diplomsko delo
Tjaša Zibelnik (Author), Lucija Matič (Reviewer), Tina Gogova (Mentor), Urška Janžič (Co-mentor)

Abstract

Uvod: Pljučni rak je eno izmed najpogostejših rakavih obolenj na svetu. Njegovo zdravljenje vključuje različne metode, med katerimi je tudi novejša možnost zdravljenja z zaviralci imunskih nadzornih točk. Kljub obetavnim rezultatom zaviralci imunskih nadzornih točk prinašajo specifične neželene učinke, ki zahtevajo posebno obravnavo. Namen: Namen diplomske naloge je raziskati vlogo medicinskih sester pri obvladovanju neželenih učinkov zaviralcev imunskih nadzornih točk pri pacientih s pljučnim rakom. Cilj je ugotoviti, katere ukrepe izvajajo medicinske sestre za obvladovanje teh neželenih učinkov. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom znanstvene in strokovne literature, pridobljene prek podatkovnih baz PubMed/Medline in CINAHL. Vključeni so bili članki, s prosto dostopnim besedilom, objavljenimi med letoma 2015 in 2023, v slovenskem in angleškem jeziku. Rezultati: Najpogostejši neželeni učinki zaviralcev imunskih nadzornih točk so disfunkcije ščitnice (hipertiroidizem, hipotiroidizem), utrujenost, miokarditis, pljučna embolija, kožni izpuščaji, pnevmonitis, kolitis, driska, povišana telesna temperatura in hepatitis. Medicinske sestre so zelo pomembne pri njihovem obvladovanju. Njihova vloga vključuje izobraževanje pacientov o neželenih učinkih in pravočasnem iskanju pomoči, spremljanje simptomov in prepoznavanje zgodnjih znakov neželenih učinkov, pomoč pri izvajanju medicinskih posegov in prilagajanje zdravstvene nege glede na pacientove potrebe ter koordinacijo zdravstvene oskrbe z drugimi zdravstveni delavci za celostno obravnavo pacientov. Prav tako izvajajo specifične ukrepe za obvladovanje neželenih učinkov ZINT. Pri dermatoloških neželenih učinkih, spremljajo stanje kože, izvajajo preventivne ukrepe in izobražujejo paciente o ustrezni negi. V primeru gastrointestinalnih neželenih učinkih, kot je driska, nadzorujejo hidracijo pacienta, elektrolitsko ravnovesje in svetujejo o prehrani. Neželeni učinki povezani z dihalnim sistemom zahtevajo ukrepe kot so ocenjevanje dihalne funkcije pacienta, zagotavljanje zadostnega kisika v krvi ter pripravo pacienta na dodatne preiskave. Endokrini neželeni učinki zahtevajo redno spremljanje ščitničnih hormonov, opazovanje simptomov in izobraževanje o pomenu zdravljenja. Pri hepatitisu, kateri je neželeni učinek povezan z jetrnim sistemom medicinske sestre spremljajo jetrne funkcije, izvajajo prehransko svetovanje ter opozarjajo na nevarnost hepatotoksičnih snovi. Razprava in zaključek: Medicinske sestre imajo pomembno vlogo pri obvladovanju neželenih učinkov zaviralcev imunskih nadzornih točk, saj paciente izobražujejo in jim pomagajo prepoznati neželene učinke ter jih učijo, kako ustrezno ukrepati ob njihovem pojavu med, po ali po končanem zdravljenju. Ugotovitve diplomske naloge izpostavljajo pomembnost multidisciplinarnega pristopa in vključevanja medicinskih sester v celoten proces zdravljenja pacientov s pljučnim rakom.

Keywords

diplomska dela;zdravstvena nega;karcinom pljuč;medicinske sestre;zaviralci imunskih nadzornih točk;škodljivi učinki;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [T. Zibelnik]
UDC: 616-083
COBISS: 229080835 Link will open in a new window
Views: 150
Downloads: 56
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Other data

Secondary language: English
Secondary title: ǂThe ǂrole of nurses in managing adverse events of immunotherapy in patients with lung cancer
Secondary abstract: Introduction: Lung cancer is one of the most common cancers in the world. The treatment of lung cancer includes various methods, among which is the newer option of treatment with immune checkpoint inhibitors. Despite promising results, immune checkpoint inhibitors bring specific side effects that require special management. Purpose: The purpose of this thesis is to explore the role of nurses in managing the side effects of immune checkpoint inhibitors in patients with lung cancer. The goal is to determine which measures nurses take to manage these side effects. Methods: A descriptive method was used, with a review of scientific and professional literature obtained through the PubMed and CINAHL databases. Articles with freely accessible full text, published between 2015 and 2023 in Slovenian and English, were included. Results: The most common side effects of immune checkpoint inhibitors include thyroid dysfunction (hyperthyroidism, hypothyroidism), fatigue, myocarditis, pulmonary embolism, skin rashes, pneumonitis, colitis, diarrhea, fever, and hepatitis. Nurses play a key role in managing these side effects. Their role includes educating patients about side effects and timely seeking interventions of, monitoring symptoms and recognizing early signs of side effects, assisting in the implementation of medical interventions, adjusting care according to the patient's needs, and coordinating care with other healthcare professionals for a comprehensive approach to patient care. They also implement specific measures to manage the adverse effects of immune checkpoint inhibitors. For dermatological adverse effects, they monitor skin conditions, implement preventive measures, and educate patients on proper skin care. In the case of gastrointestinal adverse effects, such as diarrhea, they monitor patient hydration, maintain electrolyte balance, and provide dietary counseling. Adverse effects related to the respiratory system require interventions such as assessing the patient's respiratory function, ensuring adequate oxygen levels in the blood, and preparing the patient for additional examinations. Endocrine adverse effects necessitate regular monitoring of thyroid hormones, symptom observation, and patient education on the importance of treatment. In the case of hepatitis, an adverse effect related to the liver system, nurses monitor liver function, provide nutritional counseling, and warn patients about the dangers of hepatotoxic substances. Discussion and Conclusion: Nurses play an important role in managing the side effects of immune checkpoint inhibitors by educating patients, helping them recognize adverse effects, and teaching them how to respond appropriately during, after, or upon completion of treatment. The findings of the thesis highlight the importance of a multidisciplinary approach and the inclusion of nurses in the entire treatment process of patients with lung cancer.
Secondary keywords: diploma theses;nursing care;lung carcinoma;nurses;immune checkpoint inhibitors;harmful effects;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Pages: 32 str., [7] str. pril.
ID: 26057681