Aritmije i uloga medicinske sestre prilikom elektrokardioverzije Arrhythmias and the role of a nurse during electrical cardioversion Aritmije su poremećaji srčanog ritma. Poremećaje srčanog ritma dijelimo prema frekvenciji na bradiaritmije i tahiaritmije, a prema mjestu nastanka na supraventrikularne aritmije (nastaju u pretklijetkama) i na ventrikularne aritmije (nastaju u srčanim klijetkama).Aritmije srca mogu se liječiti lijekovima, elektrokardioverzijom, radiofrekventnom ablacijom i ugradnjom elektrostimulatora ili defibrilatora, a izbor terapije ovisi o vrsti aritmije, simptomima i postojanju drugih bolesti srca, kao i izboru bolesnika. Elektrokardioverzija je postupak kojim se poremećaj srčanog ritma prevodi u sinusni ritam, udarcem istosmjerne struje sinkronizirane s ventrikularnim kompleksom u elektrokardiogramu.Proces zdravstvene njege bolesnika s aritmijama zahtijeva temeljitu provedbu sestrinske anamneze i izdvajanje čim-benika koji su ključni u formiranju sestrinske dijagnoze. Sestrinske dijagnoze su opis problema koje sestra prepoznaje kod pacijenata te se na temelju tih problema pristupa definiranju ciljeva i planiranju intervencija. U skrbi za bolesnika s aaritmijama vodeće su sestrinske dijagnoze Anksioznost u/s neizvjesnošću ishoda elektrokardioverzije te Neupućenost u/s nedostatka znanja o tijeku terapijskog postupka.Planiranje zdravstvene njege za bolesnika u intezivnoj koronarnoj jedinici obuhvaća utvrđivanje prioriteta, definiranje ciljeva, planiranje intervencija te izradu plana zdravstvene njege. Suvremeni terapijski procesi nameću interdisciplinarni pristup i stalnu edukaciju. U svojem radu u intenzivnoj koronarnoj jedinici naišli smo na mnoga pitanja koja su nas potakla na razmišljanje. Uz već poznati problem organizacije rada, nedostatak osoblja i materijala, velikog opsega posla i stresa s kojima se medicinske sestre iz koronarne jedinice svakodnevno susreću, naišli smo na nedostatak protokola po kojima bi radilo i nameće se pitanje specijalizacije medicinskih sestara radi kvalitetnije i sigurnije zbrinjavanja pacijenata. Medicinske sestre su svjesne svoje odgovornosti i standarda rada koji se od njih očekuje.Arrhythmias are heart rhythm disorders. According to the frequency, cardiac arrhythmias can be divided into bradyarrhythmias and tachyarrhythmias, whereas according to the place of origin, cardiac arrhythmias can be divided into supraventricular arrhythmias (occur in the atria) and ventricular arrhythmias (occur in ventricles).Cardiac arrhythmias can be treated with medications, electrical cardioversion, radiofrequency ablation and pacemaker or defibrillator implantation, whereas the choice of a therapy depends on a type of arrhythmia, symptoms and the presence of other heart diseases as well as the selection of patients. Electricial cardioversion is a procedure in which the heart rhythm disorder is reset back to its normal sinus rhythm by causing a directed electric shock synchronized with the ventricular complex in the electrocardiogram.The process of medical care for patients w...

Arterijska hipertenzija kao čimbenik rizika bila je prisutna u 90% u 2010., a u 2015. god. kod 86% oboljelih. U 2010. godini je hiperlipidemija bila prisutna kod 85% oboljelih, dijabetes kod 43%, pušenje u 30%, a adipozitet u 44% oboljelih. U 2015. hiperlipidemija je bila prisutna kod 54% oboljelih, dijabetes kod 30%, pušenje kod 27%, a adipozitet u 33% oboljelih.Zaključak: Incidencija je sve češća u srednjim dobnim skupinama, no zadržava se veća incidencija oboljenja kod muš-karaca. Vodeći čimbenici rizika u istraživanim razdobljima bili su isti. Dobiveni podaci mogu poslužiti kao smjernice za planiranje preventivnih programa kod rizičnih skupina ljudi, posebice srednjih dobnih skupina, kod kojih se povećava incidencija AIM-a. Introduction:Acute myocardial infarction (AMI) is a key component of the burden of cardiovascular disease. Several independent factors for coronary disease such as hypertension, hyperlipidemia smoking, and diabetes, as the most important risk factors. 1 The aim of the research is to obtain data on the incidence of AMI and present risk factors in order to plan further action. Patients and Methods:The study used data obtained from the Čakovec County Hospital (ČCH) Information System. The research deals with the number of patients with AMI treated in the Department of Cardiology with Coronary Care Unit of ČCH as well as the age, the sex of patients and the risk factors that influenced the development of the disease. The study used data from 2010 and 2015.Results: In 2010, the incidence of patients with AMI was 114 including 58% of men and 42% women, and in 2015, 104 of which 66% of men and 33% women. In the age group of 30-40 the number of patients in 2010 was 1.8%, and in 2015 was 1.9%. In 2010, there were 13%, and in 2015, 6.7% in the age group of 40-50 years. In the group of 50-60 years in 2010 was 16.7%, and in 2015 31.7% of patients. In the group of 60-70 years in 2010, it was 27.2% and in 2015, 22.1% of patients. In 2010 between the age of 70-80 years it was 23.7%, and 11.5% in 2015. In 2010, patients over 80 years it was 17.5%, and 26% in 2015.Hypertension as a risk factor was present in 90% of patients in 2010, and with 86% of patients in 2015. In 2010, hyperlipidemia was present in 85%, diabetes in 43%, smoking in 30%, and adiposity in 44% of patients. In 2015, hyperlipidemia was present in 54%, diabetes in 30%, smoking in 27%, and obesity in 33% of patients. Conclusion:It is to be concluded that the incidence is more common in middle age groups, whereby the higher incidence of the disease is to be found with male population. We therefore may conclude that the leading risk factors in investigated periods are the same. The obtained data can be used as a guideline for planning prevention programs for high-risk groups of people, especially middle-aged groups, in which the increasing incidence of AMI is present.

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SAŽETAK: U Koronarnoj jedinici Županijske bolnice Čakovec zbrinjavaju se bolesnici oboljeli od bolesti srca kojima je potreban stalan nadzor. Koronarna jedinica opremljena je medicinskim uređajima, opremom za izvođenje specifičnih dijagnostičkih i terapijskih zahvata. U radu s kardiološkim bolesnicima važni su timski rad te poznavanje dobrih komunikacijskih vještina. Medicinske sestre educirane su u prepoznavanju aritmija, kao i kardiopulmonalne reanimacije, u poznavanju komplikacija bolesti te primjene i načina djelovanja lijekova. U Koronarnoj jedinici izvode se mnogi neinvazivni i invazivni dijagnostički i terapijski postupci, što zahtijeva dobru opremljenost medicinskom aparaturom te stručno osposobljeno osoblje. SUMMARY:The Coronary Care Unit (CCU) at the Čakovec County Hospital manage patients suffering from heart diseases who require constant monitoring. The CCU is equipped with medical equipment and gear for performing various diagnostic and treatment procedures. When working with cardiac patients, teamwork and good communication skills are very important. Nurses are educated in recognizing arrhythmias and in cardiopulmonary reanimation, disease complications, and the administration and action of medication. The CCU performs many invasive and non-invasive diagnostic and treatment procedures, which requires being well-equipped with medical devices and trained staff.