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Background: Antioxidants located in both the hydrophilic and lipophilic compartments of plasma act as a defence system against reactive oxygen species (ROS). . Excessive production of ROS during anaesthesia affects the antioxidant capacity of plasma and may result in oxidative stress. The aim of this study was to evaluate the antioxidant capacity of lipid- (ACL) and water-soluble (ACW) antioxidants in client-owned dogs diagnosed with periodontal disease and early-stage myxomatous mitral valve degeneration (MMVD) and anaesthetised for a dental procedure with propofol and sevoflurane or with propofol only. Results: Dogs with MMVD were anaesthetised with propofol and sevoflurane (MMVD/PS, n = 8) or with propofol only (MMVD/P, n = 10). Dogs with no evidence of MMVD (PS, n = 12) were anaesthetised with propofol and sevoflurane. Blood samples for determination of ACL and ACW were collected before and 5 minutes, 60 minutes and 6 hours after induction to anaesthesia. In dogs with MMVD and anaesthetised with propofol and sevoflurane, ACL was significantly higher at all sampling times when compared to control dogs. Compared to basal values, only anaesthesia maintained with propofol significantly increased ACL at 60 minutes in dogs with MMVD. In dogs with MMVD and anaesthetised with propofol, ACW increased after induction to anaesthesia and remained elevated up to 6 hours after anaesthesia. Compared to basal values, anaesthesia maintained with sevoflurane significantly increased ACW only at 60 minutes in both dogs with and without MMVD.The only difference between propofol and propofol/sevoflurane anaesthesia in dogs with MMVD was significantly higher ACW at 60 minutes after induction to anaesthesia in the propofol group. Conclusions: Regarding antioxidant capacity, propofol could be a better choice than sevoflurane for anaesthesia of dogs with early-stage MMVD, although further studies are necessary to clarify the advantage of this antioxidant capacity.

Srčno-žilne bolezni so v razvitem delu sveta in tudi v Sloveniji že desetletja zelo razširjen vzrok obolevnosti in umrljivosti odraslih. Najpogostejša bolezen srca je nepredvidljiv in življenjsko nevaren srčni infarkt, ki lahko pri bolniku povzroči številne psihološke posledice. V literaturi je moč zaslediti, da se lahko srčni bolniki po srčnem infarktu srečujejo z anksioznostjo, depresijo in z bolj intenzivnim doživljanjem stresa. V magistrskem delu smo želeli preveriti učinke programa zgodnje psihofiziološke rehabilitacije (v nadaljevanju ZPFR program) na zmanjšanje anksioznih in depresivnih simptomov, na zaznavo stresa in psihološko fleksibilnost, na psihološko blagostanje, vsakodnevno funkcioniranje ter rizično vedenje. Vpliv ZPFR-programa smo preverjali pri dveh skupinah, in sicer pri eksperimentalni skupini, ki je sedem tednov obiskovala srečanja, usmerjena na psihoedukacijo, tehnike sproščanja in vaje čuječnosti, in pri kontrolni skupini, ki srečanj ni obiskovala. V raziskavi smo uporabili pet merskih pripomočkov: lestvico bolnišnične anksioznosti in depresije, lestvico zaznanega stresa, lestvico kazalca blaginje, vprašalnik za merjenje izida terapije in vprašalnik sprejemanja in akcije. Rezultati so pokazali, da je ZPFR-program pripomogel k zmanjšanju simptomov anksioznosti in ohranjanju trenutnih simptomov depresije, prav tako pa so udeleženci po ZPFR-programu zaznavali nižji stres in boljše vsakodnevno funkcioniranje. Na podlagi rezultatov je razvidno, da pri udeležencih kontrolne skupine ni prišlo do pomembnih sprememb na lestvici anksioznosti, nasprotno pa so udeleženci programa poročali o večji prisotnosti depresivnih simptomov in višji zaznavi stresa. Program ZPFR ni pripomogel k izboljšanju psihološkega blagostanja in psihološke fleksibilnosti, saj sta obe skupini poročali o podobnih vrednostih ne glede na čas ali udeleženost. Na podlagi rezultatov lahko zaključimo, da ima psihološka podpora v obliki ZPFR-programa določene blagodejne učinke na duševno zdravje srčnih bolnikov v našem vzorcu. Študija osvetljuje pomembnost večje informiranosti ter psihološke podpore za srčne bolnike. Študija hkrati ponuja smernice za nove raziskave na tem področju ter ponuja smernice za razmislek o vzpostavitvi ZPFR-programa, katerega bi lahko tudi prilagodili za številne druge bolnike. Cardiovascular diseases have been a widespread cause of adult morbidity and mortality in the developed part of the world and in Slovenia for decades. The most common heart disease is an unpredictable and life-threatening heart attack, which can have a number of psychological consequences for a patient. In literature it can be seen that cardiac patients after a heart attack may experience anxiety, depression, and a more intense experience of stress. In the master's thesis we wanted to examine the effects of the program of early psychophysiological rehabilitation (in continuation ZPFR program) on the reduction