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 Wysłany: Czw 22:33, 17 Mar 2011 Temat postu: Military nurse Student admission Motivation _4309 |
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Military nurse Student admission Motivation
Resection of the Chinese books and reference materials Classification Classification R714 vaginal hysterectomy (transv8nalhysterectomy, rVH) implementation is the use of vaginal hysterectomy natural grotto, with a shorter operation time, trauma and disturbance of the abdominal organs, post-operative pain and , short hospital stay, abdominal wall without leaving scars, rapid recovery, medical costs low. And more in line with the principles of minimally invasive technique is an effective method for treating uterine prolapse 【lJ. Our department to carry out nearly a year of new non-prolapsed uterus vaginal surgery in 28 cases, no complication occurred in 1 case, and achieved satisfactory results. Nursing now reported as follows: 1 clinical data of the 28 patients aged 62 years maximum, minimum of 31 years, mean 45 years. Of which 25 cases of uterine fibroids, dysfunctional uterine bleeding in 2 cases, 1 case of atypical endometrial hyperplasia. 2 2.1 preoperative psychological nursing care of patients and their families have different levels of this operation the fear of patiently and carefully to the patients and their families to explain the technical procedure. Some worry that young patients after local shape changes affect the sex life. We care, sympathetic talk with patients, targeted to the anatomical and physiological functions of the reproductive system to explain to patients and their families. On the one hand simple hysterectomy patients have a correct understanding,[link widoczny dla zalogowanych], while there are respected and feel valued. For those worried about impact of sexual life of patients after surgery, if necessary, so that the work of the husband for his wife, the husband of his wife's understanding and support itself is one of the greatest comfort. Special obese patients to explain to them may cause abdominal fat liquefaction and infection lead to poor wound healing, and vaginal surgery may be more ideal. Individual cases, so have done this surgery coming out preaching to introduce their own experiences. So that each patient can be relaxed, with a good attitude for surgery. 2.2 The completion of the preoperative routine for routine examination and laboratory examinations, the evening of 1 sedated before surgery, the skin (with abdominal surgery), so as to avoid difficulties in vaginal surgery converted to abdominal surgery. With an emphasis on the preparation of the perineum and around the anus, inner thighs on both sides of 1 / 3. 2.3 Preoperative vaginal preparation with a 1:500 O 3d vaginal wash potassium permanganate, and coated with 0.75% iodine in the cervical, 2 times / d; vaginal examination degree of cleanliness I no trichomoniasis and fungal infections. 2.4 3d preoperative bowel preparation without residue into the semi-liquid food, oral norfloxacin capsule 0.2g, 3 times / d, the preoperative use of senna bubble suits catharsis 1d, 12h fasting before surgery. On the morning of surgery with a 1:1000 soap and water enema, fecal contamination to avoid surgery or intraoperative intestinal injury caused infection. 3 3.1 General care of patients post-operative care from the operating room flat car into the ward, to the pillow supine, head to one side,[link widoczny dla zalogowanych], blood pressure, respiration,[link widoczny dla zalogowanych], pulse, to the anesthesia and the anesthesiologist understand the current situation infusion. Anesthesia patients should pay attention to clear respiratory secretions, keep the airway open. Anesthesia can not be used on warm hot water bottle to avoid burns. Of older patients, the appropriate infusion rate should be adjusted to prevent pulmonary edema and heart failure. Compared with abdominal surgery, less postoperative pain after vaginal, pain sensitivity, analgesic prescribed to tell patients not appropriate to use analgesics to affect recovery of gastrointestinal function,[link widoczny dla zalogowanych], and there is tolerance and into the cystic to encourage people to perseverance over pain pain, try to use the procedure before going to bed that night. Discretion of flatus after eating, after eating half of the first flow of liquid food. 3.2 indwelling catheter after balloon catheter 3d, just balloon into 5ml ~ lOml saline to maintain a constant, to observe the changes in urine color and urine. Indwelling catheter after 24h a day with a 1:5000 solution 50Oral nitrofurazone flushing the bladder, and replace the urine bag 1. Catheter before pulling 1d, regular opening of the catheter, each release of urine 1 2h. Indwelling catheter for continuous open drainage, the bladder was empty state can exercise regularly open bladder function, difficulty in urination after catheter to prevent pulling. 3.3 perineal care after normal vaginal gauze packing dry 3d, pulled together with the catheter. Should observe the packing gauze and dressings with or without genital bleeding, the daily use of 1% o 2 Bromogeramine cotton ball wiping the vulva, abnormal timely report to the physician. 3.4 Observation and nursing care and issuing our department 28 patients were discharged without complication occurred, but the following observation merits and issuing clinical attention. (1) hypotension: low blood pressure often due to blood loss caused by postoperative hypovolemia, poor cardiac function may also cause. Patients should be regularly measured blood pressure, pulse, pay attention to infusion rate and vaginal bleeding,[link widoczny dla zalogowanych], and timely reporting to the physician. (2), atelectasis, pneumonia: 48h after easily occur, especially in obese and older patients. Chronic respiratory disease with previous ... r]] if 『'
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