www.public4you.fora.pl

njlpkhgea

1 case of pulmonary fungal infection amphotericin treatment observation of adverse reactions and nursing

Drug treatment methods should be used with dark bags AMB infusion in patients with fungal infection according to the degree of physical fitness,[link widoczny dla zalogowanych], and so tolerated dose of 1m from the start, the application 3,10,15,25 mg and gradually increased to 50 ~ 75mg / d, first with After the injection of liquid water lOml dissolved in 5% sugar, salt 500ml slow intravenous infusion. 6 ~ 8h losers. 2.2 chills and fever and the first infusion of care should be someone waiting at the side. Patients were observed at any circumstances. Time when warm shivering, slow infusion rate, close observation of vital signs, giving prescribed drugs such as dexamethasone, against fever, such as ice packs to give physical cooling. Sweating should change clothes in time for the patient. Prevent further cold. 2.3 Local phlebitis of the patients at the 10th infusion 50mg / d had local apparent tenderness. Direction was along the vascular cord-like swelling. Analysis is due to a thin peripheral wall. Infusion for a long time, the permeability increase the incidence of leakage, cause skin swelling, phlebitis. We have taken the following measures: ① Select the larger blood vessels, and often replace the puncture site: local heat before and after injection to ensure patency of vascular puncture and then add liquid: infusion process to strengthen inspections. Avoid drug leakage tube. And strictly control the infusion rate. ② complete infusion of 5% glucose solution for intravenous injection 5ml. When the needle injection drugs to prevent infiltration into the subcutaneous tissue. Reduce local irritation. ③ the left cubital vein of patients had peripherally inserted central venous catheter, the no recurrence of phlebitis. 2.4 The use of gastrointestinal reactions and AMB treatment of hypokalemia can cause electrolyte imbalance. Issued to increase the excretion of potassium :2009 -06-19 Revised :2009-07-20 Canadian, causing hypokalemia. Whether patients should be closely observed fatigue, abdominal distension and other symptoms. Monitoring of serum potassium concentration, regular review of ECG, while Zhu Huanzhe eat foods high in potassium and fruits 2.5 Other adverse reactions of the patients in the AMB treatment of liver and kidney function appear d12 review creatinine and uric acid, indicating that renal damage occurs. Liposomal amphotericin infusion use once again review the liver and kidney function d3. Creatinine and uric acid are decreased. That further damage kidney function did not occur. Timely application of prescribed drugs such as liver glutathione and so on. Care of patients should be observed on the appetite, sclera color, urine output, heart rate changes, regular blood tests to monitor heart, liver, kidney 2.6 AMB treatment of psychological care as long. Adverse reactions. Patients often have anxiety and fear. Patients we should make the necessary explanation. AMB treatment shows the necessity and possible adverse reactions. So that patients know what. AMB active discussion with treatment for 3 common adverse reactions are allergic reactions, decreased peripheral blood cell abnormalities, liver and kidney dysfunction, cardiac toxicity, hypokalemia, and phlebitis variety of adverse reactions was 7.3% 43.6% . Including liver and renal dysfunction and hypokalemia the most common, occurring in 43.6%, respectively, 40% and 38.2% E21. To reduce or prevent the occurrence of adverse reactions should note the following points: ① initial dose as small as possible. To 1mg / d is appropriate. Use of dexamethasone to reduce both the incidence of allergic reactions. ② from the peripheral central venous catheter in the PICC catheter used in long-term intravenous infusion and a strong irritant that can accommodate the drug around the vein [31. Best use of PICC infusion conditions. ③ periodic review of liver and kidney function, electrolytes and the electrocardiogram, the event of damage to liver protection should be strengthened, potassium and other nutrients, and symptomatic treatment of myocardial ④ the occurrence of fever and drug concentration and infusion rate of a great relationship. Must strictly control the concentration and infusion rate. ⑤ AMB case of oxidation and decomposition of light and easy. Therefore, we must now use with the active and dark. In the intravenous infusion. Application of infusion bottles and infusion tube wrapped with dark [41 short. AMB static point in the process of care. Should strengthen its adverse reactions observed. With physicians to take active and effective control measures. To reduce the incidence of adverse reactions. So as to reduce the suffering of patients. Improve the outcome. 4