Kompletná ošetrovateľská starostlivosť o imobilného pacienta, dekubity

Kategorie: Biológia (celkem: 964 referátů a seminárek)



Kompletná ošetrovateľská starostlivosť o imobilného pacienta, dekubity

KOS o imobilného pacienta, dekubity.

Ťažisko správnej ošetrovateľskej starostlivosti spočíva:
-v zabezpečení správnej ošetrovateľskej starostlivosti
-predchádzanie komplikácii z dlhodobého pobytu
-udržiavanie a zvyšovanie sebestačnosti chorého
Základná ošetrovateľská starostlivosť:
Posteľ chorého- musí mať pevnú, tvrdú podložku, potrebné sú ponorené zariadenia postele.
Poloha chorého- chorého pravidelne polohujeme, čím sa snažíme
predchádzať preležaninám.
Hygienická starostlivosť- dôležitá je hygiena posteľnej a osobnej
bielizne. Nalievanie ohrozených miest krémom.
Vyprázdňovanie- imobilní pacienti často trpia zápalom s následkom,
že sú pripútaný na lôžko. Podávame po dohovore s lekárom
glycerínové čipky. Prevencia preležanín- dôležitá je čistá koža, masírovanie tela, aby sa zlepšilo prekrvenie. Dôležitá je častá zmena polohy chorého, používanie antidekubitárnych pomôcok.
Prevencia obehových komplikácii- chorého treba nabádať, aby sám počas dňa aktívne pohyboval končatinami. V niektorých prípadoch lekár ordinuje bandáž DK.
Prevencia pľúcnych komplikácii- pľúca sa v ležiacej polohe slabšie ventilujú. Chorých ukladáme do zvýšenej polohy.
Pacientov, u ktorých nemožno dosiahnuť podstatné zlepšenie zdrav.
stavu ani po vyčerpaní všetkých liečebných prostriedkov sú odkázaní na dlhodobú ústavnú starostlivosť, sa umiestňujú v liečebniach pre dlhodobo chorých.

DEKUBITY

Dekubitus- preležanina- je miestne odumretie tkaniva- lokálna nekróza.
Stlačené sú tkanivá a cievy -najmä kapiláry a drobné žily. Cievy sa
zúžia, krvný prúd sa spomalí, až zastaví a vznikajú trombózy. Krv neprivádza v dostatočnom množstve a dostatočne rýchlo kyslík. Pre nedostatok kyslíka tkanivá postupne odumierajú, vzniká nekróza.
Miesta vzniku dekubitov:
Kožné dekubity postihujú najmä oblasti, kde sú kosti blízko povrchu kože – v PREDILEKČNÝCH MIESTACH:
v ľahu na chrbte- na tŕni 7.krčného stavcu, na lopatkách, lakťoch, v krížovej oblasti, na stehnách, na lýtkach, na vonkajšej strane stehna, nad kolenným kĺbom a na členku.
Príčiny vzniku dekubitu:
-mechanický tlak pôsobiaci na jedno miesto
-umenšenie odolnosti tkanív
-podráždenie kože vlhkosťou a nečistotou
-nervové poruchy
-srdcová insuficiencia
Klinický obraz:

1.sčervenané postihnuté miesto
2.pľuzgiere, po ich prasknutí vidieť spodné vrstvy pokožky, utváranie ložiskovej nekrózy –. červeno-fialové
3.nekrotické ložiská sa začínajú ohraničovať- tmavofilaové až čierne.

Suchá gangréna a vlhká gangréna
4.dekubitárny vred

Faktory ovplyvňujúce tvorbu preležanín
-vlhkosť- spôsobujú ju prítomnosť moču, potu, exkrétov. Zníži sa odolnosť kože. Vzniká hlavne u inkontinentného pacienta.
-hygiena- starostlivou hygienou sa zníži počet mikróbov v koži.
-výživa- pri neadekvátnej výžive dochádza k strate hmotnosti – redukuje sa vrstva medzi kosťou a kožou.
-telesná teplota- pri zvýšenej telesnej teplote je zvýšený metabolizmus a tým aj zvýšená potreba dávky kyslíku do buniek.
-anémie
-mobilita

Prevencia preležanín:

A, odstránenie vonkajších príčin: vhodná úprava lôžka, pravidelné polohovanie chorých, antidekubitárne podložky, starostlivosť o inkontinentného pacienta, pravidelná výmena osobného a posteľného prádla, pravidelné umývanie pacienta.
B, zvýšenie odolnosti kože: masáž, vhodné je kožu natierať viac krát denne, hlavne ohrozené miesta.
C, Zvýšenie celkovej odolnosti organizmu:
-liečba základného ochorenia
-podávanie stravy bohatej na vitamíny
-včasná rehabilitácia

Liečba dekubitov:
- v prvom štádiu sa môže robiť masáž
- v druhom štádiu sa snažíme zabrániť infekcii kožného defektu, dbáme na sucho a ochranu
pred mechanickým tlakom
- pri dekubitárnom vrede( 3.štádium)-nertokické tkanivo sterilne chirurgicky odstraňovať
- 4. štádium -ak je infekcia vredu, robí sa výter z rany na kultivácii, dekubitus chirurgicky ošetriť + lokálna a celtová liečba proti mikróbom =ANTIBIOTIKÁ.

