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 Wysłany: Sob 8:01, 05 Mar 2011 Temat postu: mbt scarpe ibl ccq ezql itu |
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After transurethral prostatectomy Perioperative Nursing
Bladder filling and increased bleeding. Fourth, pull out the balloon catheter, the Nursing and urination, general 1h' - 2h 1 urination, avoid factors that increase abdominal pressure, avoid secondary bleeding. Because elderly patients in bed, reduced activity, and over-excitement, it is prone to cardiac complications, so Zhu Huanzhe not immediately pull out the catheter from the bed after the event, should gradually increase the volume of activity, not excited, so smoothly through Extubation after extubation in patients with urethral sphincter to guide the functional exercise, there urethral edema, difficulty urinating, could once again line catheterization. 2.2.3 Care of insufficient fluid as the continued bleeding after prostate fossa, heart and lung function decline in elderly patients and the infusion rate of fluid volume,[link widoczny dla zalogowanych], indwelling catheter and bladder irrigation caused lower abdominal pain, bladder spasm and other food into the affected patients water. Care should pay attention: First, the use of hemostatic drugs. Second, by your doctor rehydration,[link widoczny dla zalogowanych], elderly patients may be uniform within the fluid volume in the 24h infusion, to prevent heart failure. Third,[link widoczny dla zalogowanych], if conditions permit, encourage patients to drink more water. Fourth, 6h before surgery, the effective traction balloon catheter to prevent balloon rupture causing massive hemorrhage, the absolute horizontal position after 24h. Fifth, the observed changes in skin elasticity and vital signs, and make detailed records. 2.2.4 spasm of pain care and time given to agents and analgesics. Indwelling epidural catheter after surgery in some patients, the morphine 1Omg, plus lidocaine to 1OmL, pain when pushing 2mL, or pain when injected with pethidine. Patiently explained to patients the causes of pain, avoiding urination, bowel movements. Severe pain, the suspension of bladder irrigation. Activity or coughing, hold down the wound, the drainage tube fixed to prevent pulling, twisting cause pain. Cold weather can be a little fluid temperature and avoid fluid temperature and the temperature is too large, causing the bladder contracture. 2.2.5 Training of constipation in patients with preoperative care bed defecation. 3 days after surgery to encourage eating a small amount of the intestines are rich in fiber foods such as fresh vegetables, fruits, bananas, honey. Conditions permitting activities to encourage bed early; necessary, taking laxatives, hanged Hypertonic saline enema in order to avoid the prostate fossa hemorrhage. 2.2.6 2.2.6.1 predictive nursing catheter combined with prevention of infection in surgical patients due to low immunity, high incidence of urinary tract infection and precision, therefore, must observe the changes in body temperature and white blood cells to observe whether the testis, scrotal swelling and pain, with or without chills, fever and other symptoms, early use of antibiotics to prevent infection; daily with cotton ball wipe BROMOGERAMINE 2 outside the urethra to prevent pollution of urethral discharge caused by retrograde infection. Closely observe the drainage of fluid color, character; original anus, perineum eczema who, timely application of appropriate drugs. To prevent pulmonary infection: inhalation when necessary to help patients take back expectoration. 2.2.6.2 skin care elderly patients with poor blood circulation, poor nutrition, coupled with the long-term bed rest after surgery, will easily cause pressure sores are perineal moisture. And should protect the skin after 24h, the support for each 2h sacrococcygeal with elbows, hips elevated so as to facilitate ventilation. After 24h, the establishment of stand up card, turn over once every 2h ~ 4h; kept dry and flat sheets, ready to replace the dressing and wet sheets in a single; conditions allow, into the high-protein, high calorie diet, eating less by infusion of amino acids, albumin, fat emulsion; if skin redness, ulceration when rubbed with iodine 1 per 2h,[link widoczny dla zalogowanych], to the skin until the skin off the aging; 3 times a day to scrub the perineum, the use of talcum powder; patients with diabetes mellitus in the use of hot-water bottle when must use a towel wrapped, or placed between two layers of the quilt, not direct contact with the skin, to prevent burns, the water temperature was 5O ℃. 2.2.7 Health Education Division I in elderly patients from rural villages, and cultural level is not high, usually have few opportunities to access to medical knowledge, lack of understanding of this disease on a long and continuous bladder irrigation catheterization lack of knowledge. Therefore, nurses should be a brief time to explain to patients and their families the disease pathology, surgery, postoperative discomfort during catheterization and mitigation methods; encouragement and ward patients have been cured in the exchange of experience; allocation and discharge tube guidance urethral sphincter function in patients with exercise, avoid alcohol and strenuous exercise. 3 experience on the set of 100 cases of surgical patient care, using nursing procedures and specialist nursing knowledge, so that patients discharged from hospital to receiving a complete set of health education, so that patients and their families understand the diagnosis and treatment of BPH, care and knowledge about self-care and stressed the importance of family influence on individual health, give full play the positive role of the family,[link widoczny dla zalogowanych], so that patients and their families actively participate in care activities. Received: 2003.04.03 Author: Yu-Juan Li (1963 a), female, Shandong Province, people, charge nurse, the main I engaged in clinical care.
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