nyenaceyg
Dołączył: 13 Gru 2010
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Skąd: England
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 Wysłany: Śro 22:36, 02 Mar 2011 Temat postu: Observation of delayed rupture of the disease and |
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Delayed splenic rupture condition observation and nursing care
Pulmonary edema and heart failure. (3) record intake and output: the emergency rescue process, accurate record of the input hand the amount of fluid as the basis for subsequent treatment. (4) inhalation of oxygen: oxygen nasal catheter 6 ~ 8L per minute of traffic, improve symptoms of hypoxia caused by blood loss. (5) to do preparatory work before surgery: ① the range of skin preparation should be prepared for elective surgery than the larger skin area, to prevent intraoperative injury of other organs was found to expand the scope of surgical treatment. ② check blood venous blood, cross matching of blood, hematocrit, hemostatic screening tests, electrolytes, renal function and so on. ③ do susceptibility testing, to ensure postoperative safety, rational use of drugs. ④ good placement of the pipeline, the lumen tube should be selected coarse, to ensure the smooth operation. Male patients over age 50, prostate catheter balloon catheter can be used. ⑤ conscious who do missionary work before surgery, to eliminate the tension,[link widoczny dla zalogowanych], fear. Consciousness who do the work of the families thought that surgery as soon as possible. ⑥ supine, shock patient in principle, easy to move, raise the head and torso 20. 30. The lower limbs up 15. A 20. Timely clear respiratory secretions, keep the airway open. These efforts should race against time to complete, as soon as anyone to the operating room for treatment. 4.2 Environment 4.2.1 Postoperative care after the patient should be placed in a quiet, comfortable ward environment, ensure adequate rest and sleep is conducive to a speedy recovery. 4.2.2 Select position supine under anesthesia mode selection, anesthesia is not clear who take supine, head to one side to avoid the mouth or nasal secretions strayed into the airway of vomit; anesthesia to consciousness, to take the low half sitting or lying position,[link widoczny dla zalogowanych], can reduce abdominal wall tension, reduce wound pain, and it helps breathing; spinal anesthesia, supine 6 ~ 8h, prevent cerebrospinal fluid leakage caused by headache. 4.2.3 Observation of vital signs (1) Blood pressure: every 15 ~ 30min measurement time, pay attention to changes in pulse pressure, to observe whether there is internal bleeding in stable condition later changed to once every 1 ~ 2h measured and recorded. (2) temperature: After 24h, the temperature measured once every 4h, 6h after each time, until the body temperature normal to 1 to 2 times. (3) Pulse: Note the pulse of strength, speed, when the circulating volume is low, the pulse may be faster, thin and delicate. (4) Breathing: To observe the breathing rhythm and speed, if shortness of breath or breathing difficulties, should be promptly removed respiratory secretions, inhalation of oxygen per minute, 3 ~ 5L, and check the tightness of athletic appropriate adjustments. 4.2.4 take all care to ensure that the drainage pipe flow, properly fixed, anti-blocking, twisting, folding and off, and record the amount of drainage material, color,[link widoczny dla zalogowanych], character. (1) tube: the timely use of saline flush Jinie and maintain tube patency, observe and record the drainage, traits. Line due to preoperative fasting and the conventional preparation gastrointestinal tract, so the tube to maintain its smooth operation to relieve abdominal distension, wound healing is essential. (2) catheter: disinfection urethra,[link widoczny dla zalogowanych], 2 times a day, catheter occlusion, timing open drainage, and record hourly urine output, to better grasp the shock and improve the situation. 4.2.5 Incision Care (1) athletic compression bandage: to avoid coughing, caused when spurts of wound dehiscence, wound dressing application of athletic pressure. (2) Note incision bleeding, exudate, dressing fixed and local redness, swelling, heat, pain, etc., if the dressing was contaminated urine or sweat should be replaced to prevent wound infection. 4.2.6 the implementation of accurate and timely infusion care doctor's advice, given antibiotics and fluid therapy, blood pressure and urine output, etc. according to infusion rate adjustment, if necessary, checking blood samples taken to maintain water and electrolyte balance. 4.2.7 Other (1) should keep warm, to stamp quilts,[link widoczny dla zalogowanych], blankets and other measures to avoid application of hot-water bottle, thermos, etc. heated surface to prevent burns and skin blood vessels to dilate, causing blood flow to vital organs reduction and increased hypoxia. (2) pain: the pain is most intense within 24h after surgery, when patients after the disappearance of narcotic drugs, there may be pain, postoperative use of conditional analgesia pump; after general anesthesia patients often need to use analgesics meperidine 50 ~ lOOmg intramuscular injection, if necessary, 4 ~ 6h can be used repeatedly to reduce the unnecessary suffering of patients. (3) prevention of lung infection: the patient should be encouraged to cough, to cough, hard cough unable or afraid to be above the sternal notch in the press with your fingers to stimulate the trachea, to promote cough; incisional pain rather than a result of his cough, nursing patients who can hold hands or cuts both sides of the hypochondrium, to limit the range of abdominal activity, deep breathing again after the hard cough. If the viscosity is not easy to cough up sputum, you can use ultrasonic atomizing inhalation of mucus, is conducive to cough. (4) during fasting and oral care.
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