dekubit
, | 09. dubna 2007
Už tretí rok liečim manželove dekubity,mal ich päť.Prvé sa mi podarilo po 9mesiacoch vyliečiť,na zadku bol už dvakrát zahojený a zase praskol,neviem si rady,náš oš.lekár na nás kašle-pomôžte mi!Manžel je po úraze hlavy,celkom bezvládny,inkont.,má kontraktúry a stým všetkým som ho vzala do dom.oš.,to všetko mu spôsobili v nemocnici v Komárne v r.2005 S pozdravom Droppanová
dekubit
, | 09. dubna 2007
Už tretí rok liečim manželove dekubity,mal ich päť.Prvé sa mi podarilo po 9mesiacoch vyliečiť,na zadku bol už dvakrát zahojený a zase praskol,neviem si rady,náš oš.lekár na nás kašle-pomôžte mi!Manžel je po úraze hlavy,celkom bezvládny,inkont.,má kontraktúry a stým všetkým som ho vzala do dom.oš.,to všetko mu spôsobili v nemocnici v Komárne v r.2005 S pozdravom Droppanová
Re: dekubit
aluša, | 29. června 2007
1.6.2007 si mamina zlomila nohu.Pre pľúcnu embóliu nebola operovaná a po piatich dní prišli dekubity.Dneska po polohovaní a liečení antibiotikami nevidno žiadne výsledky hojenia, naopak mám pocit že dekubity sú rozšírené po celom zadku. Ak máte akékoľvek skúsenosti s liečbou , prosímreagujte na môj článok. Budem vďačná za každú radu. Ďakujem Aluša
, | 08. října 2007
Viem čo je to opatrovať imobilného chorého doma a hlavne ak má nejaké komplikácie z imobility ako sú dekubity. Môžem Vám poradiť, aby ste sa obrátili na ošetrujúceho lekára a žiadali, aby Vám poslal sestru z Agentúry domácej ošetrovateľskej starostlivosti, ktorá Vám bude chodiť odborne ošetrovať dekubity denne.
Re: dekubity
Droppanová, | 29. ledna 2008
Tak isto už tri roky sa starám o imobilného,k lôžku pripútaného manžela,s dekubitmi,zatiaľ mi nikto nepomohol,a aj k nám na začiatku chodila jedna pani z ADOSU,ale nemôžem povedať,že nám pomohla-musela som ju vyhodiť!!!!
Re: dekubity
, | 17. února 2008
Milá pani prihláste sa u nás, poradíme vám. 100% istota.
Re: dekubity
Droppanová, | 24. března 2008
Dobrý deň,neviem,či to bolo pre mňa,na čo mám reagovať-ale som tu!
Re: dekubity
Droppanová, | 03. dubna 2008
Kde sa mám prihlásiť?Nechajte na seba kontakt alebo tu je môj:ruzena.droppanova@azet.sk
Re: dekubity
rr, | 10. srpna 2008
Dobra den, rada by som sa informovala, ci by ste mi mohli pomoct. starame sa o pacienta kt. je imobilny. Nema cit v celej lavej casti tela, nevie hybat s lavou rukou a lavou nohou.Vcera sme po 2.mesacnej hospitalizacii v nemocnici zbadali prve dekubity na stehne a lavom ramene. Pravdepodobne boli vzniknute zlou staroslivostou v nemocnici.Chcela by som sa spytat ake su moznosti, ci cez nejaku agenturu je vobec mozne ziadat aby mu bola pridelena osobka, kt. by nam odborne pomohla pri liecbe dekubitov.Dakujem
Re: dekubity
, | 14. května 2010
prosim vas poradte nam ako sa starat o imobilneho pacienta s dekubitmi
Re: dekubity
V.Stúpalová, | 07. června 2010
Pacienta treba polohovať minimálne každé 3 hodiny. Treba dbať o hygienu a prevenčne telo premasťovať. Ak je však už dekubit vytvorený, musí terapiu stanoviť odborník, bez vhodnej terapeutickej liečby totiž dekubit neuzavriete. Produkty k ošetreniu rán tiež nedostanete voľne v lekárni,je nutné ich predpísať.Zdravotníci z geriatrie, oddelení LDCH majú veľa skúseností. Z Trnavy a okolia pomôžem...
Re: dekubity
Droppanová, | 03. dubna 2008
Nášmu oš.lekárovi je jedno,ako sa cíti človek-upútaný na lôžko,minulý rok som mala niečo s chrbtom,ani pohnúť som sa nemohla,keď som mu vravela,nech mi zoženie niekoho z ADOSU-povedal mi,ako si to predstavujem,my sme od mesta ďaleko,tu nikto nepríde a vôbec sa nesnažil,aj s takými bolesťami som sa musela postarať o manžela,je to hnus-čo sú to za lekári a ešte si pýtajú zvýšenie platu?za čo?Dnas bola dcéra u zubára,za jednu plombu pýtal 900sk-,to sa im žije!!!
Re: dekubity
, | 18. listopadu 2008
Dobrý deŇ,nám sa osvedčil takýto postup. a/ ránu vyčistiť / Betadine/ b/ ranu natrieť mastičkou IRUXOL - MONO C/ prikriť gazou a nechať to podľa možnosti čím dlhhšie na vzduchu / bez naplsti / Osobne s naplasťami nemáme dobre skúsenosti lebo rána pod nimi len mokvá.
dekubity
benova, | 24. března 2008
dobry den mamina ma dekubit na zadku 4.stupna a uz to nedokazeme ustrazit stale sa to vzadsuje a uz sme pouzili vsetky dostupne liecby.nakolko mam trombozu jej to nemozu vystrihovat.da sa to nejak liecit s nejakyma bylinkami?dakujem
Re: dekubity
Droppanová, | 07. dubna 2008
Dobrý deň,skúste do toho striekať /Menalind-olej v spreji,vyplavia sa nečistoty a potom Biatain-náplasť s Ag-penová náplasť,vymývať s fiziologom-okolie osušiť,spojte sa s kožným lekárom alebo chirurgom.
