{"id":760,"date":"2009-06-09T14:57:46","date_gmt":"2009-06-09T13:57:46","guid":{"rendered":"http:\/\/www.zdravstvena.info\/vsznj\/?p=760"},"modified":"2010-06-15T10:13:38","modified_gmt":"2010-06-15T09:13:38","slug":"zn-otroka-obolenja-secil-povisana-tt-obolenja-prebavil-ari-nahod-angina","status":"publish","type":"post","link":"https:\/\/www.zdravstvena.info\/vsznj\/zn-otroka-obolenja-secil-povisana-tt-obolenja-prebavil-ari-nahod-angina\/","title":{"rendered":"ZN otroka obolenja se\u010dil, povi\u0161ana tt, obolenja prebavil, ari, nahod, angina.."},"content":{"rendered":"

\"nefritis\"OBOLENJA SE\u010cIL <\/strong>
\nMesta oku\u017ebe:<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vnetje se\u010dnice – uretritis<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vnetje se\u010dnega mehurja – cistitis<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vnetje ledvi\u010dnih \u010da\u0161ic in ledvi\u010dnega meha – pielitis<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vnetje ledvic – nefritis<\/p>\n

Vzrokov za obolenje se\u010dil je ve\u010d:<\/strong><\/p>\n

Se\u010dila so sterilna, izjema je le spodnji del se\u010dnice. Oku\u017ebe lahko nastanejo z vstopom bakterij skozi zunanje ustje se\u010dnice in se \u0161irijo po se\u010dilih navzgor<\/p>\n

<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nezadostna in nepravilna intimna nega<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Gramnegativne bakterije (Escherichia coli)<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vezikourentni refluks – se\u010d se zaradi nepravilno delujo\u010de vezikouretrne zaklopke vra\u010da iz se\u010dnega mehurja proti ledvicam<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oku\u017eba po hematogeni poti<\/p>\n


\nZnaki so odvisni od mesta oku\u017ebe in od otrokove starosti. Mlaj\u0161i ko je otrok, manj zna\u010dilni so znaki.
\nPri novorojen\u010dku se lahko pojavi prikrita bakteriurija ali septikemija.<\/p>\n

Nezna\u010dilni simptomi, ki so pri dojen\u010dku povezani z oku\u017ebo se\u010dil so: <\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Povi\u0161ana telesna temperatura
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Slabo napredovanje
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Neje\u0161\u010dnost
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bruhanje
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Driska
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Razdra\u017eljivost
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bledica, cianoza
\n
\nPri ve\u010djih otrocih so znaki podobni kot pri odraslih:<\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bole\u010dine v trebuhu ali ledvenem predelu
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Povi\u0161ana telesna temperatura z mrzlico
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Periorbitalni edem
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Neprijeten vonj urina
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Spremembe pri uriniranju (napenjanje, prekinjen curek, uriniranje po kapljicah, pogosto ali peko\u010de uriniranje, enureza)
\nDiagnostika<\/strong>
\n–\u00a0\u00a0\u00a0\u00a0 Anamneza
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Klini\u010dni pregled
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Osnovne laboratorijske preiskave krvi (KKS, sedimentacija) in urina (pH, specifi\u010dna te\u017ea, patolo\u0161ki izvidi, sanford, uricult)
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 UZ se\u010dil
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cistoskopija
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 i.v urografija
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dinami\u010dna scintigrafija ledvic
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Radioizotopski mikcijski cistogram
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 RTG preiskave: urografija, retrogradna pielografija, mikcijska cistourografija
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Radioizotopske preiskave: scintigrafija ledvic, mikcijski cistigram
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 CT<\/p>\n

Zdravljenje
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Antibiotiki, \u010cimprej!<\/p>\n

