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The work of nurses at the Immunology
Institute ward
Bc.Dita Růčková
Charles University Immunology Institute 2nd Medical Faculty and University Hospital Motol
Most frequent types of Dg.
CVID ( common variable immunodeficiency)Atopic eczema (more severe cases, methylprenisolon
i.v.)Bruton agammaglobulinemia Selective IgA deficiencySelective IgG subclass deficiencyHereditary angioedema type I.,II.Transient hypogammaglobulinemia in childhood
Main clinical symptoms in immunodeficiency
Increased predisposition to bacterial infections and frequent relapses
Increased inclination to infections caused by viruses, bacteria, fungi, parasites
i.e. persistent sinusitis, temperature, productive cough, chronic fatigue
Frequent otitisWeak or no response to vaccinationLack of progress
Treatment on the ward.
Intravenous immunoglobulin (IVIG)
regularly once every month ● measuring physiological functions, ● control blood samples, (M+S,KO, immunology,
biochemistry),● bioassay● Infusion takes approximately 2-4hours,
Treatment on the ward
Subcutaneous immunoglobulin (SCIG)●abdomen area 15 ml may be administered into one place application time ½ h – 1 h the speed depends on the child’s age, the
quality of the subcutaneous and the amount of the medicine (Newborn baby– 5ml/h)
using a special infusion pump or rapid push up
metod● can be delivered once a week or twice a
month
S.C. application
education for home caretraining parents for treating the child at home
using an infusion pump parents receive written step-by-step
instructions how to work at homeindividual approach to training parents, min. 3
appl. on our care centrecontrol patients on home therapy is every
three month
S.C. application patients get material for home therapy we have a plan monitoring the skill of
application technology on home therapy one or twice a year
we focus on the psychological work with patients and their family
Frequent concerns of parents
The sterile preparation of the actual drugAdministering to their own child (we guide
by hand for the 1st application.)
Factual content
The content of the communication comprises one fourth
(1/4 ) of what takes place between the speaker and the
listener
(for instance: a husband is eating a sauce and spots
something green swimming inside and observes: “There’s
something green in here (he enquires about factual
content)”.
Each communication not only hides information Each communication not only hides information about the factual content conveyed but also self-about the factual content conveyed but also self-disclosure about the person confessing. “I don’t disclosure about the person confessing. “I don’t know what it is” (self-disclosure)know what it is” (self-disclosure)
Said in an exasperated fashion i.e. I’m tired.
In a curiously manner................I’m surprised that you have neglected something
Ironically.................I don’t respect you.
Self-disclosure
Relationship
Or rather how I judge you and how we work together.
The report reveals how the speaker relates to the listener, what kind of relationship they have.
We learn about the mutual relationship in communications by means of gestures, tone of voice and its gradient, the suitability or unsuitability of timing assertions, facial expressions and other accompanying signals of a non-verbal nature.
In terms of these aspects of the report, the recipient has especially sensitive hearing because he feels like a person who is being treated in a certain way.
(I’m relying on the fact that you know. I trust that you wouldn’t put anything bad in the sauce because we care about each other.)
ConclusionsConclusions
Or rather what I’d like to encourage you to do.
We rarely say something just for the sake of it.
Almost every communication assumes the role
of influencing the listener to do or not to do
something. This attempt at influencing may be
more or less clear or hidden, we then talk of
handling (I want you to tell me what it is.)
A piece of communication took place in our examples
which involved a relationship of trust between the
speaker and the listener (wife), but also involved a
relaxed moment eating.
If this information is conveyed in a offended voice, it will
come out entirely differently. The communication:
“There’s something green here”, reveals that the
speaker doesn’t like the sauce (self-disclosure), that
he considers his wife to be a bad cook (relationship)
and he wants the sauce to be removed from the table
(challenge).