Re: dekubity
, | 21. května 2008
Manželovi som vyliečila dekubit 4. stupna za 3 mesiace, tym ze som ho vyplachovala salviovym cajom, na ranu som davala nechtikovy gel a ranu som ozarovala biolampou. Trikrát denne. Na okolie rany, ktore sa hojilo som prikladala laliove listy namocene v alkohole, pripadne laliovy gel.
dekubity
Petra, | 13. dubna 2008
Dobry den. Prosim vas tiez o radu,ja opatrujem pani ktora ma dekubit 2stupna, cervena rana pluzgier sa vytvara. Teraz sme jej kupili matrac antidekubitovy,prosim vas o radu ako pokracovat s liecbou z hladiska higienickeho osetrovania.Dakujem
Re: dekubity
terezia, | 17. ledna 2009
Poprosim Vas o radu kde by som mohla kupit antidekubitárnu podložky popr. aj matrac a kolko to stoji DAkujem
Re: dekubity
Ruzena droppanova, | 22. dubna 2009
Dobry den,mala by som na predaj matrac aj s kompresorom,pekny den.
Re: dekubity
, | 10. května 2009
antidekubitárny matrac vám môže predpísať aj lekár k tomu určený. napríklad rehabilitačný lekár, najlepšie matrace sú s tvárovou pamäťou, mám pocit, že sa na ne niečo dopláca, ale len smiešna suma.
dekubity
Joja, | 14. května 2008
dekubity sa hoja veľmi ťažko to už vieme, treba vyrovnávať posteľnú plachtu ,meniť polohu aspoň každé 2hod cez deň-3 hod v noci.Miesta vystavené tlaku podkladať vzduchovými vankušikmi a potierať mentolovým liehom ./asi by som sa od bolesti po...pri vyššom stupni dekubitu , mentol na otvorenú ranu určite nie ale čo s dekubitom v horšom stupni keď je tkanivo otvorené a mokvá od hnisu 4 stupeň???? Odstrániť vlhkosť, dostatočná hygiena na neumytej pokožke sa zmnožujú baktérie, zhoršuje sa hojenie, podporovať stravovanie aby nenastal úbytok hmotnosti a nedostatok vitamínu c zhoršuje hojenie rán, horúčka potenie podporuje vznik dek.pomôcky proti dekubitom syntetické rúno, molitanové venčeky podhlavníky, kúpacie koleso, podložne koleso . 2 krát denne kúpať na posteli , alebo v sprche. /je to náročná práca najmä keď nevládze ani ten čo kúpe, ani ten čo je kúpaný/Masírovanie , polohovanie, potraviny s dostatkom vlákniny, podložnú misu podáme hneď na požiadanie /keď sa nestihne kolobeh s prezliekaním, kúpaním,natieraním, vysušením polohovaním kto to zvládne je super, no musí sa to spraviť . A hlavne pokiaľ sa pohybujeme, nesmieme ostať ležať ,pohyb , pohyb ,podporovať pohyb.No aj uľahčovať pohyb povzbudzovať k aktívnemu cvičeniu.
dekubity
jarka, | 28. října 2008
pred časom sme zabránili vzniku dekubitov švagrovi. Bol dlho ležiaci onkologocký pacient a to iste sa nám darí pri 87-ročnej svokre,ktorá má totálne zlú-slabú pokožku. 1,ak je možné hygiena pod tečúcou vodou-sprchovaním a namiesto akého koľvek mydla používame šampón na vlaswy, brezový, alebo pokryvový na poškodemé miesto.Po sprche kožu usušíme a bud roztokom betadíne, alebo liehom. poškodené miesto dezinfikujeme a bud v leže, alebo v sede podľa možnosti pacienta zadezinfikované miesto prykryjeme čistým uterákom a necháme čonajdlhšie voľné bez akejkoľvek náplaste čiže liečenie vzduchom. Potom okolie dekubitu natierame krémom MENALIND a samotný dekubit zas zadezinfikujeme a dávame náplaste na dekubity od kožnej lekárky.Taktiež používame čistiacu penu MENALIND a tiež olej MENALIDN= sú to naj...naj...najúčinnejšie prostriedky z lekárne. Ak nie je možná sprcha chorého tak umyvame telo napr. detskou plienkou. Taktiež dlhodobo prikladáme harmančekové obklady po objladoch zadezinfikujeme čiže zasušujeme a pokračujeme v ošetrovaní. Všdetky pomôcku musia byť vysosko sterilné
Re: dekubity
deli.b, | 23. září 2009
Menalindove pripravky su fakt velmi kvalitne pracujem v nemocnici kde tieto pripravky pouzivame, velmi kvalitne su aj tender Wety atrauman na liecbu dekubitov
dekubity
jarka, | 28. října 2008
pred časom sme zabránili vzniku dekubitov švagrovi. Bol dlho ležiaci onkologocký pacient a to iste sa nám darí pri 87-ročnej svokre,ktorá má totálne zlú-slabú pokožku. Ak je možné hygiena pod tečúcou vodou-sprchovaním a namiesto akého koľvek mydla používame šampón na vlaswy, brezový, alebo pokryvový na poškodemé miesto.Po sprche kožu usušíme a bud roztokom betadíne, alebo liehom. poškodené miesto dezinfikujeme a bud v leže, alebo v sede podľa možnosti pacienta zadezinfikované miesto prykryjeme čistým uterákom a necháme čonajdlhšie voľné bez akejkoľvek náplaste čiže liečenie vzduchom. Potom okolie dekubitu natierame krémom MENALIND a samotný dekubit zas zadezinfikujeme a dávame náplaste na dekubity od kožnej lekárky.Taktiež používame čistiacu penu MENALIND a tiež olej MENALIND= sú to naj...naj...najúčinnejšie prostriedky z lekárne. Ak nie je možná sprcha chorého tak umyvame telo napr. detskou plienkou. Taktiež dlhodobo prikladáme harmančekové obklady po obkladoch zadezinfikujeme čiže zasušujeme a pokračujeme v ošetrovaní. Všdetky pomôcku musia byť vysosko sterilné.Olejom MENALIND natierame celé telo. Pacient s dekubitami si vyžaduje 24 hodinový hygienický servis. Tým chcem povedať, že v nemocnici nám ho nikto nemôže zabezpečiť. Máme jedného pacienta a máme čo robiť. Predsdtavte si , že v nemocnici je ichminimálne 30. Ak je pacient v nemocnici nechodte len k lôžku pozerať, ale vyhrnte rukávy a aspoň raz denne mu urobte uvedenú hygienu.
