Zdravstvena nega pacienta po operativnem zdravljenju aterosklerotičnih sprememb velikih žil nog : diplomsko delo

Valič, Mateja (author), Ravljen, Mirjam (mentor)

Uvod: Zožitev velikih arterij na nogi zaradi ateroskleroze lahko povzroči številne zaplete, kot na primer pojav občasne šepavosti, bolečine pri naporu ali v mirovanju, v nekaterih primerih pa lahko neprekrvljeni deli noge celo odmrejo. Zelo pomembno je pravočasno zdravljenje, ki je lahko konzervativno ali invazivno. Večje zožitve se zdravijo invazivno; ena od metod je kirurška metoda imenovana trombendarterektomija. Namen: Namen diplomskega dela je na teoretični ravni predstaviti aterosklerotične spremembe velikih žil nog in izpostaviti vlogo medicinske sestre pri pacientu po operaciji velikih žil na nogi v enoti intenzivne zdravstvene nege. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom strokovne in znanstvene literature v slovenskem in angleškem jeziku iz obdobja od 2006 do 2016. Iskanje literature je potekalo s pomočjo vzajemne kataloške baze podatkov COBIB.SI in v podatkovnih bazah MEDLINE in CINAHL. Razprava in sklep: Kirurško zdravljenje zožitev velikih žil na nogi je invaziven poseg, ki je povezan s tveganjem za razvoj številnih pooperativnih zapletov. Pravočasno prepoznavanje znakov in simptomov ter pravilno ukrepanje ob prvih kazalcih razvoja zapletov izboljša izid zdravljenja. V ospredju je spremljanje parametrov nevrološkega in hemodinamskega stanja pacienta, ocenjevanje in lajšanje bolečine ter opazovanje operativne rane in drenov. Po operaciji pacient potrebuje individualno prilagojeno pomoč pri izvajanju temeljnih življenjskih aktivnosti. Medicinska sestra ima pomembno vlogo pri samem zdravljenju, pacienta motivira in vključuje v zdravstveno nego, s katero pripomore k boljšemu uspehu zdravljenja. S štirinajstimi temeljnimi življenjskimi aktivnostmi po Hendersonovi je poudarjeno, na kaj mora biti medicinska sestra še posebej pozorna pri izvajanju zdravstvene nege. Tekom celotnega zdravljenja pa izvaja zdravstveno vzgojo, saj je le-ta zelo pomembna, da pacient razume naravo svoje bolezni, se izogiba dejavnikom tveganja in s svojo boleznijo zaživi polno in zdravo življenje.

• Language: Slovenian
• Keywords: ateroskleroza, periferna arterijska bolezen, medicinska sestra, temeljne življenjske aktivnosti
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-92535
• COBISS.SI-ID: 5278571
• Publication date in RUL: 08.06.2017

Secondary language

• Language: English
• Title: Nursing care of patient after thromboendarterectomy surgery of atherosclerotic changes on leg arteries : diploma work

Abstract

Introduction: Vasoconstriction of long leg arteries due to atherosclerosis (Peripheral Artery Disease, “PAD”) may cause numerous complications from occasional limping, feeling pain at rest or on exertion (intermittent claudication) in some cases the part of leg affected with poor blood circulation may even die off (limb ischemia). Therefore, it is of crucial importance to provide timely medical treatment, whether by conservative or invasive surgical methods. The larger vasoconstrictions require invasive surgical treatment, one of such methods is called thromboendoarterectomy. Purpose: The purpose of diploma work is to present on the theoretical level causes, risk factors, consequences of PAD treatment possibilities, and to bring to light the role of a nurse during care of patients after surgery in an intensive nursing care unit. Methods: The descriptive method of work was developed with scientific literature overviewed in both the Slovenian and English language, published between the periods from 2006 to 2016. A search was carried out in national catalogue database at COBIB.SI, MEDLINE and CINAHL. Discussion and conclusion: The surgical treatment of leg srteries constriction by thromboendoarterectomy is an invasive procedure associated with the risk of developing a number of post-operative complication. After surgery patients are admitted to an intensive nursing care unit. Timely identification and proper response to the first indicators of complications improve the treatment outcomes and contribute to the quality of patient rehabilitation. In the foreground is monitoring the parameters of neural and hemodynamic conditions of a patient, assessment, ease of pain and monitoring the state of incision and drains. After surgery, a patient needs individually adjusted assistance and support in regards to performance of basic life activities. A nurse has a distinguished role in the treatment itself, moreover he/she motivates a patient and integrates him/her in the nursing care process and by this they contribute to improved treatment results. The Henderson’s fourteen basic life activities are guidelines to which a nurse should pay attention to while providing nursing care. During care, a nurse shall educate a patient of the nature of PAD to avoid further exposure to risk factors and to start once again to live a full and healthy life.

• Keywords: atherosclerosis, peripheral arterial disease, nurse, basic life activities