Title Zdravstvena njega bolesnika s gastrostomom Title (english) HEALTH CARE PATIENTS WITH GASTROSTOMY Author Marija Biuk Mentor Dragica Kustura (mentor) Committee member Slavica Kozina (predsjednik povjerenstva)Committee member Rahela Orlandini (član povjerenstva) Committee member Dragica Kustura (član povjerenstva) Granter University of Split Defense date and country 2015-09-30, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Cilj: Cilj rada bio je definirati i objasniti enteralnu prehranu , definirati i opisati perkutanu endoskopsku gastrostomu s naglaskom na ulogu medicinske sestre te prikazati sestrinsku skrb kod bolesnika s gastrostomom.
Rasprava: Enteralna prehrana podrazumijeva unos hrane i/ili komercijalnih nutritivnih pripravaka-ponajprije uz korištenje hranidbenih sondi, u želudac, dvanaesnik ili tašto crijevo (jejunum).
Cilj primjene enteralne prehrane je prevencija ili korekcija nutritivnih deficita i sindroma malnutricije. Indicirana je u svih bolesnika koji nemogu ostvariti dostatan unos energije i nutritivnih čimbenika peroralnim hranjenjem.
Ukoliko je potrebno provoditi enteralnu prehranu dulje od 4 tjedna, bolesnicima se postavlja perkutana endoskopska gastrostoma. PEG je sonda smještena u lumen želuca kroz trbušnu stijenku pod kontrolom gastroskopa. Indikacije za postavljanje PEG-a su sva stanja kod kojih postoji nemogućnost adekvatnog podnošenja hrane peroralnim unosom ( tumori usne šupljine, neurološke bolesti kao multipla skleroza, CVI, tumori mozga, Parkinsonova bolest, neurokirurška stanja, povrede i opekotine glave i vrata).
Intervencije medicinske sestre prije zahvata podrazumijevaju razgovor s bolesnikom, provjeru sve potrebne medicinske dokumetacije te pripremu endoskopske sale i pribora za izvođenje zahvata. Tijekom zahvata medicinska sestra pomaže bolesniku pri zauzimanju odgovarajućeg položaja te asistira liječniku. Nakon zahvata medicinska sestra adekvatno zbrinjava bolesnika te je njena pažnja usmjerena na inspekciju katetera, higijenu kože oko stome, hranjenje preko gastrostome, nastanak mogućih komplikacija i njihovo rješavanje te inspekciju okoline gastrokutane fistule.
Zaključak: Enteralna prehrana preko PEG-a je složen postupak koji zahtijeva suradnju više zdravstvenih područja za postizanje istih ciljeva. Medicinska sestra ima najveću ulogu u praćenju primjene te sprječavanju komplikacija od samog početka do samog kraja enteralne prehrane preko PEG-a. Potrebno je da medicinska sestra kontinuirano obnavlja svoje znanje te da prati novosti vezane za enteralnu prehranu kojih je iz dana u dan sve više.
7. SUMMARY
Abstract (english) Aim: The aim of this paper was to define the enteral feeding, to define percutaneous endoscopic gastrostomy with emphasis on the role of a nurse and to present nursing care for gastrostoma patients.
Discussion: Enteral feeding involves food and / or commercial nutritional preparations intake- primarily with the use of feeding tubes, into the stomach, duodenum or small intestine (jejunum).
The aim of enteral feeding is the prevention or correction of nutritional deficiency and malnutrition syndrome. It is indicated in all patients who cannot achieve sufficient intake of energy and nutritional factors through oral feeding. If a patient needs enteral feeding for more than 4 weeks a percutaneous endoscopic gastrostomy is places. PEG tube is placed in the lumen of the stomach through the abdominal wall under the gastroscope control. Indications for PEG tubes are all conditions with the inability of an adequate oral food intake (tumors of the oral cavity, neurological diseases like multiple sclerosis, CVA, brain tumora, Parkinsonˈs disease, neurosurgical condition, burns and injuries of the head and neck).
Interventions of a nurse before surgery include talking with a patient, checking all necessary medical documentation and preparation of endoscopic surgery room and equipment needed to perform the surgery. During surgery the nurse helps the patient in taking the appropriate position and assists the doctor. After surgery the nurse properly takes care of the patient and her attention is focused on the inspection of the catheter, hygiene of skin around the stoma, feeding through gastrostomy, the emergence and solving of possible complications inspection of the gastric fistula.
Conclusion: Enteral feeding through PEG is a complex process which requires the cooperation of several medical areas in achievings the same goals. A nurse plays the major role in monitoring the implementation and the prevention of complications from the very beginning to the very end of enteral nutrition through PEG. It is necessary for a nurse to continuously renew her knowledge and to stay up to date with the frequent news about the enteral feeding.
Keywords
enteralna prehrana
gastrostoma
sestrinsku skrb kod bolesnika s gastrostomom
Keywords (english)
the enteral feeding
gastrostomy
to present nursing care for gastrostoma patients
Language croatian URN:NBN urn:nbn:hr:176:931172 Study programme Title: Nursing (university/undergraduate) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2019-11-18 08:57:23
