Nursing care of a patient with an adrenal crisis

Uvod: Adrenalna kriza je akutno stanje, ki se najpogosteje pojavlja pri pacientih s primarno insuficienco nadledvične žleze. Gre za potencialno smrten dogodek. Splošni simptomi in redkost bolezni pa zdravstvenemu kadru na urgentnih oddelkih omejujejo optimalno zdravstveno obravnavo. Namen diplomskega dela je opredeliti adrenalno krizo kot urgentno stanje pri pacientih z insuficienco nadledvične žleze ter opisati zdravstveno-negovalno obravnavo pacienta z adrenalno krizo. Raziskovalne metode: Izvedli smo integrativni pregled znanstvene in strokovne literature. Uporabljeni sta bili deskriptivna in komparativna metoda dela. Literaturo smo glede na vključitvene in izključitvene kriterije, ki smo jih oblikovali iz raziskovalnega vprašanja, iskali v podatkovnih bazah MEDLINE, CINAHL in SAGE. Potek iskanja pa je prikazan z diagramom PRISMA po metodi vsebinske analize. Rezultati: V končni pregled smo vključili šest člankov. Zdravstvena obravnava zajema sprejem pacienta, neprekinjen nadzor pacientovih vitalnih funkcij in njihovo dokumentiranje. Sledijo preiskave, aplikacija terapije po naročilu zdravnika ter zdravstveno-vzgojno delo. Razprava in sklep: Pacienta obravnavamo po procesni metodi dela z ugotavljanjem potreb (opazovanje, merjenje, fizični pregled, negovalna in medicinska anamneza, pridobitev informacij od svojcev). Na področju adrenalne krize je zaradi redkosti bolezni in nespecifičnosti simptomov pomembna edukacija zdravstvenega osebja na urgentnih oddelkih, saj premalo znanja vodi v neoptimalno zdravstveno obravnavo. Bistvenega pomena je tudi zdravstveno-vzgojno delo, namenjeno pacientom in svojcem.Introduction: Adrenal crisis is an acute condition that most commonly occurs in patients with primary adrenal insufficiency. It is a potentially fatal event. The general symptoms and the rarity of the disease limit the optimal medical and nursing treatment of the medical staff in the emergency departments. The purpose of the final work is to define the adrenal crisis as an urgent condition in patients with adrenal insufficiency and to describe the nursing care of a patient with adrenal crisis. Methods: We performed an integrative review of scientific and professional literature. A descriptive and comparative method of work was used. According to the inclusion and exclusion criteria, which were formed from the research question, the literature was searched in the MEDLINE, CINAHL and SAGE databases. The search process is shown with a PRISMA diagram according to the method of content analysis. Results: Six articles were included in the final review. Nursing care includes admission of the patient, continuous monitoring of the patient\u27s vital functions and review of their documentation. This is followed by examinations, application of therapy ordered by a doctor and health-educational work. Discussion and conclusion: The patient is treated according to the process method of work with the identification of needs (observation, measurement, physical examination, nursing and medical history, obtaining information from relatives). Due to the rarity of the disease and the non-specificity of symptoms, the education of medical staff in emergency departments in the field of adrenal crisis is important, as insufficient knowledge leads to suboptimal medical treatment. Health education for patients and relatives is also essential