dekubity
jarka, | 28. října 2008
neodmyslitelnou súčasťou liečenia sú antibiotika
zuzana, | 11. listopadu 2008
mam doma babku ktora sla do nemocnice po vlastnych s obycajnou bolestou v krizoch. vratila sa po mesiaci a pol sanitkou na posteli lebo nie je schopna urobit krok ani si sama sadnut na posteli. cely zivot bola zdrava, v nemocnici len pri porode, diagnozy ziadne a v nemocnici im nasli asi 10 diagnoz, sposobenych zlou liecbou doktorky neurologicky. v nemocnici zla osetrovatelska starostlivost, co uz. chcem sa opytat , babka ma v krizovej oblasti dekubit asi 3-4 stupna, v nemocnici jej to vyrezavali asi 5x. teraz je uz doma a chcem sa opytat, ci je mozne ju z toho dostat. ci existuje nejaka nadej na to ze sa z tych dekubitov dostane. na bokoch sa jej uz tvoria dalsie, prekladame ju ale je to tazke. da mi niekto nadej ze este babka bude zit plnohodnotny zivot ako predtym, hoc aj s dierou na zadku, ale aby nam nezomreli. lebo uz mi lezu na nervy vsetci ti doktori ktori tvrdia, ze zomru. nedokazem pochopit ako z uplnej vitality, behom 2 mesiacov mozu umriet!!! pomozte co a ako. urobila by som vsetko. ako sa o nich starat, co im davat na deku bit ako ho najlepsie liecit, aka strava pomaha, ake liecebne pripravky, v nemocnici im na to nedavali nic, a ja uz lekarom neverim. kto ma skusenosti oozvite sa prosim... dakujem zufala vnucka
Re: Prelezaniny
zdravotna sestra, | 13. listopadu 2008
Dobry den. Dekubity su vysledkom celkoveho zleho zdravotneho stavu.Preto, ak chcete liecit dekubity,prvoradne musite zlepsit zdravotny stav.Kedze ste neopisali presne o ake diagnozy sa jedna, su tu faktory,ktore ovplyvnuju vznik dekubitov: vlhkost(stolica,moc),zla hygienicka starostlivost,vyziva,nedostatok bielkovin,anemia,ochorenia srdca,ciev,cukrovka.Vo vseobecnych zasadach plati,ze musite zmiernovat mech. tlak na postihn. miesto,upravat postel-tzn.plachta musi byt napnuta,polohovanie- pri tazkom rozsiahlom dekubite kazdu 1/2 hodinu,pouzivat preventivne pomocky(pomozu vam v zdravotnickych potrebach a poistovna to uhradza).Miesta,kde este nevznikol dekubit a ktore nie su zacervenane mozte masirovat,cim sa lepsie prekrvi tkanivo.Dolezita je strava bohata na bielkoviny a vit.C.Ak osetrujete dekubit sama-prisne asepticke podmienky.Co sa tyka liecby,v dnesnej dobe uz existuju fantasticke pripravky a specialne naplaste na prelezaniny. Ide o hydrogelove naplaste,naplaste s obsahom striebra,ktore maju silne antibioticke ucinky a desiatky dalsich-napr.-urgosorb,agoplague. Naplaste sa daju objednat,mozno aj priamo kupit v zdrav.potrebach,ale su drahe a pri nespravnom vybere naplasti, by ste babke mohla teoreticky ublizit.Preto je dolezita spolupraca s lekarom. Povedzte mu,ze viete o tychto naplastiach a on na zaklade posudenia velkosti,stupna a charakteru prelezaniny urci vhodnu naplast.Ak vam ju predpise lekar,su uhradzane poistovnou. Vsetko to stoji vela sil,ale moznosti je stale dost.Drzim palce.
Re: dekubit
marek, | 21. listopadu 2008
Zdavim Ťa Zuzanka, problem preležanin sa da úspešne vyliečiť prir.produktami nem.spoločnosti za niekoľko dni. Prosim Ťa napiš mi na: marek.1@centrum.sk, podam Ti bližšie info aj všetkým, ktorých trápi táto nemoc. Samozrejme že bez vedľ.účinkov a ATB!!!