Negovalni problemi<\/span> <\/span><\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Zvi\u0161ana telesna temperatura
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nezadostan prehrana
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Spremenjena funkcija \u010drevesja – driska
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Primanjkljaj telesnih teko\u010din
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Slabo napredovanje v telesnem razvoju
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Zadr\u017eevanje telesnih teko\u010din, otekline okoli o\u010di
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Spremembe ko\u017ee – bledica, cianoza
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bole\u010dine v trebuhu
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mirovanje zaradi splo\u0161ne oslabelosti
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Spremembe v uriniranju
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mo\u017enosti infekcije z MO
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Pomanjkanje znanja star\u0161ev pri negi
\nNEGOVALNE INTERVENCIJE GLEDE IZLO\u010cANJA URINA <\/span><\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Podpora ali nadomestitev vsakodnevnih \u017eivljenjskih aktivnosti v zvezi z izlo\u010danjem se\u010da, opazovanje na\u010dina mokrenja in spodbujanje izlo\u010danje se\u010da (razli\u010dni \u010daji)
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Opazujemo videz urina (barva, primesi, gostota), koli\u010dino izlo\u010denega urina (oligurija, anurija, poliurija), \u0161tevilo mikcij, bole\u010de, peko\u010de uriniranje, nehoteno pu\u0161\u010danje urina – enureza
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Izvajamo poostreno anogenitalno nego
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vodimo kontrolo med popito in izlo\u010deno teko\u010dino (merimo diurezo)
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u010ce ima otrok vstavljen urinski kateter, izvajamo AG nego, skrbimo za prehodnost katetra in pazimo da kateter ne izpade
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Odvzamemo urin za preiskavo po naro\u010dilu zdravnika
\nGLEDE MERJENJA VITALNIH FUNKCIJ IZVAJAMO NASLEDNJE NEGOVALNE INTERVENCIJE<\/span><\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Merjenje in bele\u017eenje vseh vitalnih funkcij (RR!)
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Pogosto merimo telesno temperaturo in jo bele\u017eimo
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Povi\u0161ano TT zni\u017eujemo z mla\u010dno kopeljo, obkladki, ovitki ali antipiretiki, po naro\u010dilu zdravnika dajemo \u010daj, zagotovimo primerno mikroklimo (topla zra\u010dna soba)
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Otroka oble\u010demo v topla bomba\u017ena obla\u010dila
\n
\n<\/strong> GLEDE PREHRANJEVANJA, PITJA IN TELESNE TE\u017dE\u00a0IZVAJAMO <\/strong>
\n<\/span>–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dieto predpi\u0161e zdravnik glede na obolenje (manj soli, brez za\u010dimb), otroka hranimo po\u010dasi, potrpe\u017eljivo, ga spodbujamo…
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Otrok naj pije teko\u010dine (zdravnik dolo\u010di koli\u010dino), \u010daj
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vodimo bilanco zau\u017eite teko\u010dine
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Otroka tehtamo enkrat ali ve\u010dkrat dnevno zaradi kontrole edemov, edeme opazujemo in negujemo
\nGLEDE OSEBNE HIGIENE IN DOBREGA PO\u010cUTJA IZVAJAMO<\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Osve\u017eilno kopel, dobro osu\u0161imo ko\u017eo<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Poskrbimo za ustno nego
\nOsebno in posteljno perilo more biti sve\u017ee, toplo in bomba\u017eno<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Aktivnosti omejimo, vklju\u010dimo vzgojiteljico ali u\u010diteljico
\nOmogo\u010dimo prisotnost star\u0161ev pri otroku
\n1.\u00a0\u00a0\u00a0\u00a0 PREHRANJEVANJE IN PITJE<\/span><\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dovolj teko\u010dine
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vzpodbuda pri hranjenju
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hranimo ga ve\u010dkrat dnevno v manj\u0161ih koli\u010dinah, po\u010dasi in strpno
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dnevno kontroliramo telesno te\u017eo<\/p>\n

