母婴ABO血型合溶血病临床路径.docVIP

母婴ABO血型不合溶血病临床路径光疗换血 二、母婴ABO血型不合溶血病临床路径表单 适用对象：第一诊断为母婴ABO血型不合溶血病（）光疗换血常规网织红细胞血清胆红素肝肾功能电解质 患儿及其母亲血型鉴定Coombs试验试验 时间 住院第 天（换血日） 换血前 换血后 住院第7-10天（出院日） 主 要 诊 疗 工 作 明确换血指征，检查有无禁忌症 完善换血前实验室检查 家属谈话，签署换血同意书 换血前仍积极光疗 换血后继续光疗 密切观察患儿病情，监测胆红素水平决定是否需要第二次换血 观察有无胆红素脑病征象 上级医师查房，同意其出院 完成出院小结 出院宣教 重 点 医 嘱 长期医嘱： 入NICU 心电监护 预防性应用抗生素 临时医嘱： 换血前4小时起禁食 禁食后增加补液 置管医嘱 换血医嘱 完善用血前感染性疾病筛查 血气分析、胆红素、血常规、电解质、血糖 肝肾功能、凝血功能 苯巴比妥钠 换血前应用白蛋白 长期医嘱： 根据患儿情况适时开奶 换血后心电监护 临时医嘱： 光疗方式(单或多面光疗)及时间 监测胆红素水平 必要时静注丙种球蛋白 临时医嘱： 通知出院 出院带药 主要护理 工作 注意黄疸变化情况 注意患儿生命体征变化 光疗相关护理 注意黄疸变化情况 注意患儿生命体征变化 光疗相关护理 出院宣教 病情变异记录 □无 □有，原因： 1. 2. □无 □有，原因： 1. 2. □无 □有，原因： 1. 2. 护士 签名 医师 签名 spacing of 100mm. C, line line line nearby. D, spare wire unified terminal strip Terminal (terminal strip at the top of the vertical, horizontal terminal strip from the harness to Terminal Pai end at the beginning), length to ensure as far as Terminal and set aside. After e, form a wire harness, cable, line. When the line should be in the core wire for better identification and marking on the cards will be prepared in advance, alternate core core content for the cable numbering. F, finish line, according to the corresponding terminal locations, wire one by one from the bunch out, pulling line, should be kept parallel to each other and more. Core dark as possible, determined in accordance with specific conditions, it is required that: neat, beautiful, shapely, pleasing to the eye. 7.6.2 wiring technology, out of the core wire according to Terminal position, cut off the excess, with wire stripping pliers or electrician knife stripped of insulation, so that connection. Stripping should not damage the copper core. B, core wire on the oxide and chip-insulated electricians knife scrape. C, core processing has been completed, thread round long nose pliers in a clockwise direction. Circle with the screw in the direction of spin in the same direction, circle should be appropriate, it is best to sli