Pomembnost ustrezne prehranjenosti kritično bolnih in vloga medicinske sestre v enoti intenzivne terapije : diplomsko delo

Mele, Zala (author), Gogova, Tina (mentor), Pajnič, Manca (reviewer)

Uvod: Kritično bolni pacienti, ki se zdravijo v enoti intenzivne terapije imajo visoko stopnjo tveganja za podhranjenost, zato je za doseganje prehranskih potreb nujna prehranska podpora. Stanje podhranjenosti je povezano z zmanjšanjem imunskega odziva, slabšim celjenjem ran in mišično oslabelostjo kar vpliva na podaljšano hospitalizacijo in povečano tveganje za razvoj okužbe, odpoved organov in smrt. Namen: Namen diplomskega dela je poudariti pomen ustrezne prehranjenosti kritično bolnih pacientov in vlogo medicinske sestre pri tem na podlagi prehranskih smernic. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda dela s pregledom strokovne in znanstvene literature v slovenskem in angleškem jeziku povezane z obravnavano tematiko. Literaturo smo iskali v podatkovnih bazah PubMed/Medline in Cinahl Ultimate. Omejena je bila s članki, objavljenimi od leta 2014 do 2024 do katerih smo lahko dostopali preko digitalne knjižnice Univerze v Ljubljani in so dostopni v celotnem besedilu. Rezultati: Pregledali smo priporočila za zagotavljanje varnega in učinkovitega enteralnega hranjenja pacienta s strani medicinske sestre v enoti intenzivne terapije. Prehranska terapija lahko vpliva na pojav hiperglikemije, ki mora biti spremljana in nadzorovana. Vpliva lahko na nastanek poškodb zaradi pritiska nazogastrične sonde, kar poudarja potrebo za preventivno delovanje. Primerjali smo orodja za prehransko presejanje in ocenjevanje in ugotovili, da je modificirano NUTRIC orodje dobra zamenjava za originalno NUTRIC orodje, NRS – 2002 pa se je izkazalo kot boljše pri predvidevanju umrljivosti v intenzivni enoti, vendar ima omejitev uporabe pri pacientih v intenzivni enoti. Razprava in zaključek: Za varno in učinkovito zagotavljanje hranjenja in prehranjenosti je pomembno slediti sodobnim smernicam s tega področja in s tem zmanjšati možnost pojava resnejših zapletov in celo smrti, hkrati pa izboljšati oskrbo in kakovost življenja kritično bolnih pacientov.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, prehranske smernice, prehransko presejanje, enteralno hranjenje
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [Z. Mele]
• Year: 2024
• Number of pages: 32 str.
• PID: 20.500.12556/RUL-163081
• UDC: 616-083
• COBISS.SI-ID: 209973507
• Publication date in RUL: 02.10.2024

MELE, Zala, 2024, Pomembnost ustrezne prehranjenosti kritično bolnih in vloga medicinske sestre v enoti intenzivne terapije : diplomsko delo [online]. Bachelor’s thesis. Ljubljana : Z. Mele. [Accessed 23 March 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=163081

Secondary language

• Language: English
• Title: The importance of nutrition for the critically ill patients and the role of the nurse in the intensive care unit : diploma work

Abstract

Introduction: Critically ill patients treated in the intensive care unit are at high risk of malnutrition. Therefore, nutritional support is essential to meet their nutritional needs. Malnutrition is associated with a reduced immune response, impaired wound healing, and muscle weakness, which can lead to prolonged hospitalization and increased risk of infection, organ failure, and death. Purpose: The purpose of this thesis is to emphasize the importance of nutrition for critically ill patients and the role of the nurse in this context, based on nutritional guidelines. Methods: In the thesis, a descriptive method was used, reviewing professional and scientific literature in Slovenian and English related to the topic. The literature was searched in databases PubMed/Medline and Cinahl Ultimate. The search was limited to articles published from 2014 to 2024, accessible in full text, and available through the digital library of the University of Ljubljana. Results: We reviewed recommendations for ensuring safe and effective enteral feeding of a patient by a nurse in the intensive care unit. Nutritional therapy can affect the occurrence of hyperglycemia, which needs to be monitored and controlled. It can also lead to injuries caused by the pressure of the nasogastric tube, emphasizing the need for preventive measures, We compared tools for nutritional screening and assessment and found that the modified NUTRIC tool is a good substitute for the original NUTRIC tool, while the NRS-2002 proved to be better at predicting mortality in the intensive care unit, though it has limitations in its use for intensive care patients. Discussion and conclusion: For the safe and effective provision of feeding and nutrition, it is important to follow modern guidelines in this field, thereby reducing the risk of serious complications and even death, while also improving the care and quality of life for critically ill patients.

• Keywords: diploma theses, nursing care, dietary guidelines, nutritional screening, enteral feeding