Obravnava pacienta z vstavljenim Swan-Ganzovim katetrom

• Main Author: Skornšek, Erna
• Other Authors: Donik, Barbara
• Format: Bachelor Thesis
• Language: Slovenian
• Published: E. Skornšek 2016
• Subjects: Swan-Ganz kateter; zagozditveni tlak v pljučni arteriji; vloga medicinske sestre; zdravstvena nega.; Swan-Ganz catheter; pulmonary artery wedge pressure; the role of nurse; nursing care.; info:eu-repo/classification/udc/616-07:612.2(043.2); Baza; Endeavour; sami
• Online Access: https://dk.um.si/IzpisGradiva.php?id=63051; https://dk.um.si/Dokument.php?id=103404&dn=; https://plus.si.cobiss.net/opac7/bib/2254500?lang=sl

Teoretična izhodišča: Vstavitev Swan-Ganzovega katetra (SGK) je invazivni poseg, katerega izvaja izkušen in za to usposobljen zdravnik. Medicinska sestra, kot članica multidisciplinarnega tima ima pri tem svojo nalogo in odgovornost. Poseg se lahko izvaja v terapevtske in diagnostične namene. SGK je rutinska preiskava s številnimi dejavniki tveganja, še vedno pa se zanjo, kljub vsem napredkom v medicini ni našla metoda, ki bi jo kvalitetno nadomestila. V diplomskem delu smo analizirali pojem SGK in namen vstavitve, predvsem pa nas je zanimala vloga in naloge medicinske sestre pri vstavitvi katetra ter vloga medicinske sestre pri zdravstveni negi pacienta z vstavljenim SGK. Z opisanimi metodami lahko medicinska sestra bistveno pripomore k dobri fizični in psihični pripravi pacienta. Pravočasno poskrbi za ustrezno pripravo prostora in materiala, ki je potreben za poseg. Njena najpomembnejša naloga pa je, da z vso spretnostjo in strokovnim znanjem izvaja naloge, za katere je zadolžena po vstavitvi SGK predvsem pa zdravstvena nega takega pacienta. Metodologija: Pri pisanju diplomskega dela smo uporabili deskriptivno metodo dela. Uporabili smo svetovne baze podatkov CHINAL, Pubmed, ScienceDirect, Medline, Medscape Nursing WebMD, Healthline, Google učenjak in vzajemna kataloška baza podatkov COBIB.SI. Rezultati: SGK je v medicini prisoten že 40 let. Je nepogrešljiv pri hemodinamskem nadzoru pacienta. SGK je termodilucijski, upogljiv, večlumenski kateter, katerega zdravnik s pomočjo balončka na koncu katetra vstavi v desno stran srca, uporablja se za različne namene, od raznih meritev, aplikacije zdravil in infuzijskih tekočin. Omogoča nam odvzem mešane venske krvi. Njegov namen je zgodnje odkrivanje bolezenskih stanj in zdravljenje le teh. Vloga medicinske sestre pa je, da s svojo profesionalnostjo preprečuje morebitne številne zaplete povezane s SGK. Zdravstvena nega pacienta z vstavljenim SGK zahteva celosten pristop. Potrebna je iniciativa s strani medicinske sestre, predanost, strokovna podkovanost in znanje, da lahko sodeluje v timu in hitro ukrepa, ko je to potrebno. Diskusija in sklep: V diplomskem delu ugotavljamo, da so medicinske sestre v intenzivnih enotah ustrezno seznanjene z rokovanjem s SGK. Literatura je skopa, zato mora biti medicinska sestra dovolj iniciativna, da kontinuirano pridobiva znanje tudi na specialnih področjih. Pomembno je, da je pozorna na morebitne zaplete tudi po vstavitvi sami. Kljub številnim prednostim, obstajajo slabosti, katere predstavljajo veliko tveganje za pacienta. Uspeh in končni rezultat meritev je odvisen od znanja in strokovne usposobljenosti medicinske sestre. Background: The Swan-Ganz Catheter (SGC) insertion is an invasive procedure performed by an experienced and well trained physician. As members of a multidisciplinary team, nurses play a pivotal role and have important responsibilities. The SGC can be utilized for therapeutic or diagnostic purposes. Although the insertion of the SGC has become a routine procedure, it is associated with various risks, and in spite of advancements in the medical field, there is currently no method, which could be used as a qualitative replacement. In this diploma work, we aimed to define the term SGC and indications for its usage. We were particularly interested in the role of a nurse in the SGC placement and maintenance, as well as in nursing care of the patient with SGC. The goal of the proposition is that with appropriate planning and advanced measures, the patient will be better prepared to deal with outcomes related to their SGC insertion. However, foundational to this endeavour is the nurses’ knowledge base and skill set for completion of care-related tasks post SGC placement. Methodology: A descriptive research methodology was used for this study. The databases CINAHL, PubMed, Science Direct, Medline, Medscape Nursing, WebMD, Healthline, Google Scholar and the union bibliographic/catalogue database COBIB.SI were. Results: The SGC has been in clinical use for the last 40 years. The SGC is a flexible, multi-lumen catheter equipped with an inflatable balloon at the tip that is guided to the right side of the heart. With the use of a thermodilution technique it provides hemodynamic information that cannot be reliably obtained by other methods. It is used to perform different measurements, for infusing drugs and fluids. It can also be used for drawing mixed venous oxygen saturation samples. The SGC is a tool that provides diagnostic measurements and eventually leads to treatment of underlying disease, before irreversible or irreparable damage can occur. Nursing care of a patient with a SGC is complex. The nurse needs to demonstrate a personal initiative, devotion, professional expertise and knowledge set to successfully cooperate in a multidisciplinary team and intervene when necessary. Discussion and conclusion: The nurses in the intensive care units are adequately familiar with handling of the SGC. The literature about proper handling and maintenance of the SGC is scarce, therefore, the nurses have to be self-motivated to continuously acquire specific knowledge. Nurse should also become acquainted with all complications that could occur during and after the procedure. There are numerous advantages for the use of SGC however, its use can present also a significant risk. The success and the final results depend on the knowledge and professional skills of nurses.