of anxiety and depressive symptoms, on the perception of stress and psychological flexibility, on psychological well-being, daily functioning and risky behavior. The impact of the ZPFR program was examined in two groups, mainly the experimental group, which attended psychoeducation, relaxation techniques and mindfulness exercises for seven weeks, and the control group, which did not attend the meetings. Five measurement tools were used in the study: Hospital Anxiety and Depression Scale, Perceived Stress Scale, Five Well-Being Index, the CORE outcome Measure, and the Acceptance and Action Questionnaire. The results showed that the ZPFR program helped reduce anxiety symptoms and maintain current symptoms of depression, and participants under the ZPFR program perceived lower stress levels and better daily functioning. Based on the results, it is evident that there were no significant changes in the anxiety scale in the participants of the control group, on the contrary, the participants in the program reported a higher presence of depressive symptoms and a higher perception of stress. The ZPFR program did not help to improve psychological well-being and psychological flexibility, as both groups reported similar values regardless of time or participation. Based on the results, we can conclude that psychological support in the form of a ZPFR program has certain beneficial effects on the mental health of cardiac patients in our sample. The study highlights the importance of greater information and psychological support for cardiac patients. At the same time, the study provides guidelines for the future research in this area and provides guidelines for considering the establishment of a ZPFR program, which could also be adapted for many other patients.

Teoretična izhodišča: Operativni poseg je dejanje, ki grobo posega v bolnikovo integriteto in s katerim se anestezijske medicinske sestre dnevno srečujejo pri svojem delu. Zato je zelo pomembno, da je pristop k obravnavi bolnika na najvišji strokovni ravni, tako pred, med in po operativnem posegu. V diplomskem delu smo opisali bolezni srca in vlogo anestezijske medicinske sestre pri operaciji na odprtem srcu in v perioperativni zdravstveni negi. Namen raziskave: Namen diplomskega dela je predstaviti vlogo anestezijske medicinske sestre pri operaciji na odprtem srcu in obravnavi bolnika pred, med in po operaciji, ter ugotoviti individualen pogled anestezijskih medicinskih sester na delo pri operaciji na srcu in njihovo vlogo v zdravstveni negi. Metode: V empiričnem delu smo izvedli klinično raziskavo. Podatke smo zbrali s pomočjo anketnega vprašalnika, ki je vseboval 17 vprašanj zaprtega tipa. Rezultati: Ugotovili smo, da so za profesionalni razvoj perioperativne zdravstvene nege, potrebna permanentna dodatna strokovna izobraževanja medicinskih sester, da je vloga anestezijskih medicinskih sester pri operacijah premalo poznana med bolniki in da več kot polovica anketiranih meni, da bi morebitna uvedba sestrske vizite dan pred operativnim posegom pri bolniku, omogočila boljše prepoznavanje dela in njihove vloge pri operaciji med bolniki in s tem tudi javnostjo. Ugotovili smo, da anestezijske medicinske sestre pri operaciji na srcu delajo pod večjimi obremenitvami, kot na ostalih deloviščih zaradi večjega obsega dela in same narave bolezni pri tovrstnih operacijah, kar predstavlja obenem tudi večjo možnost napak pri delu. Background: A surgery is an act which largely interferes with a patient’s integrity and something nurse anesthetists encounter in their everyday practice. Therefore it is very important that a patient is approached on the highest professional level prior, during and after the surgery. The paper discussed cardiac diseases and the role of nurse anesthetist in open heart surgery and perioperative nursing care. Purpose: The purpose of this paper is present the role of nurse anesthetist in an open heart surgery and treatment of patient prior, during and after operation as well as to establish an individual perspective of nurse anesthetist on work during a heart surgery and their role in nursing care. Methods: We conducted a clinical study in the empirical part of the paper. Data was collected by means of a survey consisting of 17 closed - ended questions. Results: We established that additional professional training of nurses is required for a professional development of perioperative nursing care. We also concluded that patients are not familiar enough with the role of nurse anesthetists in surgeries and more than a half of respondents believe that introducing a nurse round a day prior to surgery would enable better identification of work and their roles during surgery among patients as well as society. Nurse anesthetists are under additional pressure during an open heart surgery on account of extra work and nature of the disease in these types of surgeries, which presents a greater possibility of making errors at work.

