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1 case of chicken pox causes deterioration of pred

 
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Dołączył: 03 Mar 2011
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PostWysłany: Pią 17:23, 25 Mar 2011    Temat postu: 1 case of chicken pox causes deterioration of pred

1 case of chicken pox causes deterioration of prednisone


Large lymph nodes, neck without resistance, heart and lungs normal. WBC 11.6 × 109 / L, neutral 85%, lymph 18%, blister fluid smears no bacteria. Disable the hormone after admission, given intravenous penicillin 3.2 million u, intramuscular gamma globulin, vitamin B1 and other supportive therapy, treated with 5% crystal violet solution. All zoster after 1 week drying, crusting, discharged. 2 to discuss the case for failure to timely diagnosis, the conventional anti-allergy skin prednisone fever as a drug, resulting in rapidly increasing disease. Although corticosteroids have good cooling, anti-inflammatory, anti-virus, anti-allergic, anti-shock and the promotion of the role of symptom relief, etc., if applied improperly, or as a extremely harmful for the body to produce effects. In this case it is corticosteroids in children with chickenpox (prednisone) taboo. So warned colleagues not confirmed disease cases are not routinely used hormones. [Edit Yan Yong Xia] Clozapine fever in 1 case with acute observations of Zheng Meihua (Yanbian Brain Hospital 133000) From a medical perspective, the fever is actually a defensive reaction of the body, fever phagocytic cell function to strengthen the body, white blood cell increase , increased antibody production, which are conducive to kill bacteria and viruses, but when the body temperature over 39 ℃, it will harm the body, significantly increased the consumption of the body, damage the heart, brain, liver, kidney and other vital organs function, there heart ~ DJI1 fast,[link widoczny dla zalogowanych], loss of appetite, nausea, vomiting, constipation, and even unconsciousness, convulsions, coma. Therefore, high fever patients to strengthen the observation and care. In the clinical causes of high fever caused by a lot of heat caused by the drugs is one of them, such as: antipsychotics - clozapine. Currently, widespread clinical use of clozapine, because of its good efficacy, patients tend to accept. However, clozapine's side effects are great, sometimes life-threatening. So, how good of clozapine, to make it more secure, more effectively play its proper effect, it is particularly important, and close observation and careful nursing is the prevention of drug use and risk of accidents occurred during the most important . Now clozapine induced acute clinical symptoms of high fever in 1 case observation and nursing summarized as follows. A case report were male, 32 years old. Due to insomnia, random words, strange behavior of nearly 3 months and 1 week before the increase, for the first time to our hospital. Diagnosis of simple schizophrenia. Admission physical examination: blood, liver function, hepatitis B five, electrocardiogram, chest X-ray and other tests were normal. With clozapine treatment 100rag / day. Gradually increase the amount to 125mg / day, the first 12 days the patient developed headache, fever, body temperature of 38.4 ℃, Jicha blood: WBC8.6 × 109 / L. Normal, given anti-inflammatory drugs and antibiotics, hormones and other treatment, the effect is not clear, therefore, due consideration is the result of taking clozapine, clozapine treatment was immediately disabled, body temperature returned to normal, change clothes Invensys through 4g / day. 9 days after withdrawal, the patient bad sleep at night, plus service clozapine 25mg / day, the fourth day of treatment the body temperature rose to 37.6 ℃, then stop taking clozapine, the body temperature has returned to normal. 2.1 Observation and nursing of 2 after treatment to observe the reaction and carefully listen to the patient complained of, attention to psychological symptoms of drug side effects and phase identification, early detection of symptoms, immediately reported to a doctor promptly discontinued, symptomatic treatment. 2.2 The monitoring of vital signs, high fever the body temperature should be measured every 4 hours 1 until body temperature returned to normal after the third day can be gradually reduced to 2 times a day at the same time to observe the patient's complexion, pulse, respiration, blood pressure, such as abnormal should promptly contact your doctor. 2.3 good diet nursing: the heat causes the heat consumption, the patient should be given high-calorie, high protein and rich in vitamins, low fat and easily digestible liquid or semi-liquid diet to meet the needs of the body heat, as do meals delicious, so patient satisfaction. 2.4 Oral Care: Dry heat can cause oral mucosa, and easily lead to stomatitis, it should be noted that the early and late postprandial oral hygiene. 2.5 Skin Care: fever patients during high fever is often a lot of sweat, in order to maintain the patient's skin clean and comfortable, should be changed frequently, clothing, mattresses, bed sheets, quilt cover, a daily sponge bath, and keep the air fresh ward, humidity 50% to 60%. 2.6 psychiatric symptoms and psychological care: When disabled antipsychotic drugs, the patient may be insomnia, random words, strange behavior or pessimistic, negative emotions. In response, staff understanding fully the one hand, but also to give patients more care and consideration, made it clear that drug use, reducing the need for drug withdrawal so as to reduce the psychological insecurity of patients, to help patients enhance confidence in treatment, and then take the initiative to cooperate with the treatment. [Edit Cui Libo]


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