AKI护理.pptVIP

* * * * * 加强各种引流液、大便颜色、伤口渗血等情况的观察；观察皮肤有无出血点、淤青、胸前有紫色小点；及早发现出血并发症，通知医生及时调整 抗凝剂的用量或改用其他抗凝方法；使用肝素抗凝的患者穿刺后按压时间应延长，动脉穿刺后必要时须加压包扎。 * * Typical Pressures During Treatment Access pod measures the extracorporeal pressure as the blood “exits” the vascular access. The access pressure is measured to prevent excessive suction by the blood pump. This pressure is measured before the blood pump and is always negative; typically -50 to -150 mmHg. Filter pod measures the extracorporeal pressure as the blood enters the hemofilter. Filter pressure is measured after the blood pump and is always positive. Since it is measured before the hemofilter, it is the most positive (highest) pressure in the PRISMA Set; typically +100 to +250 mmHg. Return pod measures the extracorporeal pressure as the blood re-enters the vascular access. This measurement prevents return of blood to the vascular access against excessive resistance. The return pressure is measured after the blood pump and is always positive; typically +50 to +150 mmHg. Effluent pod measures the pressure in the effluent line as the ultrafiltrate “exits” the hemofilter. Depending on the therapy chosen and the ultrafiltration rate, the effluent pressure can be positive or negative; typically +50 to -150 mmHg. All pressures above, except the access pressure, provide data needed by PRISMA software to calculate transmembrane pressure and filter pressure drop. These calculations are used to provide information that may indicate that clotting has begun in the filter or that the filter has clotted and the PRISMA Set must be changed. During patient treatment, actual pressures at each pod can be viewed on the Status screen. 中空纤维膜两侧压力差, TMP= （滤器压+静脉压)/2-废液压;判断真伪 :伪：压力壶膜复位 （ TMP ＝0）/真：TMP 300~400mmHg 偏高 TMP 400mmHg 以上 * 中空纤维膜两侧压力差, TMP= （滤器压+静脉压)/2-废液压;判断真伪 :伪：压力壶膜复位 （ TMP ＝0）/真：TMP 300~400mmHg 偏高 TMP 400mmHg 以上 * 严密观察病情变化 方 法 　　采用24h小时心电监护监测血压、脉搏、呼吸、心率、氧饱和度等，每小时记录一次。 密切观察患者神志、意识、体温的变化。 处 理 　　当显示的参数发生变化时，应立即对患者的病情进行重新评估，并及时通知医师对治