Re: dekubit
stolarikova lea, | 09. srpna 2009
Otec leži v nemocnici.na sedacej časti sa mu vytvoril dekubit.Prosim o radu
dekubity
hatalka, | 27. listopadu 2008
Ahojte, zdravím všetkých, ktorí bojujú s o zdravie svojich najbližších. Všetkým vám držím palce. Ja by som chcela tiež poprosiť o radu, pretože tento problém sa týka aj môjho brata. Je to mladý, čiastočne imobilný človek po ťažkom úraze. Teraz by už mohol rehabilitovať chôdzou s barlou, no dekubity na pätách mu to veľmi komplikujú.Dekubity vznikli hneď krátko po úraze, keď bol ešte v ohrození života.Postupne prešiel rôznymi oddeleniami a až na rehabilitačnom,keď začal chodiť ho začali päty bolieť a odlupovať sa odumretá koža.Dovtedy to boli \"suché\" dekubity.Postupne sa bolestivoť zvyšovala a aj okolie nekrózy sa zapálilo. Naša liečba spočívala v denných kúpeľoch piet v silnom odvare z repíka lekárskeho , obkladov z propolisu a 1xdenne ožarovania biolampou a masírovania zdravej časti chodidla. Viac sa cez návštevné hodiny stihnúť nedalo. To však rozvoju dekubitov nezabránilo. Denne na tých pätách chodil a cvičil. Mal pri tom obuté botasky. Po objavení sa prvých príznakoch zápalu okolitého tkaniva sme na radu chirurgičky, ešte vyskúšali kúpeľ v slanom roztoku. To však už bol objednaný na príjem na oddelenie chirurgie. Teraz je po chirurgickom odstránení nekrózy,prepustený domov.Kvôli infekcii dýchacich ciest užíva ATB. Neviete mi prosím poradiť ako ošetrovať takéto dekubity III.stupňa u chodiaceho pacienta? Je možné striedavo aplikovať hydrogélové náplaste a Ag náplaste. Ako je to s hygienou a sú možné aj kúpele v bylinkách? Ako často môžeme ožarovať biolampou a kedy po chirurgickom zákroku môžeme začať?
dekubit
Monika, | 28. ledna 2009
Tiez opatrujem 96 roc. starkeho. Na zaciatku mal devat dekubitov a ostali z toho dva. Odporucam pod pacientovu plachtu davat jeleniu alebo kozaciu, ci ovciu kozu, no nesmu byt hrce. Ta koza musi byt pekne vystreta. Nie je dobre pouzivat nafukovacie kolesa pod pacienta, molitanove podlozky a pod.(nam vznikali z nich este vacsie zapareniny.) Nam sa osvedcili vlastne vyrobene kolesa, podkovy, hady a to z latky sme usili podlozku a naplnili sme ju polysterinovymi gulkami. Dostat to aj v zdravotnych pomockach, no len v dvoch velkostiach bud kruh alebo had. Dolezite je sprchovanie a polohovanie. Neodporucam pouzivat laliu macanu v liehu. Aj nam pomaha zdravotna sestra, ktoru nam odporucil obvodny lekar. Na liecenie pouzivame viacero pripravkov, zavisi to od dekubitov. Ak by niekto chcel viacej informacii, ci si ich navzajom vymenit. napiste na crazypat@centrum.sk
Dekubit
Stolarikova Lea, | 09. srpna 2009
Otec leži v nemocnici. Na sedacej časti sa mu vytvoril dekubit.Odumreté tkanivo mu chirurgicky odstraňujú.každý druhý deň mu vymieňajú naplasti Tender Vet. Druhý dekubit sa mu začal tvoriť na boku,tkanivo je tmavo červené. Zatiaľ ho natierame a používame lampu bioptron. podávajú mu antibiotika. Prosím o radu. Lea
vakuova metoda
ross, | 20. září 2009
ma niekto skusenosti s liecbou dekubitov vakuovou metodou?
, | 26. září 2009
najlepsie je polohovat, vyuzivat vsetky mozne antidekubitne pomocky, hydratovat, masirovat a nespoliehat sa ze ked je niekto v nemocnici tak je vsetko v poradku. A ked budete doma pokracovat v liecbe, myslim ze sestricky vam ochotne vysvelia co a ako, a hlavne spolupracovat s chirurgom a nespoliehat sa na obvodneho lekara.
, | 12. listopadu 2009
ja
presnante!
Daniel-74, | 27. května 2010
dekubity su katastrofa a niektori tu davate uplne scestne, nerealne rady najme co sa tyka ist k obvodakovi alebo volat ADOS malo by sa to tu zmazat :((
V.Stúpalová, | 07. června 2010
Polohovanie,hygiena,podkladanie kúpacieho kolesa, premasťovanie sú spôsoby, ktorými predchádzame vzniku dekubitov!!!!!!!! Ak však je už dekubit vytvorený, NEAPLIKUJTE prosím metódy, ktoré pomohli na podobnú ranu niekomu inému! Každý dekubit môže byť iného charakteru a nevhodnou terapiou môžete stav pacienta zhoršiť. Dekubit môže byť iného stupňa a aj sa inak prejavovať. Pacient tiež môže byť alergický na niektorú zložku toho - ktorého prípravku.Najvhodnejšia je naozaj konzultácia lekára, avšak obvodný lekár sa tak často neocitá v podobnej situácii, preto by som volila geriatriu, oddelenie LDCH v príslušnom meste - nemocnici. Pokúste sa tu konzultovať problém s lekárom, prípadne na určitý čas pacienta hospitalizovať s účelom preliečenia dekubitu.Osobne viem odporučiť vhodnú liečebňu...
Re:
Azbeta, | 20. září 2010
Osetrovanie dekubitov sestrou z ADOS
lekar, www.harris.sk | 24. prosince 2010
Vsetkym, ktori si nevedia rady s osetrovanim otvorenych ran ci dekubitov u svojich blizkych v domacom prostredi odporucam nakontaktovat sa na najblizsiu ADOS- agenturu domacej osetrovatelskej starostlivosti (najdete ich napr. aj na http://www.aposs.zzz.sk/?page=adosy). Pracuju tam skusene sestry, ktore maju s osetrovanim ran skusenosti, a navstevuju pacientov doma a osetruju ich. U imobilnych alebo ciatocne imobilnych pacientov je tato sluzba plne hradena zo zdravotneho poistenia.
