diplomsko delo
Erika Debevec (Avtor), Suzana Mlinar (Recenzent), Andreja Mihelič Zajec (Mentor)

Povzetek

Uvod: Histerektomija oz. operativna odstranitev maternice je eden najpogostejših večjih kirurških posegov ženskih rodil z namenom zdravljenja benignih in malignih obolenj. V obravnavi pacientke v pooperativnem obdobju ima medicinska sestra ključno vlogo, saj je prizadeta celostna osebnost pacientke. Za strokovno obravnavo mora medicinska sestra izvesti načrt zdravstvene nege glede na najpogostejše ugotovljene negovalne probleme, postaviti negovalne diagnoze in glede na njih izvajati intervencije zdravstvene nege v pooperativnem obdobju. Namen: Ugotoviti želimo, kateri so najpogostejši negovalni problemi glede na fizične in psihične težave oz. zaplete pacientke in na podlagi tega opredeliti ključne negovalne diagnoze in intervencije v načrtu zdravstvene nege, ki bi izboljšali celostno obravnavo pacientk v zgodnjem pooperativnem obdobju po histerektomiji. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo s pregledom in analizo domače in tuje znanstvene in strokovne literature. Literaturo smo iskali s pomočjo podatkovnih baz ScienceDirect, Medline (PubMed), CINAHL, COBIB.SI., digitalne knjižnice DiKul ter v knjižnici Zdravstvene fakultete, Univerze v Ljubljani. Za identifikacijo literature smo uporabili ključne besede: hysterectomy AND postoperative AND nursing, hysterectomy AND postoperative complications AND nursing, hysterectomy AND nursing interventions, hysterectomy AND nursing diagnoses. Osredotočili smo se na empirične in pregledne znanstvene članke, objavljene od leta 2010 do 2020, ki temeljijo na najpogostejših pooperativnih zapletih, in na njihovi podlagi opredelili najpogostejše negovalne diagnoze in intervencije zdravstvene nege. Za izbor literature smo uporabili PRISMA diagram in v analizo vključili 12 člankov. Rezultati: Najpogostejši fiziološki zapleti v pooperativnem obdobju po histerektomiji so okužbe operativnih ran in sečil, obsežnejše krvavitve, retenca urina in nastanek tromboembolije, psihološki pa anksioznost, nizka samopodoba, težave v spolnosti in depresija. Negovalne diagnoze, opredeljene glede na najpogostejše zaplete, so nevarnost okužbe operativnih ran, akutna bolečina, nespečnost, nevarnost za vensko tromboembolijo, moteno doživljanje telesne podobe in podaljšano pooperativno okrevanje. Intervencije zdravstvene nege temeljijo na kakovostni komunikaciji in medsebojnem zaupanju med medicinsko sestro in pacientko, kar omogoča zgodnjo prepoznavo znakov in simptomov zapletov, zmanjša pojav motenega doživljanja telesne podobe in kasneje podaljšanega pooperativnega okrevanja. Medicinska sestra spremlja potek celjenja ran in ocenjuje stopnjo akutne bolečine za preprečevanje okužb ran in pojava nespečnosti. Apliciranje antitrombotične terapije, nameščanje kompresijskih nogavic in pomoč pri gibanju so temeljne intervencije za preprečevanje tromboembolije. Razprava in zaključek: Anksioznost, strah in zmedenost povečujejo tveganje za pojav zapletov po histerektomiji, ti pa so odvisni tudi od starosti, telesne teže, predhodne anamneze in pridruženih kroničnih bolezni pacientke. Izvajanje intervencij ERAS programa (Enhanced Recovery after Surgery), ki vsebuje zgodnjo mobilizacijo, oralno prejemanje analgetikov, hranjenje in pitje tekočine in uporabo žvečilnega gumija, pripomore k hitrejši rehabilitaciji po histerektomiji, z njihovo uporabo bi lahko izboljšali kakovost obravnave pacientk po histerektomiji tudi v slovenskem okolju. Ključne naloge medicinske sestre v pooperativnem obdobju so kakovostna individualna obravnava, preprečevanje in zmanjševanje zapletov, pravilno postavljanje negovalnih diagnoz in kasneje intervencij zdravstvene nege.

