Jure Kajzar (Avtor), Ruža Pandel Mikuš (Recenzent), Ljubiša Pađen (Mentor)

Povzetek

Uvod: Prevalenca z boleznijo povezane podhranjenosti ostaja velika in se ocenjuje, da je 15–60 % pacientov prizadetih že ob sprejemu v ustanovo. Poleg tega je podhranjenost povezana z višjo obolevnostjo, daljšo hospitalizacijo in z višjimi stroški oskrbe. Poznamo veliko orodij za prehransko presejanje, s katerimi hitro ugotovimo prehransko ogroženost ali že nastalo podhranjenost pri pacientu. Namen: Namen diplomskega dela je ugotoviti, kakšna so prehranska tveganja in prehransko stanje kirurško zdravljenih pacientov med hospitalizacijo v eni izmed slovenskih bolnišnic. Metode: V empiričnem delu je bila izvedena študija primerov, ki je vključevala 11 pacientov, ki so bili hospitalizirani zaradi amputacije spodnjega uda. Podatke smo zbrali s pomočjo prehranske anamneze. Ob sprejemu sta bila opravljena začetno in končno prehransko presejanje z orodjem Nutritional Risk Screening 2002. Ob sprejemu in odpustu smo opravili meritev električne bioimpedance, s katero smo pridobili meritev faznega kota in oceno bazalnih energijskih potreb pacienta. Med hospitalizacijo se je ocenjeval dejanski energijski vnos s pomočjo pettočkovne lestvice za ocenjevanje zaužite hrane. Rezultati: Rezultati so pokazali, da je bil po oceni z orodjem Nutritional Risk Screening 2002 prehransko ogrožen le en pacient od 11. Indeks telesne mase se je v povprečju zmanjšal, kar nakazuje na izgubo telesne mase med hospitalizacijo. Parameter električne bioimpedance, fazni kot, se med hospitalizacijo v povprečju ni spremenil, vendar je glede na začetne zastavljene spodnje mejne vrednosti še vedno nakazoval na slabo prehransko stanje pacientov. Ocenjen realen energijski vnos je zadostoval za pokritje bazalnih energijskih potreb le pri enem pacientu od 11. Energijska vrednost predpisane diete je glede na ocenjene bazalne potrebe ustrezala pri 6 pacientih (54,6 %), pri preostalih petih pacientih energijska vrednost ni bila zadostna. Realen energijski vnos pa glede na ocenjene dnevne energijske potrebe ni bil pokrit pri nobenem izmed preiskovancev. Razprava in sklep: Menimo, da je prehransko stanje pacientov z amputacijo spodnjega uda skrb vzbujajoče. Tudi predhodne raziskave v slovenskem prostoru s področja prehranske ogroženosti pacientov so pokazale, da je veliko pacientov v prehranskem tveganju ali pa imajo že nastalo podhranjenost. Nekateri avtorji navajajo, da so osebe, ki so podhranjene ali nimajo svojih zalog energije, v večjem tveganju za daljše celjenje ran, kar pa je pri pacientih z amputacijo spodnjega uda pomemben dejavnik. Pri prehrani pacienta prehranski tim igra ključno vlogo. Pomembno je dobro povezovanje med zdravniki in medicinskimi sestrami, ki so največ v stiku s pacientom in z dietetiki, ki sestavljajo jedilnike, saj bomo le tako lahko učinkovito ukrepali zoper podhranjenost in prehranska tveganja pri pacientih z amputacijo spodnjega uda. Pri vsem tem pa bi potrebovali podporo zdravstvene ustanove, saj potrebujemo dejansko aplikacijo boljše prehranske podpore v vsakdanjo prakso in spremljanje prehranjenosti.

Ključne besede

diplomska dela;zdravstvena nega;prehransko presejanje;prehranska ogroženost;električna bioimpedanca;fazni kot;energijski vnos;kirurški pacienti;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.11 - Diplomsko delo
Organizacija: UL ZF - Zdravstvena fakulteta
Založnik: [J. Kajzar]
UDK: 616-083
COBISS: 5409643 Povezava se bo odprla v novem oknu
Št. ogledov: 1350
Št. prenosov: 720
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Angleški jezik
Sekundarni naslov: Assessment of nutritional risks and nutritional status in patients with lower limb amputation
Sekundarni povzetek: Introduction: Prevalence of disease-related malnutrition in health settings remains high and it is estimated that 15–60 % of the patients are already affected at the time of admission to the care setting. In addition, malnutrition is associated with higher morbidity, longer hospitalization and higher costs of care. Many nutritional screening tools are used for quickly identification of nutritional risks or malnutrition in the patient. Purpose: The purpose of the diploma work is to determine the nutritional risks and nutritional status of surgically treated patients during hospitalization in one of the Slovenian hospitals. Methods: In the empirical part, a case study was conducted involving 11 patients who were hospitalized due to lower limb amputation. Data was collected using a nutritional anamnesis. At hospital admission initial and final nutrition screening were performed using the Nutritional Risk Screening 2002 tool. Beside Nutritional Risk Screening 2002 we performed the measurement of bioelectrical impedance analysis at admission and discharge, through which we acquired assessment of the phase angle and basal metabolic energy needs of the patient. During hospitalization actual energy intake was evaluated using a five-point scale for assessing food intake. Results: The results have shown that only 1 patient of 11 was at nutritional risk using Nutritional Risk Screening 2002 tool. Body mass index of the patients decreased during hospitalization, which indicates body weight loss during hospitalization. The electrical bioimpedance analysis parameter, the phase angle levels on average did not change during hospitalization period but in view of initial set lower cut-off value they still indicate a poor nutritional status of the patients. The estimated actual energy intake was sufficient to cover the estimated basal energy needs in only 1 patient of 11. The energy value of prescribed diet was sufficient considering to estimated basal energy needs in 6 patients (54,6 %), while in the other 5 patients the energy value of the prescribed diet was not sufficient to cover their basal energy needs. The actual energy intake considering the estimated daily energy needs was not covered by any of the subjects. Discussion and conclusion: We believe that the nutritional status of patients with lower limb amputation is worrisome. Also preliminary studies in Slovenia in the field of nutritional risks have shown that a large number of patients are at nutritional risk or malnourished. Some authors quote that people who are malnourished or do not have body energy reserves are at greater risk for longer wound healing, which in patients with lower limb amputation is an important factor. In the diet of the patient, the nutrition team has a key role. Good collaboration between physicians, registered nurses - who are most in contact with the patient and dieticians, who design the menus, is essential. In addition, the support of a health institution is needed to help the patients actually implement better nutritional support in everyday practice and monitoring of nourishment.
Sekundarne ključne besede: diploma theses;nursing care;nutrition screening;nutritional risk;bioelectrical impedance analysis;phase angle;energy intake;surgical patients;
Vrsta dela (COBISS): Diplomsko delo/naloga
Študijski program: 0
Konec prepovedi (OpenAIRE): 1970-01-01
Komentar na gradivo: Dipl. delo (bolonjski študij), Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Strani: 33 str.
ID: 10915647