尿毒症英文护理查房课件_1.ppt

Instructor: Participants： Main content General information Name:吴** Gender:female Age:48y Start dialysis:2009-8-3 Dialysis frequency:5 times/2 week Vascular access for hemodialysis: AVF Diagnosis:CGN(慢性肾小球肾炎) Present illness 患者现呈灰暗面貌，自透析以来，尿量逐渐减少，至今年10月份无尿。患者收缩压波动在140-190mmg，舒张压在70-100mmg，双下肢凹陷性浮肿明显，伴瘙痒。透析过程中常出现恶心呕吐，肌肉痉挛，曾急发左心衰。现口服降压药压氏达，抗贫血药力蜚能，纠酸药小苏打，每周一次Epiao。家庭经济状况不好。 The patient has a gloomy outlook.Since the dialysis,the urine is on the decline,untill October this year the urine is zero.The SBP of the patient ranges from 140 to 190mmHg,the DBP of the patient ranges from 70 to 100mmHg.The edema of the legs is obvious,along with the pruritus（瘙痒）.The nausea and vomiting happens frequently,the left heart failure happened twice. 压陷性水肿 Laboratory tests Nursing problem Nursing problem 1. Fluid overload Tips Use the cup which has scale; Eat something sour when feels thirsty. Use the cold water to gargle. Guide the patient to weigh seriously before and after the dialysis. 2.malnutrition Management 每日摄入充足热量的前提下，增加优质蛋白的摄入（1.1-1.2g/kg）,50%以上的蛋白应来自奶类、蛋类、鱼类、肉。 Besides the adequate heat,increase the input of high-quality protein,50% of the protein should be come from milk、eggs、fish and meat. increase the input of food which not only contain much Fe but also has high absorption rate,for example,meat、liver、blood、kelp and black fungi.Besides,the food which has rich VitC can help Fe absorb.Milk、coffee and tea should be avioded. Use EPO according to the doctors order,and supply the ferralia. 3.Bone pain,pruritus 4.Complications Na 5 mode 5.Psychological care 心理护理 1.Basic knowldege guide Explain the basic knowledge of renal failure to patient and family . Emphasize the importance of active therapy. Protect AVF carefullly, dont press ,dont carry heavy loads. Let the patient can speak of the commonly used medicine and take them on time. Observe the body whether has