2.\u00a0 IZLO\u010cANJE IN ODVAJANJE<\/strong>
\n– Redno odvajanje blata in vode
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mehur naj popolnoma izprazni
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nadzorujemo in opazujemo videz urina, koli\u010dino, \u0161tevilo mikcij, bole\u010de in peko\u010de uriniranje, enurezo (nehotno pu\u0161\u010danje urina podnevi ali pono\u010di)
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nadziramo zau\u017eito in izlo\u010deno teko\u010dino
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Odvzem urina za preiskavo<\/p>\n

3.\u00a0\u00a0\u00a0\u00a0 OSEBNA HIGIENA <\/strong>
\n<\/span>–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Natan\u010dna intimna nega
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Prhanje
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Primerno topla voda
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ko\u017eo in gube temeljito osu\u0161imo
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Opazujemo in bele\u017eimo barvo ko\u017ee in morebitne otekline<\/p>\n

4.\u00a0\u00a0\u00a0\u00a0 GIBANJE IN USTREZNA LEGA <\/strong>
\n– Omejimo aktivnosti otroka
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Po potrebi naj ostane v postelji, miruje
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Name\u0161\u010den v udoben polo\u017eaj<\/p>\n

5.\u00a0\u00a0\u00a0\u00a0 OBLA\u010cENJE IN SLA\u010cENJE<\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Topla bomba\u017ena obla\u010dila
\n6.\u00a0\u00a0\u00a0\u00a0 VZDR\u017dEVANJE PRIMERNE TT<\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Topel in zra\u010den prostor
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ukrepi za zni\u017eevanje TT<\/p>\n

7.\u00a0\u00a0\u00a0\u00a0 IZOGIBANJE NEVARNOSTIM<\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 ukrepi za prepre\u010devanje nastanka bolni\u0161ni\u010dnih oku\u017eb<\/p>\n

6. IZRA\u017dANJE \u010cUSTEV, POTREB, KOMUNIKACIJA<\/strong>
\n<\/span>–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 psihi\u010dna podpora<\/p>\n

7. IGRA, KORISTNO DELO<\/strong>
\n– aktivnosti, knjige, glasba…
\n
\n<\/span>8. U\u010cENJE IN PRIDOBIVANJE ZNANJA<\/strong>
\n– seznanimo star\u0161e o ZN…
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 o poteku preiskave…
\n9. OSTALO <\/strong>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 merimo vitalne funkcije
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 dajemo zdravila po naro\u010dilu zdravnika
\nAkutno vnetje ledvic (glomerulonefritis acuta)<\/span><\/strong>
\nNajpogosteje zbolijo otroci stari 2-12 let.
\n Vzroki<\/span>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 7 – 12 dni po oku\u017ebi zg. dihal z \u00df- hemoliti\u010dnimi streptokoki skupine A (avtoimunska bolezen)<\/p>\n

Znaki <\/span>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 slabo po\u010dutje
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 bledica
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 izguba apetita
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 ote\u017eeno izlo\u010danje urina
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 oligurija
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 kri v urinu
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 edemi okoli o\u010di
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 hipertenzija
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 slabost
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 bruhanje, bole\u010dina v trebuhu ali ledvenem predelu
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 dispneja
\n DG<\/span>
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 anamneza
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 pregled otroka
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 laboratorijske preiskave krvi in urina (hematurija, proteinourija, levkocitourija)<\/p>\n

ZN<\/strong>
\nNegovalni problemi
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 neu\u010dinkovito dihanje
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 bleda ko\u017ea
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 zadr\u017eevanje telesnih teko\u010din
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 edem okoli o\u010di
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 nezadostna prehrana – neje\u0161\u010dnost
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 spremembe urina pri uriniranju
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 bole\u010dina v trebuhu in ledvenem predelu
\n–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 mo\u017enost infekcij
\nZDRAVSTVENA NEGA OTROKA S POVI\u0160ANO TELESNO TEMPERATURO<\/strong><\/p>\n


\nKAJ JE POVI\u0160ANA TELESNA TEMPERATURA, VRO\u010cINA <\/strong><\/p>\n