Nursing care of patient with ulcus cruris

This bachelor thesis focuses in nursing care of a patient with ulcus cruris. Varicose ulcer is a chronic skin defect localized on lower limbs. Its occurrence is most often linked to a venous and arterial system disease. Number of patients with this disease has been growing in recent years. The increasing population age is probably the reason as it is known that the disease usually affects individuals over 70 years of age (Pospíšilová, 2004). This fact surely increases growing demands to nursing care, particularly the spheres typical for this diagnosis. The most frequently mentioned problems became the ground of the thesis goals. It is divided into two parts: theoretical and practical. The theoretical part explains the basic issues of the disease. With regard to the urgency of the topic the research part was focused on specific nursing care and related nursing care problems in patients with ulcus cruris. Two goals were set with regard the topic and the intended direction where the thesis might have been oriented. The first goal was to map the specifics of nursing care of patients with ulcus cruris and to find out what the most frequent problems occurring in these patients were. Three research questions were based upon the goals prepared this way. Replies to these questions were obtained upon qualitative data collection performed from February to March 2013 in the České Budějovice Hospital. The selection of respondents was intentional. The research sample consisted of 7 respondents selected from among hospitalized patients and 7 respondents selected from among nurses. Two anonymous semi-structured interviews were prepared for the research purposes, one for the selected patients being treated for this disease and the other for the selected nurses caring about patients with this disease. The first research question dealt with the nursing care specifics. The research itself has shown that the care about the defect itself, which is based on the redressing method, is the basic specific. This has to be performed under strict aseptic conditions to prevent introduction of microorganism into the wound. Removal of residues of ointments and old skin and consequent application of new healing materials are the basic point of this intervention. The research has shown that all these materials have to be applied directly to the defect itself, not to its surrounding. Non-adherence to this would cause aggravation of the wound conditions. Care about pain, which has proven to be the most frequent nursing care problem in these patients during the research, relates to the redressing. The second research question was aimed at the most frequently occurring nursing care problems. The fact that also wound secretion and odour bother the patients apart from the pain was found. These nursing care problems lead to another problem of high importance, which is social isolation. The patients cannot or do not want to socialize and shut themselves away from the world because of the disease. In some instances ties with families are reduced or even completely broken. And so individuals inflicted this way depend on the care of homecare agency nurses or practitioners and dermatologists. In the worst instances they have to rely on themselves. In such an instance the mentality gets disturbed, which is adversely reflected in somatic condition of the individual. A reply to the third research question, i.e. mapping the issues of nursing care nurses have to deal with most frequently results from the care specifics and the most frequent nursing care problems. These issues are redressing of defects, care about pain, education of patients, nourishment care and hygiene. An information brochure, which should serve particularly to the patients suffering from this disease, was prepared upon the results of the thesis