| Abstract | Cilj: Cilj je rada prikazati proces zdravstvene njege utvrđivanjem stanja, potreba i problema te zbrinjavanje dojenčeta koje je zbog aspiracije hrane u dišni put hospitalizirano na Klinici za pedijatriju KBC-a Osijek.
Opis slučaja: Dojenče dobi jedanaest mjeseci primljeno je na odjel zbog sumnje na aspiraciju hrane. Tijekom hranjenja dojenče je počelo plaviti, kašljati i hroptati. Uz pozitivne anamnestičke podatke radiološki je utvrđena prisutnost stranog tijela u dišnim putovima. Nakon bronhoskopije razvijaju se komplikacije (emfizem i pneumotoraks) te se dojenče zbrinjavalo u PJIL-u. Do sedmog dana boravka bilo je u induciranoj komi, na mehaničkoj ventilaciji, uz primjenu totalne parenteralne prehrane. Prepoznati su slijedeći problemi iz područja zdravstvene njege: neučinkovito disanje dojenčeta, smanjena prohodnost dišnih putova, neučinkovit obrazac hranjenja dojenčeta, bol, visok rizik za infekciju, visok rizik za dekubitus, poremećaj obrasca spavanja i anksioznost roditelja. Provođene su sve intervencije u skladu s planiranim ciljevima uz načelo individualizacije. Poboljšanjem općeg stanja dojenčeta postupno se smanjuje analgosedacija te se dojenče odvaja od mehaničke ventilacije. Dojenče je nadalje dobrog općeg stanja, samostalno diše i unosi hranu na usta, bez razvoja komplikacija. Dojenče se sedamnaesti dan nakon prijama otpušta kući.
Zaključak: Prikaz dojenčeta hospitaliziranog zbog aspiracije hrane ukazuje na primjer teškog oblika slučaja aspiracije koje je neposredno ugrozilo život djeteta uz potrebu za vrlo invazivnim i intenzivnim postupcima zdravstvene skrbi. Takav nepredvidiv razvoj i prognoza ishoda stanja djeteta te iznimno zahtjevan opseg zdravstvene njege iznimni su izazovi za medicinske sestre koje skrbe o dojenčetu. |
| Abstract (english) | Objective: The objective of the paper is to present the condition, needs and problems of an
infant who was hospitalized at the pediatric clinic of KBC Osijek due to aspiration of food into
the respiratory tract through the health care process.
Case description: An eleven-month-old infant was admitted for suspected food aspiration.
According to the data from the medical history, his father was feeding him with moussaka,
during feeding he started turning blue, coughing, and wheezing. In addition to positive
anamnestic data, the presence of a foreign body in the respiratory tract was radiologically
proven. Complications developed after bronchoscopy; emphysema and pneumothorax and was
treated at PJIL. The infant was in an induced coma for the next seven days, on mechanical
ventilation, with total parenteral nutrition. Continuous assessment of respiratory and
hemodynamic status, gas analysis and biochemical tests were carried out. The following
problems occurred: inefficient respiration of the infant, reduced air flow through respiratory
tract, inefficient feeding pattern, pain, high risk of infection, high risk of decubitus, sleeping
disorder and increased anxiety in parents. All interventions were carried out as planned paying
attention to the individual needs of the infant. As the infant's general condition improves,
analgosedation is gradually reduced and he is weaned off mechanical ventilation. The infant is
conscious, his vital parameters are in order, he takes food by enteral route, without the
development of possible complications. Eupneic, normohydrated, in good general condition,
regular breathing noise, without the presence of secretions, he was discharged home on the
seventeenth day of his stay.
Conclusion: The case of the hospitalized infant due to aspiration of food into the respiratory
tract shows a severe example of aspiration, which has endangered the infant’s life, with the
need for very invasive and intensive health care procedures. The unpredictable development
and prognosis of disease outcomes and the extremely demanding scope of health care are
challenges for nurses. |