, | 01. března 2015
Sylvester
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West Ham win race for Nordtveit? The Sun reports that West Ham are set to sign Havard Nordtveit on a free transfer, after Borussia Monchengladbach have confirmed that the midfielder has chosen not to extend his current deal. The 25-year-old has been a subject of interest for multiple Premier League clubs, including Everton, Tottenham and Southampton, but is believed to have his eyes set on a move to East London.
A defensive midfielder by trade but also able to fill in at centre-half, Nordtveit will provide depth in key areas for the Hammers, as the futures of Alex Song and James Collins are far from certain. The Norwegian spent three years at Arsenal, even captaining their reserve side, and will count as a homegrown player for West Ham's Premier League quota next season.
Everton boss Roberto Martínez says in the Guardian that losing star striker Romelu Lukaku would be a "sign of the modern game." - Borussia Monchengladbach want to sign Chelsea's Andreas Christensen on a permanent deal when his two-year loan expires this summer. The Mirror says the 19-year-old has impressed this season, and the German club could fork out £4m in a bid to keep him outright.
Zlatan Ibrahimovic has told beIN Sports that "for the moment" he will not be at Paris Saint-Germain next season after his four goals helped the club seal the Ligue 1 title with a 9-0 romp at Troyes. Ibrahimovic, out of contract at the end of the season, has been linked with a move to the Premier League.
The Sweden international said: "I have always had a good relationship with the fans. With the club, they always took care of me. "I have always had great relationship with everybody, no question about it. But, for the moment, I am not at PSG next year. "I have one-and-a-half months to stay here. I will enjoy it while I'm still here. What happens next year, I don't know -- but for the moment, I will not be here."
The 34-year-old ended his postmatch interview by joking: "I don't believe they can change the Eiffel Tower for my statue, even the people behind the club. "But if they can, I will stay here -- I promise you." PSG president Al-Khelaifi, also quoted by beIN Sports, said the club wants Ibrahimovic, who has scored 101 Ligue 1 goals for the team, to stay. "Paris is magic. Ibra is magic. We want Zlatan to stay," he said. "We will speak with him." The presiden
PULIS TO PAY UP Some breaking news for you, West Brom boss Tony Pulis has been ordered to pay more than £3.5m after the Premier League has ruled against him in a dispute with Crystal Palace and Steve Parish. Part of this is an approximate £2m bonus he was given for keeping the club in the top flight in 2014.
O'NEILL DELIGHTED WITH NEW DEAL Northern Ireland manager Michael O'Neill says he is delighted at signing a new four-year deal with Northern Ireland and says preparations for Euro 2016 are going well...
BENTEKE TO WEST HAM? Out-of-favour Liverpool forward Christian Benteke has been offered to West Ham United, according to the Liverpool Echo. The report suggests the Hammers are looking to bring in a new striker next season and are keen on Benteke.
CHELSEA TO BATTLE UNITED FOR FLORENZI Earlier we told you Man Utd are interested in signing versatile Roma player Alessandro Florenzi this summer. Tuttomercatoweb.com says the Red Devils are believed to be willing to pay as much as £24m for the Italy international, who has a contract at the Stadio Olimpico until the end of June 2019. However, according to the Daily Express, Chelsea will battle it out with United to sign Florenzi.
PL CLUBS BATTLE FOR TER STEGEN Liverpool will face competition from rivals Manchester United in the race to sign Barcelona goalkeeper Marc-Andre Ter Stegen this summer, according to the Liverpool Echo.
UNITED IN FOR KENT? Sheffield United are running their eye over young Liverpool winger Ryan Kent, reports The Star.
Asked by Sky Sports' Geoff Shreeves what he thinks of the public's perception of him, Sterling insists he was focused on what was best for his career, and revealed his biggest critic can actually be his mother.
He said: "The main [comment] on my Instagram is the snake sign - that's the biggest one so far - and someone that loves money, hungry for money.
"Realistically, I am trying to improve as a player and that's the most important thing for me and for my development. I just did what I thought was best for my career at that moment in time."
VILLA TIGHT-LIPPED ON GARDE Aston Villa chairman Steve Hollis has refused to confirm whether Remi Garde will be Aston Villa manager next season.
Speaking to Sky Sports News HQ, Hollis said: "I'm leaving it to the football side of the board to work through what's going to work and when they come up with their recommendations, which should be in the next week or so, we will share more." When pressed on Garde's future, he added: "Let's see where the review goes. We are giving the due time it needs so we can make informed decisions."
Julie, http://astonvilla-watford.com | 20. března 2016
Speaking to Sky Sports News HQ, Hollis said: "I'm leaving it to the football side of the board to work through what's going to work and when they come up with their recommendations, which should be in the next week or so, we will share more." When pressed on Garde's future, he added: "Let's see where the review goes. We are giving the due time it needs so we can make informed decisions."
HENDRY JOINS SHREWS Shrewsbury Town have announced the signing of Jack Hendry on loan from Wigan Athletic until the end of the campaign.
BOLANOS TO SWANS? Swansea are keen to sign £6m-rated forward Miller Bolanos from Gremio, Sky Sports understands. The clubs have entered into talks with the Premier League strugglers believed to be keen to wrap up a deal for the Ecuador striker. Championship promotion hopefuls Brighton were heavily linked to the 25-year-old, alongside Gremio's Brazilian rivals Corinthians, over the winter.
WHO’S PLAYING WHEN? With a busy week of international football ahead, we look at which rumoured Premier League transfer targets will be in action.
GARY GOES TO DONNY Scunthorpe United winger Gary McSheffrey has joined Doncaster Rovers on loan until the end of the season. McSheffrey, who cost Birmingham City £4m in 2006, has struggled to nail down a first-team place at the Iron.
