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ZDRAVSTVENA VZGOJA STARŠEV OTROK Z GASTROSTOMO HEALTH EDUCATION OF PARENTS OF CHILDREN WITH
GASTROSTOMY
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9ãWLULKGRSHWLKGQHKVRVWDUãLXVSRVREOMHQL]DVDPRVWRMQRQHJRYDQMHRWURNDYGRPDþHPRNROMX2ERGSXVWX dobijo pisna navodila o negi otroka po perkutani vstavitvi gastrostome.
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ABSTRACT
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+UDQMHQMH MH HQD QDMSRPHPEQHMãLK RVQRYQLK åLYOMHQMVNLKIXQNFLM3ULRWURNXMHSUDYLOQRKUDQMHQMH pomembno zaradi ustreznega razvoja in rasti.
0QRJHRWURNHMH]DUDGLKXGHNURQLþQHEROH]QLWHåNR hraniti oziroma se niso sposobni sami prehranjevati VNR]L XVWD 9 WHP SULPHUX MH SRWUHEQR HQWHUDOQR KUDQMHQMH 3UL SULþDNRYDQHP GDOMãHP HQWHUDOQHP KUDQMHQMX RWURND MH QDMSULPHUQHMãD SHUNXWDQD HQGRVNRSVNDJDVWURVWRPD
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=]GUDYVWYHQRY]JRMRVNXãDPRYSOLYDWLGDVHVWDUãL razvijejo v aktivne ljudi. Definicij zdravstvene Y]JRMHMHYHþYHQGDUMHYVHPVNXSQRSRXGDUMDQMH SURFHVD XþHQMD ] REOLNRYDQMHP SR]LWLYQLK VWDOLãþ QDYDG WHU REOLN REQDãDQMD /DKNR EL UHNOL GD MH ]GUDYVWYHQD Y]JRMD SURFHV V SRPRþMR NDWHUHJD VH SRVDPH]QLNL LQ VNXSLQH XþLMR UDYQDWL WDNR GD NUHSLMRRKUDQMDMRLQXYHOMDYOMDMR]GUDYMH
INDIKACIJE ZA PERKUTANO ENDOSKOPSKO GASTROSTOMO
=DUDGL QRYLK PRåQRVWL ]GUDYOMHQMD KXGR EROQLK RWURN VH YHþD ãWHYLOR RWURN NL SRWUHEXMHMR JDVWUR- stomo. Razdelimo jih glede na vrsto indikacije v tri YHþMHVNXSLQH
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=GUDYOMHQMH]GLHWQRSUHKUDQRNLWUDMDYHþNRWPHVHF GQLMHODKNRLQGLNDFLMD]DYVWDYLWHYJDVWURVWRPHSUL naslednjih boleznih:
• NHWRJHQDGLHWDSUL]GUDYOMHQMXHSLOHSVLMH
• GLHWDSUL]GUDYOMHQMXHR]LQR¿OQHHQWHURSDWLMH
• GLHWDSUL]GUDYOMHQMX&KURQRYHEROH]QLLQGUXJR
=GUDYQLNLYVRGHORYDQMXVVWDUãLSULYVDNHPRWURNX SRVHEHM SUHWHKWDMR GRGDWQH GHMDYQLNH QH JOHGH QD indikacijo za vstavitev hranilne sonde. Pomembni GHMDYQLNLVRYUVWDLQQDSRYHGL]LGDEROH]QLNOLQLþ- QRVWDQMHRWURNDSULþDNRYDQLXþLQHNHQWHUDOQHSUH- KUDQH QD NDNRYRVW åLYOMHQMD RWURND PQHQMH RWURND LQVWDUãHYRSRVHJXWHUHWLþQDYSUDãDQMD
PRIPRAVA OTROKA IN STARŠEV NA PERKUTANO ENDOSKOPSKO GASTROSTOMO
=GUDYQLN JDVWURHQWHURORJ HQGRVNRSLVW SUL SUYHP pregledu otroka za vstavitev perkutane endoskop-
VNH JDVWURVWRPH VWDUãH LQ RWURND QDWDQþQR VH]QDQL V SUHGODJDQLP SRVHJRP ] PRUHELWQLPL ]DSOHWL WHU s prednostmi perkutane endoskopske gastrostome.
