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Severe hypertension and 1 case of descending aortic dissection nursing intervention

Treatment CLC: R473.5 Document code: A Article ID :1673-498X (2007} 04-0O64-01 Department of Cardiology at the hospital in March 2006 I treated patients with severe hypertension with descending thoracic aortic dissecting aneurysm patients, and successfully carried out its stent implantation (ES),[link widoczny dla zalogowanych], nursing care on the overall concept as a guide to develop the appropriate care measures, and achieved satisfactory results. I clinical data of patients, male, 45 years old, workers, during sleep suddenly felt chest tightness, pressure, the middle and lower sternum was not to him at the radiation, was sustained, not eased, more violent, accompanied by sweating, vomiting and rushed to hospital performance. check BP: 101 / 65 sampan T1Hg, P: 85 times / rain, past history of hypertension, the highest 180/120rru ~ aHg, usually with irregular oral antihypertensive drugs control. admission by color Doppler ultrasound, CT scanning, DSA angiography and other tests, confirmed for the descending aortic dissection. aortic false lumen in the beginning part of the descending aorta, down to the abdominal aorta. in improving the effective control of the relevant examination and blood pressure, heart rate, the in 5d after admission in the main anesthesia artery dissecting aneurysm stenting, in the right femoral artery puncture directly into 5F catheter sheath, the left brachial artery simultaneously 5F sheath into the other. brachial artery sheath through the guide wire in the ultra-smooth gold under the guidance of anyone to tag 5F pigtail-type catheter to the ascending aorta, and then give it away through the femoral artery sheath catheter in the ultra-smooth 5FH1 wire guided true lumen sent to the ascending aorta, the sending of people super-hard guide wire, to retain the guide wire, cut the femoral artery , given away by the super-hard guide wire thoracic aortic stent, the slow release of the stent under fluoroscopic guidance, the DSA catheter angiography showed normal exit, the right femoral artery incision sutured and bandaged two preoperative nursing care measures 2.1 hospital patients were in intensive care immediately after its continuous monitoring of BP,[link widoczny dla zalogowanych], HR, close observation of vital signs and record the daily oxygen 20h, so that oxygen saturation remained at 95%. according to the rational use of prescription drugs, regulation of blood pressure and heart rate, medication to achieve rapid, timely, accurate, and close observation of adverse reactions after treatment. ... the care for the problem of pain, nurses in understanding the location of arterial dissection, angiography situation, carefully observe the pain location, nature. pain relief can increase the direct reaction with the progress of the disease, namely, whether the aorta Received date :2007-10-12 About: He Yongmei (1971 a), female, Chenzhou, Hunan Province, the Deputy Director, Nurse. Continue or stop stripping Peel j. explain to patients the reasons for the pain to relieve ideological concerns, give pethidine prescribed drugs such as pain, and after treatment to observe the effect and adverse reactions. to be in stable condition, according to the needs of patients and the degree of acceptance , targeted psychological counseling for patients so that patients, a sense of security and trust, actively cooperate with the treatment. 2.2 Postoperative care measures prescribed to patients with right lower limb after braking 24h, bed 48h, in order to avoid puncture bleeding. Nurses should explain patiently to do the work life of patients during ambulatory care, intensive care. observing closely changes in continuing on the basis of ECG monitoring, close observation of the situation surrounding skin puncture site, with or without bleeding, hematoma formation. Orders were given antibiotics to prevent infection after surgery, the patients in protective isolation,[link widoczny dla zalogowanych], monitoring body temperature 4 times a day. The body temperature of patients during hospitalization maintained at between 36.2 ~ 38.0 ℃, consider the absorption of heat-related aortic dissection , was prescribed antibiotics and other anti-infective and symptomatic treatment Bupleurum injection. closely observed ipsilateral lower limb skin temperature and color, with or without swelling,[link widoczny dla zalogowanych], limb blood flow is good, whether the abnormal dorsalis pedis artery pulse. lift the brake, the lower limb passive for total joint activities and calf muscles to prevent deep vein thrombosis. 3 Summary of treatment of aortic dissection is more complicated and severe hypertension associated with aortic dissection is critical in severe cardiovascular disease. in the full understanding of the based on the patient's condition, develop a practical treatment options, and have achieved good therapeutic effect. in the care process, according to the patients existing or potential health problems to develop a more comprehensive and earnest implementation of nursing interventions to minimize the concurrent the incidence of disease, the patients with severe hypertension associated with aortic dissection patients without any complications during hospitalization.
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