diplomsko delo
Nataša Slivniker (Author), Mirjam Ravljen (Reviewer), Bernarda Djekić (Mentor), Polona Gorjup (Co-mentor)

Abstract

Uvod: V zadnjih dveh desetletjih se je z novimi odkritji izboljšalo razumevanje patofiziologije povišanega intraabdominalnega tlaka. Z večjim poznavanjem možnih zapletov se lahko bistveno zmanjša umrljivost kritično bolnih v enotah intenzivnega zdravljenja. Pomembno je prepoznati bolnike z dejavniki tveganja za razvoj povišanega intraabdominalnega tlaka, pri čemer ima pomembno vlogo kontinuirano spremljanje vrednosti tlaka preko urinskega katetra. Namen: Namen diplomskega dela je predstaviti pomen kontinuiranega spremljanja intraabdominalnega tlaka pri bolnikih v enotah intenzivnega zdravljenja. Poudarjena bo vloga medicinske sestre pri pravilni izvedbi meritev in pravočasnem prepoznavanju povišanih vrednosti tlaka. Cilj diplomskega dela je predstaviti zdravstveno nego bolnika s povišanim intraabdominalnim tlakom in na dokazih podprto oblikovati protokol za merjenje intraabdominalnega tlaka preko urinskega katetra. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom in analizo domače in tuje znanstvene in strokovne literature s področja medicine in zdravstvene nege. Iskanje literature je potekalo preko oddaljenega dostopa Univerze v Ljubljani v podatkovnih bazah CINAHL, Medline/Pubmed, Science Direct, Cochrane in COBISS.SI. Rezultati: Medicinska sestra ima pomembno vlogo pri kakovostni zdravstveni obravnavi bolnika s povišanim intraabdominalnim tlakom. Pomembno je natančno merjenje tlaka, kar pomeni, da mora zelo dobro poznati tehniko merjenja in natančno slediti pravilnemu zaporedju posameznih korakov, ki so predstavljeni v izdelanem protokolu. Razprava in zaključek: Povišan intraabdominalni tlak lahko vodi v povečano obolelost in najhujših primerih tudi v umrljivost bolnikov. Za učinkovito zdravljenje je nujno čim hitreje izmeriti intraabdominalni tlak, da se prepreči intraabdominalna hipertenizija in abdominalni utesnitveni sindromom. Zaradi preprečevanje življenjsko ogroženih zapletov mora medicinska sestra imeti obsežno teoretično znanje in ustrezne praktične izkušnje. Prisotnost ustrezno strokovno usposobljene medicinske sestre omogoča pravočasno in zanesljivo merjenje intraabdominalnega tlaka, ki je ključno za nadaljnje zdravljenje obolelih. Kljub mednarodnim sprejetim smernicam s strani Svetovnega združenja za abdominalni utesnitveni sindrom v pregledani slovenski literaturi ni protokola za meritev intraabdominalnega tlaka v mehurju preko urinskega katetra. Z upoštevanjem protokola, v katerega bi bil vključen tudi kontrolni seznam za pripravo bolnika in pripomočkov za merjenje intraabdominalnega tlaka, bi zboljšali samo kakovost meritev in dobljene rezultate. To bi pripomoglo k boljši in hitrejši zdravstveni obravnavi, večji varnosti bolnika in zmanjšanju stroškov zdravljenja.

Keywords

diplomska dela;zdravstvena nega;abdominalni kompartment sindrom;abdominalni perfuzijski tlak;znotrajtrebušnik tlak;protokol;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [N. Slivniker]
UDC: 616-083
COBISS: 31120899 Link will open in a new window
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Other data

Secondary language: English
Secondary title: Monitoring intra-abdominal pressure in a critically ill patient in an intensive care unit
Secondary abstract: Introduction: Over the past two decades, new discoveries have improved understanding of the pathophysiology of increased intra-abdominal pressure. With greater knowledge of possible complications, the mortality of critically ill patients in intensive care units can be significantly reduced. It is important to identify patients with risk factors to develop increased intra-abdominal pressure, whereby the continuous monitoring of pressure through a urinary catheter is essential. Purpose: The purpose of this diploma thesis is to present the importance of continuous monitoring of intra-abdominal pressure in intensive care units. The important role of the nurse in the correct performance of measurements and timely recognition of increased pressure will be emphasized. The aim of the diploma thesis is to present the nursing care of patients with increased intra-abdominal pressure and create a protocol for measuring of intra-abdominal pressure through urinary catheter. Methods: A descriptive method, based on review and analysis of domestic and foreign scientific and professional literature in the field of medicine and nursing. The literature was searched by remote access of the University of Ljubljana in the databases CINAHL, Medline / Pubmed, Science Direct, Cochrane and COBISS.SI Results: The nurse have an important role in the quality of medical treatment for patients with increased intra-abdominal pressure. Accurate pressure measurement is important, therefore the nurse must well know the measurement technique and follow exactly the correct sequence steps, which are presented in the protocol. Discussion and conclusion: Increased intra-abdominal pressure can lead to increased prevalence, and in the worst cases, also to death. For effective treatment is necessary to measure intra-abdominal pressure as quickly as possible, to prevent intra-abdominal hypertension and abdominal compartment syndrome. To prevent life-threatening complications, the nurse must have extensive theoretical knowledge and relevant practical experience in measuring intra-abdominal pressure. The presence of a suitably qualified nurse enables timely and reliable measurement of intra-abdominal pressure, which is crucial for further treatment of patients. Despite the internationally accepted guidelines by the World Society of the Abdominal Compartment Syndrome (WSACS), there is no protocol in the reviewed Slovenian literature for the basic measurement of intra-abdominal pressure in the bladder through urinary catheter. By following the protocol, which would also include a checklist for preparation of patient and material, the quality of measurement method and the results obtained would be improved. This would help to improve and speed up medical treatment and treatment, increase safety and reduce treatment costs.
Secondary keywords: diploma theses;nursing care;abdominal compartment syndrome;abdominal perfusion pressure;intra-abdominal pressure;protocol;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Pages: 23 f.
ID: 12059905