V diplomskem delu smo predstavili pogostost srčnih obolenj, ki je pri nas še vedno zelo razširjeno. Bolezni smo razdelili na prirojene in pridobljene. Prirojene bolezni se pojavljajo pri novorojenčkih in jih zdravimo operativno. Na pridobljene bolezni srca lahko vplivamo oziroma jih preprečimo z zdravim načinom življenja ter izogibanje dejavnikom tveganja. Na dejavnike kot sta starost in dednost žal ne moremo vplivati, lahko pa vplivamo na izogibanje nezdravega načina življenja kot so nezdrava prehrana, kajenje, prekomerno uživanje alkohola, debelost, premalo gibanja. Nezdrav življenjski slog lahko privede do hude srčne bolezni, ki lahko zahteva operativno zdravljenje. Pacient ob takšni novici potrebuje veliko podpore in spodbude svoje družine. V nadaljevanju diplomskega dela smo opisali zdravstveno nego pacienta pred in med operacijo, ki zajema obdobje sprejema pacienta na oddelek, psihične in fizične priprave pacienta na operacijo, priprave pacienta na dan operacije, transport pacienta v operacijsko sobo, izvajanje zdravstvene nege med operacijo. Opisali smo pooperativno obdobje, ki se začne v sobi za zbujanje po operaciji in premestitvijo pacienta na enoto intenzivne nege, kjer pacient ostane 1-2 dni in je premeščen nazaj na oddelek za kardiologijo. Rehabilitacija pacienta po operaciji predstavlja velik pomen, ker pacientu pomaga ponovno zaživeti in se vključiti v življenje. V raziskovalnem delu diplomskega dela smo opravili študijo primera pacientke po bypass operaciji na srcu. S pomočjo študije primera smo izpostavili aktualne in potencialne negovalne probleme, ki so se pojavili pri pacientki po bypass operaciji. In the diploma thesis we present the frequency of heart disease, that in our country is still widespread. We divided disease into acquired and congenital. Congenital diseases apears with newborn babys and we treated them operationaly. On acquired disease we can make influence on or prevent them with healthy choice of life and with avoidancy to the risk factors. On factors like age and heredity we can`t make influence but we can make it on avoiding unhealthy way of living like unhealthy food, smoking, drinking too much alcohol, obesity, lack of exercise. Unhealty lifestyle can lead us to heart diseases which can require operating treatment. On that kind of news patient needs a lot of support from his family. In the diploma thesis we also described nursing care of patient before and during the surgery, which covers patients admission to the ward, physical and psychological preparation of the patient to the surgery, preparation of the patient on surgery day, patient transport to the surgery room, nursing care implementation during the surgery. We described postoperative period which begins in the recovery room after the surgery and patient transport to intensive unit care where the patient stays 1-2 days and then he is transported back to the ward of cardiology. Rehabilitation of the patient after the surgery is very important because it helps him include back to his life with new adjustments. We done the patients study case after the heart bypass surgery where we highlighted the current and potential nursing problems which occur after the heart bypass surgery.