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Dołączył: 03 Mar 2011
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 Wysłany: Pon 11:00, 07 Mar 2011 Temat postu: keen shoes sale ygy gxf hqa odr |
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38 patients with severe Guillain - Barre syndrome nursing
2008 June 23 elderly patients with advanced Alzheimer's disease and septic shock in the rescue and nursing are summarized below. l clinical data in 23 patients in this group, 17 males and 6 females, aged 69-96 years old, shock are secondary to pulmonary infection. Concurrent respiratory failure in 12 cases, 8 cases of heart failure, disseminated intravascular coagulation in 3 cases, 21 patients successfully rescued, accounting for 91.3%, 8% in 2 cases of death, length of hospital stay 12-6O days. 2.1 2 Rescue and nursing comprehensive and detailed observation, analysis of the disease, early prevention and detection of possible shock, decompensated shock is to save for a good time n】 shock. Alzheimer's patients and other reasons because of aphasia or paralysis of the symptoms are not typical of shock, we need to careful observation of patient's condition, focusing on observation of consciousness, the patient whether there is irritability, listlessness, sleepiness, pale, weakness and cold sweats. Decompensated shock due to cerebral hypoxia, peripheral vasoconstriction, heart rate, systolic blood pressure fell faster until you can touch the pulse. Simultaneous measurement of blood pressure,[link widoczny dla zalogowanych], such as systolic blood pressure decreased,[link widoczny dla zalogowanych], indicating that the phenomenon exists shock should be allowed both patients to report doctors pillow Lying side by side, to get ready. 2.2 promptly correct the immediate shock and supine, low-flow oxygen 2L/rain. (1) to maintain airway patency, to correct hypoxia and carbon dioxide retention: the main physiological function of the respiratory system is the inhalation of oxygen from outside, the excess out of the blood carbon dioxide levels in the alveolar gas exchange. Patients with advanced dementia because of physical weakness, poor cough reflex, and the different levels of sputum viscosity, sputum can not be effectively and promptly turn over to give the patient back button to help patients effectively expectoration. Blood gas analysis in this group of patients with hypoxemia were there, some persons have chronic obstructive pulmonary disease and hypercapnia. In nursing administration in ultrasonic atomization by your doctor, there are good results, so be diluted sputum, difficulty breathing with different degrees of improvement. The original COPD, oxygen therapy should be low-flow oxygen when, to prevent the r-+ - + groan -+_+,} teaching managed care} x-+-H-a - a - BU one. I add a type I respiratory failure. Shall be given not easy to cough up phlegm suction. Elderly patients with oxygen or carbon dioxide retention is more serious, not with the suction, in this case, nurses must be forced to mobilize its tie or take the method of suction to keep the airway open and prevent the occurrence of pulmonary encephalopathy and worse. Patients and sputum collection and timely submission to drug sensitivity training, closely observe the patient during suctioning of respiratory changes. Wet replaced once daily disinfection of bottles, wet bottle of cold water or distilled water plus 1 / 2. (2) to establish a good venous access: the lack of older infected vascular filling, easy to puncture; each patients to severe infection of deep venous catheter; ensure the rescue of drug input. Because septic shock greatly increased volume of the microcirculation, it is a serious shortage of blood volume, therefore, adequate fluid input process is an important first aid measures must be as soon as possible, quickly added blood volume. Effective circulating blood volume can correct microcirculation, organ function and promote recovery of normal metabolism, so that a rescue is to win every time. Prescribed liquid quickly and accurately input, and make care records. Heart and lung function for patients with advanced dementia is not good, not too fast infusion rate. Generally a venous blood volume added,[link widoczny dla zalogowanych], and the other one for the input anti-infectives. When conditions allow, in order to accurately calculate the infusion rate, the best determination of central venous pressure. If CVP 0.09kPa, infusion rate should not be too fast. Such as central venous pressure is high, and blood pressure has not improved, proof of heart dysfunction, a doctor should be promptly reported to facilitate cardiac drugs to improve heart function. (3) observation of vital signs: every 15 ~ 30min pulse and blood pressure measured once. Early shock, the pulse can occur faster, early changes in blood pressure showed faster heart pulse compensation, blood pressure is an important manifestation of shock,[link widoczny dla zalogowanych], blood pressure, pulse integrated with other monitoring to measure blood volume and tissue perfusion. Poor tissue perfusion as shock patients, there are cold temperature did not rise and the phenomenon of the limbs, may be appropriate to provide insulation measures such as stamp quilts to raise room temperature. When the body temperature up to above 38 ℃, with ice or ice caps, the line head cooling pillow, body temperature> 39 ℃, the need to strengthen physical cooling, if necessary, application of hibernation. If the patient was rescued after the decline or no increase in body temperature no lower temperature rise, is still weak and weak pulse, rapid deep breathing, blood pressure failed to return to normal, limbs, low temperature, irritability and even worse consciousness, urine output per hour 25II1l the following, all that shock had not been alleviated. If the body temperature, pulse, respiration, blood pressure have been restored to illustrate shock symptoms have improved. (4) observation of renal function: Record out of the liquid
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