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Subarahnoidalna hemoragija (SAH) se manifestira naglim nastupom jake glavobolje, poremećajima svijesti uz znakove povišenog intrakranijskog tlaka te kočenjem šije. Najčešće nastaje kao posljedica rupture aneurizme. Veličina i lokalizacija aneurizme su značajno neovisni prognostički čimbenici. Ishodi liječenja su bitno nepovoljni u bolesnika s aneurizmama stražnje cirkulacije zbog relativne kirurške nedostupnosti i blizine moždanog debla. Liječenje može biti kirurško ili endovaskularno, a ovisi o stanju bolesnika i anatomskom smještaju aneurizme. U zbrinjavanju bolesnika koji je u po život opasnom stanju naglašena je važnost brze i pravilne sestrinske procjene i intervencija te koordiniran rad cijelog tima stručnjaka: neurokirurga, neurologa, anesteziologa, što zahtjeva visoku razinu stručnog znanja i vještina medicinskih sestara/tehničara koje skrbe za bolesnika SAH-om u jedinici intenzivnog liječenja (JIL). Prvostupnica sestrinstva u JIL-u sudjeluje u svim segmentima zdravstvene skrbi za bolesnika, izvodi sestrinsko medicinske postupke, planira zdravstvenu njegu, postavlja sestrinske dijagnoze, provodi sestrinske intervencije i evaluaciju provedenog te koordinira rad i postupke cijelog tima. Subarachnoid hemorrhage (SAH) is manifested by suden onset of severe headache, disturbans of concioness with signs of increased intracranial pressure and inhibition of neck. Most often ocurs as a result of aneurysm rupture. Aneurysm size and location are significantly independent factors. Treatment outcomes are significantly unfavorable in patients with aneurysms of the posterior circulation due relative surgical inaccessibility and proximaty of brain steam. Treatment can be surgical or endovascular, depends on the patient's condition and anatomical location of the aneurysm. In care for patient who is in life threatening condition, the importance of quick and correct nursing assessment and intervetion is important, as the coordinated work of entire team of experts: neurosurgeon, neurologist, anesthesiologist, which requires a hight level of professional knowlege and skils of the nurse who cares for patient with subarahnoid hemorrage in intensive care unit (ICU). The Bachelor of Nursing in the ICU participates in all segments of health care for the patient, performs nursing medical procedures, plan health care, makes nursing diagnoses, nursing interventions and evaluation of treatment care, coordinates the work and procedures of the entire team. |
