英語(yǔ)護(hù)理查房最全課件

1、英語(yǔ)護(hù)理查房英語(yǔ)護(hù)理查房1234ContentsCase Report Knowledge of IntussusceptionTherapeutic ManagementHealth Guidance for Discharged Patients1234ContentsCase Report Kn Case Report Case Report BIOLOGICAL DATA: Name ：Chen Jingya Sex： female Age： 7-month-old Date of Admission：2015-04-23 14:40 Case Report Case Report C

2、hiefComplaint： paroxysmal crying vomiting bloody stool ERX-Ray:Intussusception unable to resetCase Report ChiefComplaint：Case Repo Case ReportAdmission Diagnosis:Acute IntussusceptionPhysical Examination:T:36.9 P:110/min R:20/min Wt:7.5kg Case ReportLaboratory examination:routine bloodroution urinef

3、ull biochemicalfull blood coagulation testHIV,HBV,HCV,RPRDate of Intussusception surgery:2015-04-23Date of discharge:2015-05-05 Case Report Case Report Knowledge of Intussusception Knowledge of IntussusceptioEtiologySymptoms & SignsDefinitionIntussusceptionEtiologySymptoms DefinitionInt What is intu

4、ssusception? Intussusceptionis a medical condition in which a part of the intestine has invaginated into another section of intestine.Knowledge of Intussusception-Definition What is intussusce Children intussusception Intussusception is an common abdominal emergency in children. It is one of the mos

5、t common causes of abdominal obstruction in infants. 4-10monthKnowledge of Intussusception-Definition Children intussusception ETIOLOGY Knowledge of Intussusception ETIOLOGY KnowlAge: 80%2 years old, most common in infants aged 4-10 months.Sex: the ratio of the male-to-female is approximately 3:1.Se

6、ason: the seasonal peak is in spring and summer. Incidence:Knowledge of Intussusception-EtiologyAge: 80%2 years old, most comWhats the reason of the disease? Why it happens to infants mostly?Knowledge of Intussusception-EtiologyWhats the reason of the diseaPredisposing factors: caused by disorder of

7、 the intestinal peristalsis, such as:Dietary alteration: complementary solid food.Diseases: gastroenteritis, diarrhea, fever,etal.Virus infections: adenovirus, rotavirus, reovirus, echovirus.Knowledge of Intussusception-EtiologyPredisposing factors: KnowledgDietary alterationKnowledge of Intussuscep

8、tion-EtiologyDietary alterationKnowledge ofThe complementary food of children can not be changed too soon.It is supposed to be transformed step by step.Dietary alterationKnowledge of Intussusception-EtiologyDietary alterationKnowledge ofPredisposing factors: caused by disorder of the intestinal peri

9、stalsis, such as:Dietary alteration: complementary solid food.Diseases: gastroenteritis, diarrhea, fever, et al.Virus infections: adenovirus, rotavirus, reovirus, echovirus.Knowledge of Intussusception-EtiologyPredisposing factors: KnowledgNonsurgical Therapy-Nonsurgical TherapyPredisposing factors:

10、Infantperiodaddassistfoodinfants mostly?Surgical Indicationrotavirus, reovirus, echovirus.* Wipe the stoma byflexure of the colonTherapeutic Management* If the wound is red orNonsurgical TherapyKnowledge of Intussusception-EtiologyName ：Chen Jingyatheoriginalisfromsingletomultiple5、Sausage-shaped ma

11、ss3-10 months healthy fat infantHight risk for fluid volume deficitfever(acute upper reappiratory tract infection)lost its normal function /enterospasmDiseaseKnowledge of Intussusception-EtiologyNonsurgical Therapy-feverlosPredisposing factors: caused by disorder of the intestinal peristalsis, such

12、as:Dietary alteration: complementary solid food.Diseases: gastroenteritis, diarrhea, fever, et al.Virus infections: adenovirus, rotavirus,reovirus, echovirus.Knowledge of Intussusception-EtiologyPredisposing factors: KnowledgResearchers suspect that infectious agents: rotavirus&adenovirus.Virus infe

13、ctionKnowledge of Intussusception-EtiologyResearchers suspect that infecIntussusception causes have not clearly established or understood.They can include infections, anatomical factors, and altered motility. Studies and analysis have not conclusively established this. Knowledge of Intussusception-E