Ključne besede

diplomska dela;zdravstvena nega;ginekološke operacije;pooperativno obdobje;zapleti;kakovost življenja;medicinske sestre;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.11 - Diplomsko delo
Organizacija: UL ZF - Zdravstvena fakulteta
Založnik: [E. Debevec]
UDK: 616-083
COBISS: 39270147 Povezava se bo odprla v novem oknu
Št. ogledov: 648
Št. prenosov: 234
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: ǂThe ǂmost common nursing diagnoses and nursing interventions in the earliest postoperative period after hysterectomy
Sekundarni povzetek: Introduction: Hysterectomy or surgical removal of the uterus is one of the most common major surgical procedures of the female reproductive organs, in order to treat benign and malignant diseases. In the treatment of the patient in the postoperative period, the nurse has a key role to play, as the overall personality of the patient is affected. For professional treatment, the nurse must implement a nursing plan, according to the most common identified nursing problems, make nursing diagnoses and, according to them, carry out nursing interventions in the postoperative period. Purpose: We want to determine which the most common nursing problems are, considering the physical and mental problems or complications of the patient and on this basis to define key nursing diagnoses and interventions in the nursing plan that would improve comprehensive treatment of patients in the early postoperative period after hysterectomy. Methods: We decided on a qualitative research approach, a descriptive method of work will be used with a review and analysis of domestic and foreign scientific and professional Slovene and English literature. We will search for literature with the help of ScienceDirect, Medline/PubMed, CINAHL, COBIB.SI databases and with the help of DiKul digital libraries, as well as in the library of the Faculty of Health Sciences, University of Ljubljana. We will focus on empirical and transparent scientific articles, published from 2010 to 2020, based on the most common postoperative complications and based on them identify the most common nursing diagnoses and nursing interventions. We will search the literature with keywords: hysterectomy AND postoperative AND nursing, hysterectomy AND postoperative complications AND nursing, hysterectomy AND nursing interventions, hysterectomy AND nursing diagnoses. We used the PRIZMA diagram to select the literature and we included 12 articles in analysis. Results: The most common physiological complications in the postoperative period after hysterectomy are infections of operative wounds and urinary tract, extensive bleeding, urinary retention and thromboembolism, and psychological anxiety, low self-esteem, sexual problems and depression. Nursing diagnoses defined according to the most common complications are the risk of infection of operative wounds, acute pain, insomnia, risk of venous thromboembolism, disturbed body image experience, and prolonged postoperative recovery. Nursing interventions are based on quality communications and trust between a nurse and a patient. This allows early recognition of signs and symptoms, reduces the occurrence of disturbed body image experience and prolonged postoperative recovery. To prevent wound infections and sleep problems like insomnia, nurse must monitor the wound healing process and measure the degree of acute pain. Very important interventions to prevent thromboembolism are applying anticoagulant therapy, use of graduated elastic compression stocking or sleeves and assisting patient with passive or active range of motion. Discussion and conclusion: Anxiety, fear and confusion are increasing the risk of complications after a hysterectomy, which also depends on patient's age, weight, previous medical history and associated chronic diseases. Implementation of ERAS (Enhanced Recovery after Surgery) interventions, which include early mobilization, oral analgesics, feeding and drinking fluids, using chewing gum, could help to reach faster rehabilitation after hysterectomy. These interventions can also improve the quality of treatment and women`s satisfaction after hysterectomy in Slovenian clinical environment. The key role of a nurse in postoperative period is quality individual treatment, preventing and reducing complications, proper placement of key nursing diagnoses and later nursing interventions in the nursing plan.
Sekundarne ključne besede: diploma theses;nursing care;gynecological surgeries;postoperative period;complications;the quality of life;nurses;
Vrsta dela (COBISS): Diplomsko delo/naloga
Študijski program: 0
Komentar na gradivo: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Strani: 42 str., [1] str. pril.
ID: 12189438