Proces zdravstvene njege bolesnika s prijelomom rebara Nursing process of health care in patients with rib fractures

U kliničkoj slici prevladava bol u projekciji prsišta koja se pojačava pri disanju, kašljanju i kihanju, i to na ozlijeđenoj strani. Iznimno je bolna osjetljivost mjesta prijeloma na palpaciju i kod pritiska na sternum. Dijagnoza prijeloma verificira se RTG-snimkom prsišta. RTG-snimka verificira postojanje prijeloma rebara, te omogućuje otkrivanje postojanja krvi unutar prsišta [hemotoraks] i/ili limfne tekućine [hilotoraks]. Osim potvrde dijagnoze [iako se ne mora vidjeti frakturna pukotina], snimka je potrebna da se otkrije eventualni hemotoraks ili likvidotoraks koji nisu klinički manifestirani. Osnovna je svrha liječenja smanjenje stupnja bolnosti. Metode/postupci za umanjenje bolnosti jesu: uporaba nenarSažetak: Prijelomi rebara najčešće nastaju kao posljedica traume prsišta. Najučestalija lokalizacija prijeloma jesu srednja rebra, a najrjeđe su prijelomi lokalizirani na početna tri rebra. Nadalje, lokalizacija prijeloma najčešća je na prednjim ili zadnjim rebrima, a prijelomi su uzrokovani djelovanjem izravnih ili neizravnih sila. Postoje dvije vrste prijeloma poprečni i kosi. Kao posljedica prijeloma rebara nastaju komplikacije: infekcija krvi koja je lokalizirana na mjestu prijeloma, s mogućim nastankom osteomijelitisa i/ili apscesa zida prsnoga koša, slomljeni dijelovi rebara mogu uzrokovati puknuća međurebarnih krvnih žila s posljedičnim nastankom krvarenja unutar prsišta. Također mogu uzrokovati ozljede unutarnjih organa [pluća, pneumotoraks, hemotoraks, tamponada srca, ozljede jetara, slezene, želuca, vijuga crijeva i sl.]. Prijelom rebara uzrokuje smanjenje respiratorne funkcije pluća, a u najtežim slučajevima dolazi do pojave atelektaze i sekundarne upale plućnog parenhima. Opće metode/postupci za liječenje prijeloma rebara jesu: kupiranje boli, mirovanje, smanjenje kašlja, sprječavanje nastanka sekundarne infekcije pluća. Specifične metode/postupci za liječenja prijeloma rebara jesu: zbrinjavanje krvarenja, kirurško zbrinjavanje rascjepa srčane i/ili plućne maramice. Uloga medicinske sestre/tehničara ključna je u oporavku bolesnika, a sastoji se od intervencija koje su u svezi s rješavanjem specifičnih problema koje uzrokuju prijelomi rebara te od intervencija koje se odnose na poboljšanje stupnja osnovnih potreba bolesnika. Ključne riječi: prijelom rebara • zdravstvena njega • medicinska sestra Kratki naslov: njega bolesnika i prijelom rebara Abstract: Rib fractures usually occur as a result of thoracic trauma. The most common localization of the fracture is the center of the rib. The fractures with the rarest localization are the initial three ribs. Furthermore, the localization of the fracture is the most common in the front or rear corners, and fractures are caused by direct or indirect forces. There are two types of fractures: transverse and oblique. Rib fractures could cause complications, such as blood infection, which is localized at the site of the fracture with the potential emergence of osteomyelitis and / or abscess of the chest wall, broken parts of the ribs could cause rupture of intercostal arteries with a consequent emergence of bleeding within the chest, injury to internal organs [lung, pneumothorax, haemothorax, cardiac tamponade, injury to the liver, spleen, stomach, winding hoses, etc.]. Fractured ribs could cause a decrease in respiratory function of the lungs, and in severe cases lead to the atelectasis and secondary inflammation of lung parenchyma. General methods/procedures for the treatment of rib fractures are: docking pain, improving methods for sleeping, decreased coughing and prevention of secondary infection of the lungs. Specific methods/procedures for treatment of rib fractures ribs are as follows: management of bleeding, surgical management of cleft heart and/or lung tissue. The role of nurses/technicians is crucial in the recovery of patients and consists of interventions that are related to solving specific problems that cause rib fractures, and the interventions related to improving the level of basic patient needs.

• Publication year

  2014

• Venue

  Unknown venue

• Publication date

  2014-04-01

• Fields of study

  Not labeled

• Identifiers
  DOI 10.11608/SGNJ.2014.19.010
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  Open on Semantic Scholar

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  Semantic Scholar

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