14、tiologyIntussusception causes have noA review of sparse data on the possible association: the virus & intussusception has not demonstrated until very recently. Knowledge of Intussusception-EtiologyA review of sparse data on theSymptoms and Signs1、General appearance2、Paroxysmal crying3、Bilious vomiti

15、ng4、Red currant jelly stool5、Sausage-shaped massKnowledge of IntussusceptionSymptoms and Signs1、General Therapeutic ManagementNonsurgical TherapySurgical Therapy Therapeutic ManagementNonsurNonsurgical Therapy Air Enema Barium EnemaNonsurgical Therapy Air Enem Nonsurgical Therapy - Barium EnemaNonsu

16、rgical Therapy-Barium Enema Nonsurgical Therapy - BariumNonsurgical Therapy -Barium Enemacomplicationchemical peritonitisNonsurgical Therapy- Barium EnemaNonsurgical Therapy -Barium EnIntussusception presenting 48 hours.Good general appearance.Without abdominal distention, high temperature and toxic

17、osis . ETIOLOGYNonsurgical Therapy - Air Enema1.IndicationsNonsurgical Therapy- Air Enema Intussusception presenting 4 2.Procedure Restrained the patient, inserted the Foley catheter into rectum, inflated the balloon.Nonsurgical Therapy- Air Enema 2.ProcedureNonsurgical The2.head of intussusceptum l

18、ocated in the hepatic flexure of the colon1.before air clysis3.reduction occur4.reduction go on5.the filling of numerous loops of intestine2.head of intussusceptum 13.Signs of Complete ReductionFree flow of air into several loops of small bowel with simultaneous expulsion of feces.Stop crying, be qu

19、iet.Disappear of the abdominal mass. Nonsurgical Therapy- Air Enema 3.Signs of Complete Reduction4.Nursing Care of Post- air enemaCarbon test: take 0.5-1g activated carbon orally, appearing in stool 6-8 hours later.Basic therapy.Dietary guidance.Clinical observation closely. Nonsurgical Therapy- Air

20、 Enema 4.Nursing Care of Post- aiSurgical Therapy Surgical Therapy Pure manual reduction Intestinal anastomosis EterostomySurgical Therapy Pure manual reductionSurgica1.Surgical IndicationEnema failure. Intussusception occuring more than 48-72 hours.Intestinal necrosis. Intestinal perforation.Surgic

21、al Therapy 1.Surgical IndicationEnema fai 2.Nursing DiagnosisPainAnxietyHight risk for fluid volume deficitPotencial complicaion: shockSurgical Therapy 2.Nursing DiagnosisPainSurgi3.Postoperative Nursing InterventionMonitoring the vital signs and consciousness state.Oral feeding on a gradual schedul

22、e -obeying the doctors instruction. Surgical Therapy 3.Postoperative Intensive care for nasogastric tube.Prevention of complications: prevention of intestinal adhesion, fluid infusion to prevent bleeding, infection, etc.3.Postoperative Nursing InterventionSurgical Therapy Intensive care for nasogast

23、ric Activity : Passive activity3.Postoperative Nursing InterventionSurgical Therapy Activity : Passive activityHealth Guidance for discharged patientsAn important way to preventintussusception and finddiseases in time.Health Guidance for * Living guide* Disease observation* Diet guide* Special care

24、guide * Living guideLiving Guide*Let the parents realize the importance of keep moving.*Enough physical activities.*Prevention of intestinal adhesion.EXERCISELiving GuideEXERCISEINFECTION PREVENTIONAdenovirus infection Intestinal lymoph follicles hyperplasiaExcessive intestinal Stimulate the autonom

25、ic nervous systemperistalsisIntussusceptionSo*Prevent colds*Safety foodLiving GuideINFECTION PREVENTIONAdenovirusDisease ObservationWOUND NURSING* Take a shower instead of bath.* Get rid of the risk factors of damaging the wound.* If the wound is red or cracks,please go to hospital.Disease Observati

26、onWOUND NURSIDisease ObservationPain nursingAttentions!If the child cries with any paroxysmal,you had better do a timely manner B to exceed cheek,against to rule out the possibility of intussucception.pain3-10 months healthy fat infant *colicky abdominal pain *abdominal swelling or distention *bilious vomiting *“red currant jelly stool *sausage-shaped mass Disease ObservationPain nursin* If the wound is red or* Often change or cleanStudies and analysis have not conclusively established this.Nonsurgical Therapy-* Disease observationTHE US