diplomsko delo
Branko Ribić (Author), Robert Sotler (Reviewer), Bernarda Djekić (Mentor), Goranka Beguš (Co-mentor)

Abstract

Uvod: Odpoved dihanja, ki je razlog za sprejem bolnika v enoto intenzivnega zdravljenja, je sindrom, pri katerem pljuča niso zmožna opravljati izmenjave plinov med vdihanim zrakom, krvjo v pljučnem obtoku in izdihanim zrakom. V tistem trenutku, ko je odpoved dokončna, nastopi potreba po mehanskem predihavanju, ki omogoča oksigenacijo vseh tkiv in zadostno minutno ventilacijo. Dokler zdravstveno stanje bolnika dopušča, se izvaja neinvazivno, ko je ta možnost izčrpana, bolnik potrebuje invazivno mehansko predihavanje. Potrebna sta neprekinjeno spremljanje in nadzor hitro spreminjajočega se zdravstvenega stanja bolnika, da se ugotovijo zgodnji znaki kliničnega poslabšanja in zmanjšajo tveganja za iatrogeno škodo. Namen: Želeli smo predstaviti pomen neprekinjenega spremljanja poteka mehanskega predihavanja pri kritično bolnem v enoti intenzivnega zdravljenja, s poudarkom na pomembni vlogi medicinske sestre pri pravočasnem prepoznavanju sprememb. Cilj diplomskega dela je predstaviti pomen parametrov, ki sodijo k spremljanju mehanskega predihavanja, in opozoriti na vrednosti plinske analize arterijske krvi. Metode dela: Uporabili smo deskriptivno raziskovalno metodo dela s pregledom strokovne in znanstvene literature s področja invazivnega in neinvazivnega mehanskega predihavanja. Časovni okvir za vključitev so bili članki, izdani med letoma 2009 in 2021. Za dosego postavljenih ciljev je narejena vsebinska analiza 41 člankov. Rezultati: Medicinska sestra je neprekinjeno ob bolniku, zato je njena vloga pri prepoznavanju nevarnih sprememb zdravstvenega stanja bolnika izjemno pomembna. Za spremljanje in vzdrževanje učinkovitega predihavanja se uporabljata pulzna oksimetrija in kapnografija. Treba je poznati tudi vhodne parametre ventilatorja, kot sta dihalni volumen in frekvenca dihanja. Ko so vsi ti parametri v mejah normale in se bolnik učinkovito mehansko predihava, se po določenem času opravi plinska analiza arterijske krvi, da se oceni stanje kislinsko-bazičnega ravnovesja. Razprava in zaključek: Medicinska sestra mora biti seznanjena s funkcijami ventilatorja, načini ventilacije ter vzroki za dihalno stisko in neskladnost z ventilatorjem, saj je prva oseba ob bolniku z ventilatorjem, ki te spremembe prepozna. Medicinska sestra na podlagi znanja in izkušenj lahko pomembno prispeva k varni in kakovostni ter na bolnika osredotočeni oskrbi. Zaradi hitrega razvoja v zdravstveni negi, medicini in tehnologiji je potrebno neprekinjeno spremljanje novosti, s poudarkom na strokovnem izpopolnjevanju in izobraževanju vseh zdravstvenih delavcev, ki so vključeni v zdravstveno obravnavo te ogrožene skupine kritično bolnih.

Keywords

diplomska dela;zdravstvena nega;opazovanje dihanja;mehansko predihavanje;plinska analiza arterijske krvi;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [B. Ribić]
UDC: 616-083
COBISS: 75116547 Link will open in a new window
Views: 351
Downloads: 63
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Other data

Secondary language: English
Secondary title: Patient monitoring during mechanical ventilation
Secondary abstract: Introduction: Respiratory failure, being the reason for admitting a patient to an intensive care unit, is a syndrome in which the lungs are unable to exchange gases between inhaled air, blood in the pulmonary circulation and exhaled air. At the moment when the failure is final, there is a need for mechanical ventilation, which allows oxygenation of all tissues and sufficient minute ventilation. As long as the patient's medical condition allows, it is performed non-invasively, but when this option is exhausted, the patient needs invasive mechanical ventilation. Continuous monitoring and surveillance of a rapidly changing patient's health is needed to identify early signs of clinical deterioration and reduce the risk of iatrogenic damage. Purpose: We wanted to show the importance of continuous monitoring of the course of mechanical ventilation in a critically ill patient in the intensive care unit with an emphasis on the important role of the nurse in the timely recognition of changes. The aim of this thesis is to present the importance of parameters related to the monitoring of mechanical ventilation, and to draw attention to the values of gas analysis of arterial blood. Working methods: We used a descriptive research method of work with a review of professional and scientific literature in the field of invasive and non-invasive mechanical ventilation. The time frame for inclusion were the articles, published between 2009 and 2021. In order to achieve the set goals, a content analysis of 41 articles was made. Results: The nurse is constantly present with the patient, so her role in identifying dangerous changes in the patient's health is extremely important. Pulse oximetry and capnography are used to monitor and maintain effective ventilation. It is also necessary to be familiar with the input parameters of the fan, such as tidal volume and respiratory rate. When all these parameters are within normal limits and the patient breathes effectively mechanically, a gas analysis of arterial blood is performed after a certain time, to assess the state of acid-base balance. Discussion and conclusion: The nurse must be familiar with the functions of the ventilator, the methods of ventilation, and the causes of respiratory distress and non-compliance with the ventilator, as the first person next to the patient with a ventilator who recognizes these changes. Based on knowledge and experience, a nurse can make an important contribution to safe and quality patient-centered care. Due to the rapid development in nursing, medicine and technology, it is necessary to continuously monitor innovations with an emphasis on professional development and education of all health professionals involved in the medical treatment of this vulnerable group of critically ill patients.
Secondary keywords: diploma theses;nursing care;observation of breathing;mechanical ventilation;arterial blood gas analysis;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Embargo end date (OpenAIRE): 1970-01-01
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Pages: 33 str.
ID: 13292538