Treatment of patients with chronic critical limb ischemia and the importance of nursing care after revascularization surgery

Izhodišča, namen: V diplomskem delu smo obravnavali pacienta s kritično kronično ishemijo udov po revaskularizacijskem posegu. Opisali smo potek in zdravljenje obolenja. Posebej smo poudarili aktivnosti medicinske sestre in pomen zdravstvene nege po revaskularizacijskem posegu. Raziskovalne metode: Raziskava je temeljila na kvalitativni metodologiji. Izvedli smo študijo primera pri pacientu v enem zdravstvene zavodu. Z metodo opazovanja in intervjujem smo ugotavljali potrebe po zdravstveni negi po 14 osnovnih življenjskih aktivnostih po Virginiji Henderson. Izbrane informacije smo analizirali na podlagi vsebinske analize. Pri tem smo glede na ugotovljeno problematiko izpostavili kategorije, ki smo jih razčlenili na podkategorije in kode. Glede na izpostavljenje potrebe po zdravstveni negi smo pripravili individualni negovalni načrt. Rezultati: Ugotovili smo, da je pacient pred posegom imel močne bolečine v nogi. Zaradi bolečin je imel težave z gibanjem, spanjem, in zmanjšanim apetitom. Že več dni ni odvajal blata. Pacient je bil pred posegom zaskrbljen. Pri zadovoljevanju osnovnih življenjskih aktivnostih je potreboval pomoč. Po posegu pacient ni imel več bolečin, izboljšalo se je spanje. Z izidom operativnega posega je bil zadovoljen, zaradi odsotnosti bolečine. Apetit je bil še vedno slab, tudi blata ni odvajal. Bil je izpostavljen k okužbi rane, nastanku krvavitev in zapletom pri celjenju rane. Odsotnost uda je predstavljala dodatno omejitev v gibanju in nevarnost poškod. Diskusija in zaključek: Pri obravnavi pacienta moramo dobro opazovati in biti pozorni na bolečino, rano in možnost pojava krvavitve po posegu ter preprečevati morebitne pooperativne zaplete. Pacientu nudimo zdravstvenovzgojne nasvete v okviru kompetenc. Strah zmanjšujemo s pogovorom in ustreznem informiranjem in nudenjem psihične podpore.Introduction: In diploma thesis we deal with a patient with critical chronic limb ischaemia and importance of health care after revasculuarization surgery. We described disease and treatment. The most we emphasized the activitis of the nurse and the importance of nursing care after revascularization surgery. Research method: The research work was carried out by a case study in a patient in one of the health care institutions. With observation and questionnaire we identified the need for nursing care after 14 basic life activities by Virginia Henderson. The selected information was analyzed on the basis of the content analysis. Depending on the need for care, we prepared an individual care plan. Results: We found that the patient had severe leg pain prior to the procedure. Because of pain, he had problems with movement, sleep and decreased appetite. He has not taken the mud for several days. The patient was worried before the procedure. Help in meeting basic life activities was needed. After the procedure, the patient had no more pain, and sleep was improved. With the outcome of the surgery, he was satisfied because of the absence of pain. The appetite was stil poor, and the mud was not laxative. He was exposed to wound infection, bleeding and complications in wound healing. The absence of a limb constituted an additional limitation on movement and the risk of injury. Discussion and conclusion: When considering the patient, we must be well observed and pay attention to the pain, early and possible bleeding after the procedure and to prevent possible postoperative complications. We offer healthcare advice within the competence to the patient. Fear is reduced by talking and informing and providing psychological support