‘HE’D LOVE LAZIO MOVE’ Emanuele Giaccherini’s agent has said the Italian international would love a move from Sunderland to Lazio in the summer. The winger has impressed during his season-long loan back in Serie A at Bologna after being frozen out in England. His agent Furio Valcareggi told Lalaziosiamonoi.it: “On June 30 Emanuele will return to Sunderland, where he signed a four-year contract.
NO MORE ADDITIONS FOR DYCHE Burnley manager Sean Dyche has said he won't add any more players to his squad ahead of tomorrow's loan window deadline, according to the Lancashire Telegraph. The Clarets are currently top of the Sky Bet Championship table and unbeaten in the last seven league games, with the boss saying of possible additions:
ROB BACK WITH ROBINS Reading youngster Rob Dickie has rejoined National League table toppers Cheltenham Town on loan until the end of the season, after playing 22 times for the Robins earlier this term.
ROONEY v IBRA Manchester United midfielder Juan Mata has said he would welcome Zlatan Ibrahimovic at the club next season. The Swedish star has previously hinted he will be on his way to the Premier League this summer, but could he fit in at Old Trafford? And, in particular, would he be able to play in the same side as Wayne Rooney?
UNITED LINKED TO EMBOLO Manchester United have been linked with a move for talented Switzerland forward Breel Embolo, says the Manchester Evening News. He has made 47 appearances and scored 16 goals for Basel since making his professional debut in March 2014, with Wolfsburg making a late €27m bid for the 19-year-old in the January transfer window – but were rejected by the Swiss club.
HAMMERS WANTED 'SEXY FOOTBALL West Ham wanted Chelsea target Antonio Conte for 'sexy football' before Slaven Bilic, according to the London Evening Standard. Hammers owner David Sullivan says he tried to lure the Italy manager to east London after the departure of Sam Allardyce last summer, but doesn’t regret his eventual choice, adding:
NAPOLI ALSO WANT IBRA Watch out Manchester United, Napoli are considering moving for Zlatan Ibrahimovic should Gonzalo Higuain leave in summer, according to Tuttosport.
ZLAT LINKED WITH UTD Manchester United are planning a summer move for Zlatan Ibrahimovic and are ready to offer him £250,000-a-week, according to the Daily Star. The 34-year-old will be a free agent in June after failing to agree a new deal with Paris St-Germain.
Xavi believes Leicester's Riyad Mahrez is good enough to play for Barcelona following his impressive season in the Premier League. Barcelona legend Xavi, now playing in Qatar for Al Sadd, says Mahrez could play for the La Liga leaders in the future, while admitting he hadn't heard of the Algerian before this season. "He is a very good player," Xavi told Al Araby Al Jadeed. "He suddenly came to my attention this season, I didn't know about him before, but this season he has blown up."
Roma have reportedly slapped a £35m price-tag on midfielder Radja Nainggolan, who is a possible target for Chelsea and Manchester United. (Daily Express)
Manchester United playmaker Juan Mata has been linked with a shock move to Turkish side Fenerbahce. (Daily Express)
Antonio Conte has suggested he would be keen to bring Arturo Vidal to Chelsea when he takes over. (Evening Standard)
Alvaro Morata has professed himself open to the possibility of a move to the Premier League amid reports that have thrown his future at Juventus into doubt. (Evening Standard)
Aymeric Laporte's proposed move to Manchester City could be in doubt after he suffered an ankle injury playing for France under 21s. (Manchester Evening News)
WBA GRILL BREMEN West Brom are considering an approach for Werder Bremen talent Florian Grillitsch this summer, according to reports in Germany. Big things are expected of Grillitsch and he could be availiable at a cut down price if Werder suffer relegation this season.
BILIC CONTRACT TALK West Ham are planning to reward manager Slaven Bilic with a new contract – but won’t make a final decision until January.
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“What makes the desert beautiful,' said the little prince, 'is that somewhere it hides a well...”
“When people don't express themselves, they die one piece at a time.”
“If people refuse to look at you in a new light and they can only see you for what you were, only see you for the mistakes you've made, if they don't realize that you are not your mistakes, then they have to go.”
“If you think you are too small to make a difference, try sleeping with a mosquito.”
“Anyone can hide. Facing up to things, working through them, that's what makes you strong.”
“Letting go means to come to the realization that some people are a part of your history, but not a part of your destiny.”
“In the end these things matter most: How well did you love? How fully did you live? How deeply did you let go?”
“What do we live for, if it is not to make life less difficult for each other?”
“Go on with what your heart tells you, or you will lose all.”
“When one tugs at a single thing in nature, he finds it attached to the rest of the world.”
“All parents damage their children. It cannot be helped. Youth, like pristine glass, absorbs the prints of its handlers. Some parents smudge, others crack, a few shatter childhoods completely into jagged little pieces, beyond repair.”
“I kept always two books in my pocket, one to read, one to write in.
“Change will not come if we wait for some other person, or if we wait for some other time. We are the ones we've been waiting for. We are the change that we seek.”
“Kindness is a language which the deaf can hear and the blind can see.”
“It's not the size of the dog in the fight, it's the size of the fight in the dog.”
“The purpose of life is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience.”
“The only way that we can live, is if we grow. The only way that we can grow is if we change. The only way that we can change is if we learn. The only way we can learn is if we are exposed. And the only way that we can become exposed is if we throw ourselves out into the open. Do it. Throw yourself.”
“I will love you always. When this red hair is white, I will still love you. When the smooth softness of youth is replaced by the delicate softness of age, I will still want to touch your skin. When your face is full of the lines of every smile you have ever smiled, of every surprise I have seen flash through your eyes, when every tear you have ever cried has left its mark upon your face,I will treasure you all the more, because I was there to see it all. I will share your life with you, Meredith, and I will love you until the last breath leaves your body or mine.”
