diplomsko delo
Zala Muhič (Avtor), Darja Thaler (Recenzent), Suzana Mlinar (Mentor), Andreja Marn-Pernat (Komentor)

Povzetek

Uvod: Ledvice opravljajo izločevalno, urejevalno, hormonsko in presnovno nalogo. Njihovo delovanje pa se lahko spremeni ob prisotnosti različnih bolezenskih stanj. Stopnjo ledvične okvare ugotovimo z oceno hitrosti očistka glomerulne filtracije, ki opredeljuje, kolikšno količino krvi očistijo ledvice v nekem časovnem obdobju. Pri kronični ledvični bolezni se hitrost očistka glomerulne filtracije zniža pod 60 ml/min/1,73 m2. Ko pa ženska s kronično ledvično boleznijo zanosi, se pretok plazme in očistek glomerulne filtracije povečata za 40 do 65% oz. za 50 do 85%. Namen: Namen diplomskega dela je predstaviti vpliv delovanja KLB na nosečnost in potek nosečnosti pri ženski s kronično ledvično boleznijo. Metode dela: Uporabljena je bila deskriptivna metoda dela. Opravljen je bil pregled domače ter tuje strokovne literature o nosečnicah s kronično ledvično boleznijo. Iskanje literature je potekalo v štirih tujih podatkovnih bazah, tj. MEDLINE, ScienceDirect, CINAHL in PubMed, in v dveh slovenskih bibliografskih sistemih, tj. COBBIS in DiKul. Rezultati: Pri ženskah s kronično ledvično boleznijo so zapleti v času nosečnosti, med samim porodom in po slednjem pogostejši, zato potrebujejo pomoč strokovnjakov pri svetovanju in vodenju v obdobju pred zanositvijo, v času nosečnosti in po porodu. Če ima nosečnica napredovano kronično ledvično bolezen, je potrebno predčasno pričeti z nadomestnim hemodializnim zdravljenjem, ki zmanjša škodljive učinke uremičnih toksinov na rast in razvoj ploda. Hemodializa se izvaja vsakodnevno in poteka nekaj ur hkrati, kar za nosečnico predstavlja izjemno obremenitev, zato ji je potrebno nuditi zdravstvenovzgojno pomoč, za katero mora biti zadolžena usposobljena medicinska sestra. Razprava in zaključek: Napredovana kronična ledvična bolezen zmanjša možnost za uspešno zanositev in donositev zdravega ploda, zato strokovnjaki ženskam s kronično ledvično boleznijo svetujejo, naj ne odlašajo predolgo s prvo zanositvijo. Pri mlajši populaciji bolnic se pojavlja manj zapletov kot pri starejši populaciji, počasneje pa napreduje tudi ledvična okvara. Ker se ledvična bolnica med nosečnostjo dodatno sooča s stisko, je priporočljivo, da ji dodeljeno medicinsko osebje in multidisciplinarni tim (tj. porodničarski in nefrološki tim) nudi oporo in z njo vzpostavi zaupljiv odnos in tako olajša njeno stisko. Strokovni nasveti, podpora pri prilagajanju bolnice na intenzivno hemodializno zdravljenje, pogosti pregledi, spoštovanje življenjskega ritma ženske, visoka raven sočutja in spodbudna beseda izboljšajo počutje bolnice ter okrepijo njeno zaupanje in zadovoljstvo v času obravnave, kar zagotavlja uspešen izid nosečnosti.

Ključne besede

diplomska dela;zdravstvena nega;okvare ledvic;nadomestno zdravljenje;zdravstvena vzgoja;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.11 - Diplomsko delo
Organizacija: UL ZF - Zdravstvena fakulteta
Založnik: [Z. Muhič]
UDK: 616-083
COBISS: 120524803 Povezava se bo odprla v novem oknu
Št. ogledov: 50
Št. prenosov: 27
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: Chronic kidney disease and pregnancy
Sekundarni povzetek: Introduction: The kidneys perform excretory, regulatory, hormonal and metabolic functions. However, their function may change in the presence of various medical conditions. The degree of renal function loss can be determined via the estimation of the clearance rate of glomerular filtration rate (GFR) which determines the volume of blood that is filtered by the kidneys per unit of time. In chronic kidney disease (CKD),the clearance rate of glomerular filtration rate decreases below 60 mL/min/1.73 m2. However, when a female patient with chronic kidney diseases conceives, the renal plasma flow and the clearance rate of glomerular filtration rate increase by 40% to 50% or by 50% to 85%. Purpose: The purpose of the diploma thesis is to present the influence of chronic kidney disease on the very pregnancy and the characteristics of pregnancy in women with chronic kidney disease. Methods: A descriptive reseach design was employed. A systematic review of Slovene and foreign scientific literature relating to pregnant women with chronic kidney disease was conducted. Literature search was conducted in four foreign electronic databases, i.e. MEDLINE, ScienceDirect, CINAHL and PubMed, and in two Slovene bibliographic-catalogue databases, i.e. COBBIS and DiKul. Results: The presence of chronic kidney disease in pregnant women has been associated with an increased risk of complications during the very pregnancy, during labour, and in the postnatal period, therefore these patients need the support of healthcare professionals who can provide counselling and guidance in the preconception period, during the very pregnancy, and in the postpartum period. Women with advanced chronic kidney disease need to undergo early hemodialysis replacement therapy which reduces the adverse effects of uremic toxins on the growth and development of the fetus. Hemodialysis is conducted on a daily basis, with each session lasting for several hours at a time, which places a significant burden on the pregnant patient, so the latter needs to be provided with health education which should be delivered by a qualified nurse. Discussion and conclusion: Advanced chronic kidney disease reduces the chance of a successful conception and pregnancy outcome and the delivery of a healthy fetus, so women with chronic kidney disease are advised not to delay the first pregnancy. Younger women have a lower risk of complications than their older counterparts, and their renal impairment progresses at a much slower pace. Since a female patient experiences additional distress during the very pregnancy, the assigned healthcare professionals and the members of the multidisciplinary team (i.e. the team of obstetricians and nephrologists) should stimulate a supportive and trusting relationship in order to relieve the distress. Professional advice, support during the transition to intensive hemodialysis, regular health assessment, awareness of the lifestyle of the pregnant woman, a high level of empathy and a few words of encouragement enhance the well-being of the patient and increase the level of trust and satisfaction during the very treatment, which ensures a successful pregnancy outcome.
Sekundarne ključne besede: diploma theses;nursing care;kidney failure;replacement therapy;health education;
Vrsta dela (COBISS): Diplomsko delo/naloga
Študijski program: 0
Komentar na gradivo: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Strani: 35 str.
ID: 16391489