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One case of diabetic patients undergoing variceal ligation of Nursing

Trauma patients in the treatment of nursing experience in the process of experience, analysis of close monitoring and careful nursing of the important relationship between the prognosis of patients. Results through close observation of vital signs, pupil, awareness, physical activity, strengthening primary care and specialist care, patients with severe head injury in the 6O patients, discharged 4o cases, improved in 18 cases, 2 died. Conclusion observing closely, to detect changes in condition and take appropriate measures to improve the ICU on the cure rate in patients with severe head trauma, mortality is significant. Key words ICU; severe brain injury; condition monitoring; care 【Key Words】 R472 Document code】【B】【article number 1003 --- 6350 (2009) 07-168-03 with the level of medical technology development and intensive care unit (ICU) of the establishment, greatly strengthened the monitoring of critically ill patient's condition, so that patients can receive timely and effective treatment and care, improving the cure rate and reduce mortality. Section 2006 now I l2 months to September 2008 in the intensive care unit patients treated 6O monitoring and nursing report as follows: 1 Data and methods 1.1 Clinical data of the group 6O patients aged 20-70 years old The average age of 43.5 years, of which 28 cases of severe brain injury (epidural hematoma in 15 cases, 8 cases of subdural hematoma, intracerebral hematoma in 5 cases), cerebral contusion 2O cases of intracranial brain contusion hematoma in 9 cases, 3 cases of primary brain stem injury. People's homes 21 cases of GCS, 3-5 ,6-8 minutes and 39 cases. 1.2 Monitoring indicators we use multi-parameter monitors on patients body temperature, heart rate, respiration, blood pressure and blood oxygen saturation 24h dynamic monitoring, and close monitoring of consciousness, pupil and central venous pressure (CVP), urine volume, body movements and sensory changes. 2, monitoring of disease surveillance 2.1 Awareness illness prompted a change of consciousness change, is to determine the severity of head trauma patients an important indicator of prognosis with patients. GCS score sheet every day through the eyes open in the language, movement in three areas to determine the state of consciousness, Author: Wu Ping (1977 a), female, Hengyang City, Hunan Province, who, Nurse. Awareness of the patients were divided into the following situations: awake, lethargy, drowsiness, shallow or deep coma and coma. Nurses should be mastered in the observation condition to judge the state of consciousness, it is difficult to judge when to consult a doctor or a common analysis. Clear: clear memory, orientation is correct, answer the questions correctly; sleepiness: The patient is sleeping, but able to wake up, wake up when the correct answer, then is time again to sleep; sleeping: patient drowsy,[link widoczny dla zalogowanych], unresponsive, do not answer questions correct check can not match; light coma: Most patients with loss of consciousness, and call not, but the response to pain stimuli, pupillary reaction, corneal reaction,[link widoczny dla zalogowanych], weaken or slow the cough reflex; deep coma: loss of consciousness, of pain no response, a variety of reflex disappeared. Methods used: time calling patients, if no response is further stimulated by pain,[link widoczny dla zalogowanych], that acupuncture pressure supraorbital nerve or the lateral border of pectoralis major muscle and pinching and other methods to observe the response of patients, while physical activity can be observed in patients, Check for corneal reflex, swallowing reflex, with or without incontinence, and other changes in the nervous system and so on. Such as agitation in patients with sudden quiet, sleeping, should be suspected disease progression or sedative drugs used; such as deep coma patients swallowing reflex, avoid action or state of mind into clear, both got better tips. 2.2 The monitoring of pupil pupil larvae L change the important signs of traumatic brain injury, to determine the condition, is very important to detect cerebral hernia. It should be stressed that the observation of dynamic bilateral pupil than once, one side of the observation more meaningful. General acute observation of a 15-30rain, 3.3 Observation Project Steering esophageal ligation surgery is a treatment and prevention of esophageal variceal bleeding due to the means, and its risk factors did not eliminate, primary disease does not cure the patient and family members of project steering is particularly important. Such as: cough, abdominal pain,[link widoczny dla zalogowanych], diarrhea, there may be infection; black stool, dark red stool with fatigue, there may be bleeding; weight gain, increased abdominal girth may have ascites; personality and behavior disorders, with 168 * hands trembling, a liver encephalopathy may, immediately to the hospital examination and treatment.
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