Vloga medicinske sestre pri endotrahealni aspiraciji prezgodaj rojenega otroka : diplomsko delo

Seljak, Barbara (author), Mihelič Zajec, Andreja (mentor)

Uvod: Dihanje je osnovna funkcija vsakega živega bitja. Nedonošenček, ki je rojen, prej kot so pljuča sposobna za sekrecijo surfaktanta, lahko razvije takoj po rojstvu respiratorni distres sindrom. Nedonošenčku z dihalno stisko pomagamo z različnimi načini umetnega predihavanja, priključen mora biti na monitor, medicinsko osebje je stalno prisotno in izvaja čiščenje dihalnih poti. Medicinska sestra ima pri tem pomembno vlogo, saj je pogost negovalni postopek intubiranega nedonošenčka aspiracija iz endotrahealnega tubusa. Namen:Namen diplomskega dela je ugotoviti pomen endotrahealne aspiracije pri intubiranem in mehansko ventiliranem nedonošenčku. Poleg tega pa želimo ugotoviti, kakšna je vloga medicinske sestre pri endotrahealni aspiraciji in kako nedonošenček občuti bolečino. Metode dela:V diplomskem delu smo uporabili deskriptivno metodo s sistematičnim pregledom literature. Pri iskanju smo uporabili časovni okvir, in sicer od leta 2006 do 2016. Literatura je bila iskana v angleškem jeziku s ključnimi besedami premature baby intubation, premature baby AND endotracheal tube suction AND open and closed system suction, nursing premature baby AND open and closed system endotracheal suctioning AND premature pain v podatkovnih bazah CINAHL, Medline (PubMed), Medscape ter v bazi podatkov Wiley Online Libary. V analizo smo vključili 25 člankov. Članki so bili ovrednoteni glede na moč dokazov s štiristopenjsko lestvico Eccles, Manson (2001). Rezultati: Dolgotrajen način mehanske ventilacije lahko pušča kronične bolezni, kot so bronhopulmonalna displazija, retinopatija in možganska krvavitev. Z aplikacijo surfaktanta se skrajša čas trajanja invazivne podpore pri dihanju. Medicinska sestra ima pri izvajanju zdravstvene nege intubiranega in mehansko ventiliranega nedonošenčka pomembno vlogo. Izvaja neprekinjen nadzor nedonošenčka in nadzira delovanje ventilatorja. Skrbi za pravilno lokacijo tubusa in prehodnost tubusa z rednimi aspiracijami, bodisi z odprtim ali z zaprtim načinom aspiracije. Individualno se odloča, na kakšen način bo nedonošenčku izvedla toaleto dihalnih poti. Zaprt način aspiracije naj bi bil za nedonošenčka bolj varen, saj je ves čas prikjučen na mehanski ventilator. Razprava in sklep: Oba načina endotrahealne aspiracije sta za nedonošenčka neprijetna, stresna in boleča. Z nedonošenčkom delamo nežno in z občutkom.

• Language: Slovenian
• Keywords: nedonošenček, intubacija nedonošenčka, endotrahealna aspiracija, zaprt/odprt sistem aspiracije, zdravstvena nega nedonošenčka, bolečina pri nedonošenčku
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-91109
• COBISS.SI-ID: 5243755
• Publication date in RUL: 20.03.2017

Secondary language

• Language: English
• Title: The role of a nurse in endotracheal tube suction in a premature baby : diploma thesis

Abstract

Introduction: Breathing is an essential function of every living creature. Premature baby who was born before the lungs could synthesise surfactant could develop respiratory distress sindrome right after they were born. Premature baby with respiratory distress can be helped with numerous ways of artificial ventilation, they have to be monitored and the medical staff should be present at all times and clean the airways. A nurse has an important role in it as endotracheal suction is a common procedure in handling intubated premature infants. Aim:of this thesis is to determinate the role of endotracheal intubation in intubated and mechanically ventilated premature infant. Furthermore, we want to determine what role a nurse plays in endotracheal tube suction and pain. Methods: In the thesis, we used a descriptive method with systematic review of the literature, which was time limited with the time span from 2006 to 2016. We searched for literature in English language in databases such as CINAHL, Medline (PubMed), Medscape and Wiley Online Libary. The key words used were premature baby intubation, premature baby intubation AND endotracheal tube suction AND open and close system suction, nursing premature baby AND open and closed system endotracheal suctioning AND premature pain. We included 25 articles in the analysis. In terms of strenght they were evaluated with the four level scale Eccles, Manson (2001). Results: Long term mechanical ventilation can result in chronic disease, for example bronchopulmonary dysplasia, retinopathy, brain haemorrhage etc. bay applying surfactant we can shorten the invasive support of breathing. Closed system of aspiration is thought to be safer for the premature baby because they are connected to the mechanical ventilator all the time and there is minimal handling. A nurse has a major role in providing medical care of a premature baby. She continuosly controls the baby and the ventilator, makes sure the tube is located properly and it does not occlude in between the aspirations. Discussion and conclusion: As both types of endotracheal aspiration are painful, stresfull and unpleasant for the premature infants a nurse also has to be gentle and have a special feeling for the baby.

• Keywords: premature baby, intubation of a premature baby, endotracheal aspiration, vs open closed system of aspiration, nursing care of a premature baby, premature pain