diplomskega dela je predstaviti dejavnike tveganja za pljučno embolijo v nosečnosti, znake in simptome, načine preprečevanja in zdravljena ter vlogo MS pri obravnavi nosečnice, pri kateri obstaja sum na pljučno embolijo. Metode dela: Pri diplomskem delu smo uporabili deskriptivno metodo dela, s pregledom in analizo predvsem angleške strokovne literature. Iskanje le te je potekalo po podatkovnih bazah MedLine, CINAHL s celotnim besedilom, Base in Sience Direct. Iskanje literature je bilo omejeno od leta 2013 do vključno 2019, potekalo pa je od julija 2019 do septembra 2019. Rezultati: Incidenca pljučne embolije v razvitem svetu v nosečnosti narašča, tveganje za pljučno embolijo se poveča z nastopom nosečnosti, traja celotno nosečnost in doseže vrh v poporodnem obdobju. Že sama nosečnost je dejavnik tveganja za pljučno embolijo. Znaki in simptomi, ki so sicer značilni za pljučno embolijo so v nosečnosti lahko hitro spregledani, ker posnemajo fiziološke znake nosečnosti. Nizkomolekularni heparin je prva izbira pri zdravljenju trombotičnih dogodkov v času nosečnosti, ne prehajajo skozi posteljico, so varni in enostavni za uporabo. Razprava in zaključek: V nosečnosti je ključnega pomena natančna diagnoza pljučne embolije, le-ta predstavlja svojevrsten izziv zaradi treh glavnih vzrokov. Fiziološki simptomi nosečnosti posnemajo podobne znake in simptome pljučne embolije, neinvazivne diagnostične strategije, ki se običajno uporabljajo pri postavitvi diagnoze, pri nosečnicah niso bile ustrezno preiskane. Nenazadnje pa slikovni testi, ki so potrebni za postavitev diagnoze lahko predstavljajo tveganje za zdravje nosečnice. Zaradi tega so medicinske sestre ključna skupina zdravstvenih delavcev, ki morajo znati prepoznati znake in simptome pljučne embolije ter pravilno ukrepati. Če so medicinske sestre dobro usposobljene, znajo prepoznati znake in simptome bolezni ter dejavnike tveganja, skupaj z zdravnikom pripomorejo k ustrezni zdravstveni obravnavi ter boljšemu izidu zdravljenja.

• Language: Slovenian
• Keywords: pljučna embolija, nosečnost, dejavniki tveganja, znaki in simptomi medicinska sestra
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-112694
• COBISS.SI-ID: 5724011
• Publication date in RUL: 06.11.2019

Secondary language

• Language: English
• Title: Pulmonary embolism in pregnancy and nurse role : diploma work

Abstract

Introduction: During pregnancy, different changes are occurring in the female body, both physiological and anatomical. Women in pregnancy are five times more vulnerable than otherwise. There are a number of risk factors that can lead to disease, but signs may be non-specific. Purpose: The purpose of the thesis is to present risk factors for pulmonary embolism in pregnancy, signs and symptoms, prevention and treatment methods, and the role of nurse in addressing pregnant women suspected of having a pulmonary embolism. Methods: In the thesis we used the descriptive method of work, with a review and analysis of mainly English professional literature. This search was made by MedLine, CINAHL with full text, Base and Science Direct databases. The search for literature was limited from 2013 to 2019 inclusive. The literature search took place from July 2019 to the September 2019. Results: The incidence of pulmonary embolism in the developed world in pregnancy increases. The risk of pulmonary embolism is increased by the onset of pregnancy, takes the whole pregnancy and reaches the peak in the postnatal period. The pregnancy is a risk factor for pulmonary embolism. Signs and symptoms that are otherwise specific to pulmonary embolism may be overlooked in pregnancy because they are physiological signs of pregnancy. Low-molecular heparin is the first choice in the treatment of thrombotic events during pregnancy because they are safe and easy to use. Discussion and conclusion: In pregnancy, the exact diagnosis of pulmonary embolism is crucial, but this is a unique challenge for the three main causes. Physiological symptoms of pregnancy are similar signs and symptoms of pulmonary embolism. Non-invasive diagnostic strategy, commonly used in the diagnosis, were not properly investigated in pregnant women. Lastly, the imaging tests needed to the diagnosis can represents a risk to the health of pregnant women. Because of that nurses are a key group of health professionals who need to know the signs and symptoms of pulmonary embolism and take proper action. If nurses are well trained and know how to identify signs and symptoms of the disease and risk factors, together with the doctors, contribute to appropriate medical treatment and a better outcome of treatment.

• Keywords: pulmonary embolism, pregnancy, risk factors, sings and symptoms, nurse