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IZVEDBA POSEGA
3RVHJL]YDMDPRYVSORãQLDQHVWH]LML=GUDYQLNHQ- GRVNRSLVW L]YHGH JDVWURVNRSLMR V NDWHUR XJRWRYL SUHKRGQRVWLQVWDQMHVOX]QLFH]JRUQMLKSUHEDYLOäH- ORGHFQDSROQL]]UDNRPLQSUHVYHWOLåHORGþQRVWHQR 6NXSDM]GUXJLP]GUDYQLNRPNLRSHULUDGRORþLWD PHVWR YVWDYLWYH VWRPH NL JD RSHUDWHU WXGL R]QDþL Mesto vstavitve gastrostome je najpogosteje tik ob HSLJDVWULMXSRGOHYLPUHEUQLPORNRP3RVHJMH L]YHGHQKLWURPDQMLQYD]LYQRLQWXGLEROMYDUQRNRW ELELODNLUXUãNDYVWDYLWHYJDVWURVWRPH
ZDRAVSTVENA NEGA OTROKA IN ZDRAVSTVENA VZGOJA STARŠEV PO POSEGU
Ko MH RWURN YLWDOQR VWDELOHQ VH YUQH QD EROQLãNL RGGHOHNNMHUQDGDOMXMHPR]GUDYVWYHQRQHJRRWURND LQ]GUDYVWYHQRY]JRMRVWDUãHY6WDUãLVRQDRGGHONX GHMDYQR YNOMXþHQL Y XVSRVDEOMDQMH ]D VDPRVWRMQR negovanje in hranjenje po gastrostomi.
1DVOHGQMLK QHNDM GQL RWURN RVWDQH Y EROQLãQLFL RGYLVQR RG KUDQMHQMD LQ SRþXWMD 9 WHP þDVX MH SRWUHEQR VWDUãH QDXþLWL SULSUDYOMDWL LQ VKUDQMHYDWL KUDQR KUDQLWL SR JDVWURVWRPL þLVWLWL SULERU QHJRYDWL NRåR RNROL JDVWURVWRPH LQ SUHSR]QDYDWL WHUSUDYRþDVQRXNUHSDWLRE]DSOHWLK
KAKO BODO STARŠI NEGOVALI OTROKA DOMA?
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0HGLFLQVND VHVWUD VWDUãHP SRMDVQL GD MH SRWUHEQR RNROLFR YVWRSQHJD PHVWD GQHYQR RþLVWLWL LQ RSD]RYDWL9SUYLKGYHKWHGQLKSRSRVHJXNRUDQD ãH QL ]DFHOMHQD VR ]ORåHQFL QXMQR SRWUHEQL9 WHP þDVX VH RWURN QH VPH WXãLUDWL .R MH UDQD VXKD LQ ]DFHOMHQD]ORåHQFLQLVRYHþSRWUHEQL7DNUDWODKNR VWDUãLRWURNHWXGLWXãLUDMRR]LURPDNRSDMR
• 3UHG QHJR NRåH VL MH SRWUHEQR WHPHOMLWR XPLWL URNH]YRGRLQPLORP
• 6WDUD SUHYH]D VH RGVWUDQL 3RWUHEQR MH GREUR opazovati okolico stome. Posebno pozornost SRVYHþDPREROHþLQLREþXWOMLYRVWLUGHþLQLRWH- NOLQL]HOHQHPXDOLUXPHQHPXL]FHGNXL]VWR- malne odprtine. Minimalen iztok je normalen
• .RåDVHRþLVWLVWRSORYRGRLQUD]WRSLQREODJHJD PLOD 3RPHPEQR MH GD VH RþLãþHQL GHOL GREUR SRVXãLMRGDQHSULGHGRRNXåEHNRåH
3UL ]PHGHQLK QHPLUQLK RWURFLK NL EL FHYNR ODKNR L]SXOLOL PRUDMR VWDUãL VWRPR ]DãþLWLWL ] ]ORåHQFHP DOL]PUHåLFR
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Pred hranjenjem si je treba vedno temeljito umiti roke. Preveri se prehodnost sonde in izmeri ]DRVWDQHN KUDQH Y åHORGFX EUL]JDOND VH VSRML ] åHORGþQRVRQGRQDWRSDVHSRYOHþHYDQMRåHORGþQD vsebina.
