Today, providing medical care to patients requires a specialist not only to have perfect practical skills, but also solid theoretical knowledge, which students of medical schools will receive. Specialty 223 Nursing corresponds to the first level of higher education "Bachelor" and is aimed at training specialists capable of professional medical activity as a head (senior) nurse, physician's assistant [1, p.39]. Accordingly, the normative discipline "Medical Chemistry" provides basic theoretical knowledge about the properties of substances, the features of their interaction, the effect on the body of various compounds - components of medicines, the features of various forms of drugs used in the treatment and rehabilitation of patients [2, p. 20; 5, p. 38].
The curriculum of the discipline provides for students to study the biological role and application in medicine of the most important compounds of macro- and microelements, the features of the toxic effects of heavy metals and other environmental pollutants on the human body, as well as on individual systems and organs [3, p. 210]. We draw the attention of future nurses to the problem of detoxifying the body using synthetic or chelate complexes, as well as natural chelators such as pectins. In this topic, you must first consider the very concept of complex compounds, the features of their structure and properties. We suggest that students complete two laboratory tasks – obtain cationic ammonia complexes and conduct the reaction of the EDTA chelate complex with metal cations. Thus, through experimentation, the concept of chelation therapy and the limits of its application are formed. This is especially important in the current conditions of war in Ukraine, when the environment and population are daily exposed to various poisons released during ammunition explosions and fires. Studies conducted by scientists of the department on heavy metal contamination of water bodies and soils in the deoccupied territories of eastern Ukraine prove the need to pay attention to this problem and train specialists who will be ready to work in such conditions.
It is important to acquaint nursing students with different ways of expressing the concentration of solutions, since a significant number of drugs are used in the form of liquid dosage forms. We pay special attention to the relationship between different ways of expressing the concentrations of a solute in a solution, in particular, mass fraction and molar concentration, titer, because these are the metho ds most often used in practical medicine. It is difficult to overestimate the importance of water in the vital activity of the human body: water is present both in cells and in the intercellular space, and the organs that work most intensively contain the most water. Therefore, it is important to familiarize students with the process of normal hydration of the body, the biological importance of water for the successful course of biochemical processes, in particular hydrolysis reactions. When considering the topic "Colligative Properties of Solutions", we draw students' attention to osmotic pressure, which determines the distribution of water between various organs and tissues of the body. The mechanism of osmosis depends on the nature of the membranes. Due to the selective permeability of the membranes, the transfer of nutrients and the removal of metabolic products occurs. We emphasize that inside the cell, the osmotic pressure is somewhat higher than in the extracellular fluid, and together with the students, we analyze such phenomena as diffusion, osmosis, turgor, active and passive transport of substances through biological membranes, ion exchange, and water-electrolyte balance in the body. We form the concept of factors that cause high osmotic pressure of blood plasma and the contribution of electrolytes to its formation, in particular, sodium chloride [4, p.496]. Sufficient attention is required to study the phenomena of plasmolysis and hemolysis, as well as the related use of isotonic, hypertonic, and hypotonic solutions in the practical work of nurses. For a deeper understanding of this material, we use laboratory work, during which students can model plasmolysis and hemolysis and examine these phenomena under a microscope.
Another important topic in the formation of a Bachelor of Nursing is acid-base balance in the body. Medical students, through laboratory work, acquire skills in experimental determination of pH by the indicator method and using a pH meter. It is mandatory to learn the normal pH values of biological fluids, the limits of deviation under pathological conditions, understanding the phenomena of acidosis and alkalosis, their causes [4, p.496]. Biochemical buffer systems maintain a constant pH of arterial and venous blood. During laboratory work with acetate buffer, we elucidate the mechanisms of action of biochemical buffer systems that maintain their constant pH value, which is a necessary condition for homeostasis.
The topic is «Kinetics of biochemical reactions. Heterogeneous equilibrium in the homeostasis of the organism" forms in future nursing specialists the concept of the rate of reactions and the factors that influence it. We focus attention on the nature and mechanism of action of enzymes, the specificity and high efficiency of enzymes, sensitivity to changes in pH and temperature. Students are particularly interested in laboratory work on studying the effect of concentration on the reaction rate and comparing the effectiveness of the inorganic catalyst Manganese (IV) oxide and the catalase enzyme. In this topic, students study the theoretical foundations of chemical equilibrium, heterogeneous processes, conditions for the formation and dissolution of sediments that underlie the mineralization and demineralization of bone tissue, conditions for the formation of hydroxyapatite crystals and their dissolution. The concept of the formation of kidney stones, which are poorly soluble phosphates, urates, and calcium oxalates, is being formed, as well as how to create conditions where these salts will dissolve.
The concepts of adsorption, dispersed systems, and high-molecular compounds are important for nurses, since in practical work they deal with various forms of drugs every day - colloidal solutions, various types of emulsions, suspensions, aerosols, pastes, etc. It is important to understand the properties of these forms of drugs, their interaction with each other, the possibilities of external or internal application. Medical students study the chemical foundations of adsorption therapy, hemodialysis, electrophoresis - methods that are widely used in the treatment of patients, and nurses will take a direct part in this process. Also, in practical classes, future nursing specialists, while performing laboratory work, acquire skills in electrochemical research methods, paper and column chromatography, and practically determine the isoelectric point of a protein.
Conclusion: Medical chemistry as a normative discipline of the educational and professional program of specialty 223 "Nursing" provides thorough theoretical training for first-year students and is a basis for studying theoretical (medical biology, biochemistry, physiology) and clinical disciplines. Deep knowledge and understanding of the basics of chemical processes in the human body are formed in students by enriching practical classes with laboratory work (2-4 in each class), which students perform independently in small groups under the guidance of a teacher. A sufficient number of hours of practical classes is important, which ideally should be more than is currently provided for.
Literature:
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