| Sažetak | Cilj istraživanja: Cilj je prikazati demografske karakteristike i zastupljenost najčešćih sestrinskih dijagnoza prilikom prijema djece hospitalizirane zbog krupa, prikazati ulogu medicinske sestre pri fizikalnom pregledu i uzimanju anamneze te ukazati na važnost njenog smirenog pristupa bolesnicima. Uz to, cilj je prikazati intervencije u rješavanju problema u zdravstvenoj njezi djeteta s krupom kao i prikazati ulogu medicinske sestre u skrbi o bolesniku.
Materijali i metode: Uzorak ispitanika čini 16 bolesnika koji su se liječili od krupa u Klinici za dječje bolesti Kliničkog bolničkog centra Split u razdoblju od 1.1.2014. do 31.12.2015. Materijali korišteni u ovom istraživanju su povijesti bolesti djece hospitalizirane u navedenom periodu. Zabilježeni su podaci o spolu i dobi liječene djece, duljini njihove hospitalizacije, mjestu njihovog stanovanja, broju djece koja su bila prethodno hospitalizirana ili ambulantno liječena zbog bolesti dišnog sustava, kao i broju djece koja imaju alergije te broju djece koja imaju pozitivnu obiteljsku anamnezu obolijevanja od bolesti dišnog sustava. Zabilježen je i broj djece koji su bili u kontaktu s osobom s akutnom bolešću dišnog sustava. Napravljena je evidencija sestrinskih dijagnoza u procesu zdravstvene njege djeteta sa krupom.
Rezultati: Prosječna dob liječene djece je bila 1,9 ±1,7 godina. Prosječna duljina hospitalizacije djece je bila 6,9 ± 4,3 dana. Dječaci su činili 81 % od 16 liječenih. Čak 75 % ispitanika je u trenutku hospitalizacije živjelo uz obalu Dalmacije ili u priobalju, a 25 % je živjelo u unutrašnjosti Dalmacije. Udio od 81 % ispitanika u anamnezi ima naveden podatak ranijeg obolijevanja od bolesti dišnog sustava. Na neki od poznatih alergena je alergično 38 % ispitanika, 44 % je u kućanstvu imalo člana obitelji koji je u trenutku njihove hospitalizacije bio akutno respiracijski bolestan, a 31 % ispitanika ima pozitivnu obiteljsku anamnezu češćih bolesti dišnog sustava. Najčešće sestrinske dijagnoze kod hospitalizirane djece su smanjeno podnošenje napora (100 %), smanjena prohodnost dišnog puta (94 %), visok rizik za bakterijsku superinfekciju (94 %), strah i anksioznost (87,5 %), visok rizik za poteškoće u primjeni terapije zbog dobi djece (87,5 %) te povišena tjelesna temperatura (81 %). Druge česte dijagnoze su neupućenost roditelja (69 %), visok rizik za dehidraciju djeteta (69 %) , visok rizik za razvoj opstrukcije dišnog puta (62,5 %), smanjen unos hrane i tekućine (44 %). Visok rizik za poremećaj rada srca u/s primjenom terapije za krup zbog urođenih srčanih bolesti je nađen u 19 % ispitanika.
Zaključak: Dječaka je bilo hospitalizirano značajno više nego djevojčica. Većina ispitanika je ranije bolovala od bolesti dišnog sustava te je u trenutku hospitalizacije živjela na obalnom i priobalnom području. Najčešće sestrinske dijagnoze kod djece su smanjeno podnošenje napora, smanjena prohodnost dišnog puta, visok rizik za bakterijsku superinfekciju, strah i anksioznost djeteta i/ili roditelja, visok rizik za teškoće prilikom primjene terapije te povišena tjelesna temperatura. Karakteristični simptomi krupa morali bi biti pravovremeno prepoznati od strane medicinskih sestara čija zadaća je kvalitetno uzeti anamnezu bolesnika. Moraju se eliminirati druge životno ugrožavajuće bolesti koje se mogu javljati sa simptomima sličnim kao kod krupa, a u pristupu djetetu najvažnija je smirenost. Medicinska sestra mora poznavati probleme u procesu zdravstvene njege djeteta s krupom i intervencije kojima se oni mogu riješiti te mora znati pravilno skrbiti o bolesniku s krupom. |
| Sažetak (engleski) | Aim: The aim of this study was to show the demographic characteristics and the prevalence of the most common nursing diagnoses on admission of children hospitalized for croup and to show the role of nurses in the physical examination and during medical history obtaining process. The aim was to point out the importance of calm approach to patients. In addition, the goal was to show the interventions which could solve problems in the health care of children with croup and to demonstrate the role of nurses in health care.
Materials and Methods: Sixteen patients were treated for croup in the Department of Pediatrics of the University Hospital Centre Split in the period from January 1st 2014. untill December 31st 2015. Materials used in this study were medical histories of hospitalized children. Relevant information for this study were the sex and age of treated children, the length of their hospital stay, the place of their residence, number of children who were previously hospitalized or were outpatients because of respiratory diseases, as well as the number of children who have allergies and the number of children who have a family history of respiratory diseases. The number of children who have been in contact with a person with an acute respiratory disease was also noted and nursing diagnoses in the process of health care of a child with croup were registered.
Results: The average age of hospitalized children was 1.9 ± 1.7 years. The average length of hospital stay of children was 6.9 ± 4.3 days. Eighty-one percent of 16 treated were boys. Along the coast of Dalmatia were living 75 % of patients at the time of hospitalization and 25 % were living in the Dalmatian hinterland. Eighty-one percent of patients suffered from previous respiratory disease. Thirty-eight percent of patients are allergic to one of the known allergens, 44 % had a family member who was acute respiratory ill at the time of their hospitalization, and 31% of respondents have a family history of frequent respiratory diseases. The most common nursing diagnoses in hospitalized children were decreased exercise tolerance (100 %), reduced airway patency (94 %), high risk of bacterial superinfection (94 %), fear and anxiety (87.5 %), high risk for difficulties in applying the therapy due to the age of the children (87.5 %) and fever (81 %). Other frequent diagnoses were ignorance of parents (69 %), high risk for dehydration of a child (69 %), high risk of airway obstruction (62.5 %), reduced intake of food and fluids (44 %). High risk for a disorder of the heart because of the application of therapy for croup disease was reported in 19 % of subjects because of their congenital heart disease.
Conclusion: There were significantly more hospitalized boys than girls. Most patients had previously suffered from respiratory diseases and at the time of hospitalization they lived in the coastal area. The most common nursing diagnoses in children are decreased exercise tolerance, reduced airway patency, a high risk of bacterial superinfection, fear and anxiety of the child and/or parents, high risk for difficulties in applying the therapy and fever. Characteristic symptoms of croup should be promptly recognized by nurses whose task is also to take medical history of patients. They have to eliminate other life-threatening diseases that may occur with symptoms similar to that of croup and their approach to child should be calm. The nurses must know the problems in the health care of children with croup and interventions that could solve them as well as taking proper care of the patients with croup. |