“Great heroes need great sorrows and burdens, or half their greatness goes unnoticed. It is all part of the fairy tale.”
“I'd rather be hated for who I am, than loved for who I am not.”
“please believe that things are good with me, and even when they're not, they will be soon enough. And i will always believe the same about you.”
“My concern is not whether God is on our side; my greatest concern is to be on God's side, for God is always right.”
“A woman's heart should be so hidden in God that a man has to seek Him just to find her.”
“Trees that are slow to grow bear the best fruit.”
“Lack of direction, not lack of time, is the problem. We all have twenty-four hour days.”
“Never be bullied into silence. Never allow yourself to be made a victim. Accept no one's definition of your life, but define yourself.”
“What's terrible is to pretend that second-rate is first-rate. To pretend that you don't need love when you do; or you like your work when you know quite well you're capable of better.”
“Once you have read a book you care about, some part of it is always with you.”
“The brick walls are there for a reason. The brick walls are not there to keep us out. The brick walls are there to give us a chance to show how badly we want something. Because the brick walls are there to stop the people who don’t want it badly enough. They’re there to stop the other people.”
“If we listened to our intellect we'd never have a love affair. We'd never have a friendship. We'd never go in business because we'd be cynical: "It's gonna go wrong." Or "She's going to hurt me." Or,"I've had a couple of bad love affairs, so therefore . . ." Well, that's nonsense. You're going to miss life. You've got to jump off the cliff all the time and build your wings on the way down.”
“Incredible change happens in your life when you decide to take control of what you do have power over instead of craving control over what you don't.”
“We never know the quality of someone else's life, though we seldom resist the temptation to assume and pass judgement.”
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“The starting point of all achievement is DESIRE. Keep this constantly in mind. Weak desire brings weak results, just as a small fire makes a small amount of heat.”
“It's not what you look at that matters, it's what you see.”
“I am a part of all that I have met.”
“There is nothing more dreadful than the habit of doubt. Doubt separates people. It is a poison that disintegrates friendships and breaks up pleasant relations. It is a thorn that irritates and hurts; it is a sword that kills.”
To-morrow, and to-morrow, and to-morrow, Creeps in this petty pace from day to day, To the last syllable of recorded time; And all our yesterdays have lighted fools The way to dusty death. Out, out, brief candle! Life's but a walking shadow, a poor player, That struts and frets his hour upon the stage, And then is heard no more. It is a tale Told by an idiot, full of sound and fury, Signifying nothing.”
“I must be a mermaid, Rango. I have no fear of depths and a great fear of shallow living.”
“Atticus, he was real nice." "Most people are, Scout, when you finally see them.”
“All thinking men are atheists.”
“A man who dares to waste one hour of time has not discovered the value of life.”
“If we have no peace, it is because we have forgotten that we belong to each other.”
“Courage isn't having the strength to go on - it is going on when you don't have strength.”
“Stepping onto a brand-new path is difficult, but not more difficult than remaining in a situation, which is not nurturing to the whole woman.”
“If you want to be happy, be.”
“The desire to reach for the stars is ambitious. The desire to reach hearts is wise.”
“I just want you to know that you’re very special… and the only reason I’m telling you is that I don’t know if anyone else ever has.”
“Jane, be still; don't struggle so like a wild, frantic bird, that is rending its own plumage in its desperation." "I am no bird; and no net ensnares me; I am a free human being, with an independent will; which I now exert to leave you.”
“No matter how plain a woman may be, if truth and honesty are written across her face, she will be beautiful.”
“My only advice is to stay aware, listen carefully, and yell for help if you need it.”
“I have never met a man so ignorant that I couldn't learn something from him.”
“Keep your face always toward the sunshine - and shadows will fall behind you.”
“No matter how your heart is grieving, if you keep on believing, the dreams that you wish will come true.”
“The real heroes anyway aren't the people doing things; the real heroes are the people NOTICING things, paying attention.”
“Never look back unless you are planning to go that way.”
“For me, I am driven by two main philosophies: know more today about the world than I knew yesterday and lessen the suffering of others. You'd be surprised how far that gets you.”
“Change the way you look at things and the things you look at change.”
“Many of life's failures are people who did not realize how close they were to success when they gave up.”
“If your feet are firmly planted on the ground you'll never be able to dance.”
“We travel, some of us forever, to seek other states, other lives, other souls.”
“For like a shaft, clear and cold, the thought pierced him that in the end the Shadow was only a small and passing thing: there was light and high beauty for ever beyond its reach.”
“For like a shaft, clear and cold, the thought pierced him that in the end the Shadow was only a small and passing thing: there was light and high beauty for ever beyond its reach.”
“For like a shaft, clear and cold, the thought pierced him that in the end the Shadow was only a small and passing thing: there was light and high beauty for ever beyond its reach.”
“Believe you can and you're halfway there.”
“The best things in life make you sweaty.”
“Just be yourself, there is no one better.”
“I may not always be with you But when we're far apart Remember you will be with me Right inside my heart”
“And out of that hopeless attempt has come nearly all that we call human history—money, poverty, ambition, war, prostitution, classes, empires, slavery—the long terrible story of man trying to find something other than God which will make him happy.”
“Never dull your shine for somebody else.”
“When you arise in the morning think of what a privilege it is to be alive, to think, to enjoy, to love ...” ― Marcus Aurelius, Meditations
“I have a dream that one day little black boys and girls will be holding hands with little white boys and girls.”
“Amateurs sit and wait for inspiration, the rest of us just get up and go to work.”
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Loan, | 29. července 2016
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Loan, | 29. července 2016
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