Zdravstvena nega pacienta po odstranitvi vranice : diplomsko delo

Aljančič, Špela (author), Ravljen, Mirjam (mentor), Zore, Anamarija (co-mentor)

Uvod: Krvavitev notranjih organov po topi poškodbi je eden izmed pogostih dejavnikov za smrt. V trebušni votlini je najpogostejši vzrok za večje krvavitve poškodba vranice. Za paciente z obsežno krvavitvijo vranice je kirurška odstranitev najboljša izbira za preživetje. Odstranitev vranice ni pogost poseg, vendar je pri obsežnih poškodbah vranice izjemno pomembno za preživetje poškodovanca. Vranica ima v našem telesu pomembno imunsko in hematološko vlogo, zato je odstanitev organa tvegana in jo lahko spremlja kar nekaj zapletov. Medicinska sestra igra pri obravnavi pacienta ključno vlogo. Namen: Namen diplomskega dela je predstaviti vlogo medicinske sestre po odstranitvi vranice zaradi poškodbe in zdravstveno nego pacienta po izbranih temeljnih življenjskih aktivnostih v pooperativnem obdobju. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda dela s pregledom domače in tuje literature, ki je bila iskana v spletnih podatkovnih bazah PubMed, CINAHL, COBISS.SI in preko spletnega brskalnika Google učenjak. Uporabljene so bile naslednje ključne besede: spleen trauma, postsplenectomy infection, vaccination, blunt object trauma, postoperative complications. Pri iskanju po tujih bazah podatkov smo uporabili napredno iskanje in pri tem Boolov operator AND. V spletnem brskalniku Google učenjak smo s temi ključnimi besedami našli 230 zadetkov od katerih smo jih uporabili 27. Rezultati: Po splenektomiji se lahko pojavi veliko težav. Najpogostejše so krvavitve in infekcije, ki jih lahko s strokovno in celostno obravnavo pacienta preprečimo. Medicinska sestra je tista, ki lahko prva ugotovi spremembe v pacientovem stanju in pravočasno obvesti zdravnika. Prav tako medicinska sestra promovira cepljenje ter vzpodbuja pacienta k zdravem načinu življenja. Razprava in sklep: Življenje brez vranice lahko poteka normalno ali pa je ob napačnem ravnanju lahko usodno. Zato je še posebej pomembno izobraževanje pacientov o možnosti infekcije po splenektomiji in kako jo preprečiti. Potrebno je slediti smernicam cepljenja, ki so za pacientovo varnost potrebne in jih predpisuje Nacionalni inštitut za javno zdravje. Z dobrim znanjem zdravstvenih delavcev in prenašanjem tega znanja na paciente lahko preprečimo veliko komplikacij in zagotovimo celostno oskrbo pacienta in kakovostno zdravstveno nego.

• Language: Slovenian
• Keywords: poškodba vranice, splenektomija, preprečevanje infekcije, promoviranje cepljenja
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-101799
• COBISS.SI-ID: 5455467
• Publication date in RUL: 06.07.2018

Secondary language

• Language: English
• Title: Health care of a postsplenectomy patient : diploma work

Abstract

Introduction: Bleeding of internal organs after blunt damage is one of the common causes of death. In the abdomen, the most common cause of major bleeding is spleen damage. For patients with extensive spleen bleeding, surgical removal is the best choice for survival of the patient. Removal of the spleen is not a common procedure, but it is extremely important for large spleen injuries. The spleen has an important immune and hematologic role in our body, therefore the absence of it can cause quite a few risks. The nurse plays a key role in the treatment of the patient. Purpose: The purpose of this thesis is to present the role of a nurse after the removal of the spleen due to injury and patient care after selected basic life activities in the postoperative period. Methods: In the thesis we used descriptive method of work with a review of Slovene and foreign literature, which was searched in the online databases PubMed, CINAHL, COBISS.SI and through the Google Scholar Web browser. The following key words were used: traumatic spleen, postsplenectomy infection, vaccination, blunt object trauma, postoperative complications. We searched for foreign databases using advanced search and Boolean operator AND. With these keywords, we found 230 hits in the Google Scholar Web browser from which we used 27 of them. Results: After splenectomy, there may be a lot of problems. The most common are bleeding and infections, that can be prevented by professional and holistic consideration of the patient. A nurse is the one who can first detect changes in the patient's condition and inform the doctor in due time. Likewise, the nurse is a source of information for the patient and their relatives, she educates and promotes vaccination, and encourages the patient's healthy lifestyle. Discussion and conclusion: Life without a spleen can be normal or it can be fatal if dealt with it the wrong way. Therefore, it is particularly important to educate patients about the possibility of infection folowing splenectomy and how to prevent it. It is necessary to follow the vaccination guidelines recomended by the National Institute of Public Health, which helps us to protect the patient. With good knowledge of health workers and with transferring this knowledge to patients, we can prevent many complications and ensure a quality health care.

• Keywords: spleen damage, spleen removal, prevention of infection, promotion of vaccination