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Kontinuální eliminační metody v intenzivní péči z pohledu všeobecné sestry / Continuous Elimination methods in Intesice Care from The Perspective of Nurses (Theoretical work).HOROVÁ, Petra January 2017 (has links)
The purpose of the dissertation Continuous Elimination Methods in Intensive Care in Prospective of Hospital Nurse is to inform about acute kidney injury and chronic kidney disease. These are major reason to use elimination methods at intensive care units and anesthesiological resuscitation departments. We further determine elimination issues. Continuous elimination methods in intensive care medicine are important medical treatment at acute kidney injury and chronic kidney disease. Particularly, acute kidney injury belongs to frequent complications at critically diseased patients, therefore will be properly discussed. It is afraid, because decreased renal function leads to incapability to excrete waste products of metabolism and sustain homeostasis. Mortality at acute kidney injury is higher than at chronic kidney disease so support or renal replacement therapy, in order to save life, is the only accepted method of choice at present time. The techniques of renal support or replacement therapy are integral part of instensive care medicine. The aim of this thesis is to elaborate latest accessible findings and specialized nursing care at continuous elimination methods. Ve have tried to create integrated, comprehensible summary of knowledge of this topic. We expect these findings are fundamental to high-quality nursing at patients with this disorder. The dissertation was conducted as a method of review and synthesis. As long as this part is purely theoretical-based, it gathers informations from czech and also foreign sources. The data was acquired from scientific publications, technical papers, monographs and web. The outcome of this work can be used for further research of this topic or contribute to resource information for paramedical staff. In the thesis we analyze acute kidney injury, briefly chronic kidney disease, then we proceed through the history of dialysis and its specifications. These are closely explained. We focus on technical aspect of various elimination methods, the division, indication to initation, advantage and disadvantage, vascular access will also be described. The possibilities of anticoagulation have been defined, the types of membrane hemofiltrates and dialysators, substitutional and dialysing solutions have been characterized, the need of dietary measures has been emphasized. The complications that can happen during the use of elimination method have not been left out of consideration. We describe the intensive care units, nurse competencies, their work, monitoration, patients' and elimination unit preparation and vascular access care.
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Avaliação morfofuncional do rim de cães com e sem nefropatias submetidos a anestesia / Morfofunctional kidney evaluation in nephropathic and non-nephropatic dogs submitted to anesthesiaCastro, Luma Tatiana Silva 02 March 2016 (has links)
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Previous issue date: 2016-03-02 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Surgeries and anesthesia performed on dogs could cause kidney injury or worsen their renal
functions if they are already sick. There is a literature gap in studies discussing post-surgery
monitoring and its effects. This study aimed to evaluate dogs who undergone surgeries, in
animals considered healthy and in those who had any renal alterations before surgery to
evaluate if they developed any renal impairment due to surgery and anesthesia. Dogs were
monitored and evaluated before and after surgeries in order to detect if they had any renal
injury due to surgery or post-operative procedures. Evaluation took place right after the
surgery and after certain time range from the surgery (Two, Seven, 28 and 90 days). Blood
and Urine samples were drawn from the dogs to better classify them as healthy or having
kidney injury. Consequently, hematological, urinary and blood gases profiles were
proceeded. Few dogs with normal renal function that were submitted to surgery had
transitory renal injury (23%). Nephropatic dogs that received specific therapy for renal
protection did not presented tubular lesion due to surgery. Hypotension occurred in
nephropatic dogs despite the use of non-hypotensive drug therapy but in a low frequency
and had brief renal impairment. Anesthesia induced hypotension in non nephropatic dogs
(54%) for the usage of hypotensive drug therapy. / Procedimentos anestésicos podem contribuir para a disfunção renal no paciente hígido ou
mesmo agravar a injúria do nefropata. Na medicina veterinária, há um déficit de literatura
sobre a temática relacionando lesão renal decorrente da anestesia e monitorização destes
animais, uma vez que o acompanhamento no pós-operatório, na maioria das vezes, não é
realizado. O estudo objetivou avaliar a morfofuncionalidade do rim em 23 cães submetidos
a cirurgia atendidos no Hospital Veterinário da Escola de Veterinária e Zootecnia da
Universidade Federal de Goiás. Exames clínicos e laboratoriais foram feitos para
determinação do perfil renal dos pacientes e, posteriormente, determinar se os mesmos
seriam incluídos no grupo nefropata ou no grupo não nefropata. Exames de bioquímica
sérica e urinária, exame de urina, razão PU/CU, hemogasometria, hemograma e excreção
fracionada de sódio e potássio foram procedidos. Os pacientes foram monitorizados com
mensurações dos parâmetros clínicos e laboratoriais anterior ao procedimento, ao final da
cirurgia, com dois dias, sete, 28 e 90 dias. Constatou-se que cães sem evidência clínica e
laboratorial de nefropatia e submetidos a condições adequadas de pré, trans e pós-operatório
houve lesão tubular secundária a anestesia foi transitória e em poucos pacientes (23%).
Cães nefropatas estabilizados e submetidos protocolos diferenciados no pré, trans e pósoperatório,
não apresentaram indicativo de lesão tubular secundária a anestesia. Na cirurgia,
os cães nefropatas (30%) submetidos a protocolos anestésicos sem acepromazina,
apresentam menor ocorrência de hipotensão que os não nefropatas (54%), submetidos a
protocolos anestésicos com acepromazina. Hipotensão anestésica afeta a integridade renal
de forma transitória.
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