Aspirirano hrano je treba vedno ponovno vbrizgati QD]DMYåHORGHFGDQHSULGHGRL]JXEHHOHNWUROLWRY in hranilnih vrednosti.
ýHMHåHORGþQDYVHELQDNLVHDVSLULUDYHþMDRG POMHYVHELQRSRWUHEQRYUQLWLYåHORGHFLQSUHORåLWL KUDQMHQMH]DGYHXUL9SULPHUXGDMHSRGYHKXUDK ]DRVWDQHN KUDQH Y åHORGFX ãH YHGQR YHþML RG POKUDQMHQMHRGORåLPRãH]DGYHXULýHVH]JRGL HQDNR ãH Y WUHWMHP SRL]NXVX MH WUHED SRNOLFDWL ]GUDYQLND
6RQGR VSHUHPR V WRSOR YRGR DOL ] QHVODGNDQLP þDMHP V þLPHU ]DJRWRYLPR SUHKRGQRVW VRQGH (sondo je potrebno sprati tudi pred in po dajanju ]GUDYLO 1LNROL SD VH FHYND QH VPH SUHEUL]JDYDWL V VLOR .ROLþLQD YRGH MH RGYLVQD RG RWURNRYH VWDURVWLýHVHFHYND]DPDãLMHSRWUHEQRREYHVWLWL zdravnika.
6OHGL KUDQMHQMH NL VH ODKNR L]YHGH Y EROXVX V
PLOLOLWUVNREUL]JDONR0HGSROQMHQMHPEUL]JDONH FHYNRYHGQR]DSLUDPR+UDQMHQMHQDMSRWHNDSRþDVL þDVKUDQMHQMDQDMERSULEOLåQRWDNRGROJNRWMHSUL QDYDGQHPKUDQMHQMXSUHNRXVWWRMHSULEOLåQR±
PLQXW 6WRPD SD MH SULPHUQD WXGL ]D KUDQMHQMH ] GREUR SDVLUDQR DOL WHNRþR KUDQR NL MR GDMHPR V SRPRþMRHQWHUDOQHþUSDONH
Po hranjenju je potrebno cevko sprati z vodo ali QHVODGNDQLPþDMHPNDUSUHSUHþXMHGDELVHKUDQD ]DOHSLOD QD FHYNR ýH FHYNR VSLUDPR V þDMHP PRUDELWLQHVODGNDQVDMVODGNRUODKNRSXVWLREORJH QD VWHQL FHYNH LQ VH OHWD ODKNR ]DPDãL &HYNR je potrebno sprati tudi v primeru neprekinjenega KUDQMHQMDLQVLFHUYVDNHWULXUH
Po hranjenju hranilno cevko zapremo in uredimo otroka. Umijemo roke. Po vsakem hranjenju je SRWUHEQR EUL]JDONR GREUR VSUDWL LQ RVXãLWL 3ULERU QDMERVKUDQMHQSRGREQRNRWVHKUDQLMHGLOQLSULERU NURåQLNL VNRGHOLFH WM WDP NMHU VH QH SUDãL LQ QL dostopno raznim vplivom iz okolja.
'DMDQMH]GUDYLO
Po stomi se lahko dajejo tudi zdravila v obliki pra- ãNRY]GUREOMHQLKWDEOHWLQVLUXSRYSRPHãDQLKVWH- NRþLQR7XGLSULGDMDQMX]GUDYLOVWRPRSUHEUL]JD- PRVSULPHUQRNROLþLQRYRGH=GUDYLOPHGVHERMQH PHãDPR]DUDGLPRUHELWQHJDPHGVHERMQHJDXþLQNR- YDQMD,]RJLEDPRVHGDMDQMXGRORþHQLK]GUDYLONRW VRNDOLMåHOH]RLQDQWDFLGLNHUVRLQNRPSDWLELOQL]
HQWHUDOQLPLIRUPXODPLLQSRY]URþDMRREORJHQDVWH- QLKUDQLOQHFHYNH
02ä1,=$3/(7,
Po vstavitvi gastrostome lahko pride do zapletov.
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