Hypertensive nursing papers 1: TCM nursing analysis of hypertensive patients Objective To explore TCM nursing measures for hypertensive patients. Methods The nursing experience of 120 patients was summarized. Results After careful treatment and nursing, the treatment effect was satisfactory, and all patients were cured and discharged. Conclusion Careful nursing guidance is the key to patients' rehabilitation.
key word
Hypertension; Chinese medicine nursing; measure
Hypertension is a common disease, mainly caused by the increase of arterial blood pressure. If left untreated, improperly treated or improperly cared for, it will lead to damage to the heart, brain, kidneys and other organs. Hypertension belongs to the category of dizziness and headache in traditional Chinese medicine. The etiology and pathogenesis are mostly mental stress, excessive thinking and excessive emotion. Or overwork, overeating, leading to yin-yang imbalance, abnormal operation of qi and blood meridians, qi stagnation and blood stasis, obstruction of collaterals, qi disorder, phlegm and dampness. According to the different clinical manifestations and symptoms of patients, dialectical nursing is helpful to improve the prognosis of hypertension. Nursing experience is summarized as follows.
Clinical data of 1
This group is 1 20 patients admitted to our hospital from 2007 to 2000 120 10. After careful treatment and nursing, the treatment effect was satisfactory, and all patients were cured and discharged.
2 nursing
2. 1 health education When entering the hospital, the nursing staff first introduced the knowledge about hypertension to the patients, such as diet, exercise, lifestyle, medication knowledge, etc. After discharge, patients are required to arrange their life reasonably, pay attention to the combination of work and rest, check their blood pressure regularly, especially those with family history, and insist on taking medicine for a long time. When adjusting drug dosage or dressing change, it must be carried out under the guidance of a doctor, and drug withdrawal or dressing change is not allowed without authorization.
2.2 Psychological nursing staff should pay more attention to the condition and give psychological counseling, and give individualized nursing and correct guidance according to different situations of patients; Communicate with patients frequently, communicate verbally and nonverbally, let patients vent their dissatisfaction and encourage patients to tell the reasons of anxiety and irritability. Nurses should understand and respect patients, explain the occurrence and development of diseases, relieve patients' psychological pressure, adjust their mentality, eliminate anxiety and irritability, help patients establish healthy behavior patterns, make them treat diseases correctly and enhance their confidence in treatment. You can play some music that patients like every day to divert attention, improve anxiety and achieve the effect of lowering blood pressure; According to patients' hobbies and cultural literacy, cultivate patients' interests, make patients have a pleasant psychological experience, cultivate their love for life and eliminate their worries about diseases.
2.3 General nursing staff should keep the indoor air fresh and the environment quiet and tidy; Keep sheets clean and comfortable, and indoor light is soft; Room temperature18 ~ 20℃; Living in an environment with 50%~60% humidity; Medical staff should be polite, enthusiastic and considerate to patients, so that patients always feel warm and comfortable; During the treatment, the patient has no endurance due to deficiency of qi and blood and marrow, fatigue and weakness due to deficiency of both heart and spleen, headache and dizziness due to hyperactivity of liver yang, so the patient needs to stay in bed, close his eyes, avoid changing his position and squatting greatly, and need help when getting out of bed to go to the toilet to avoid squatting for a long time; When taking a bath, the water temperature should not be too high and the time should not be too long to prevent accidents; Observe the onset time, degree and nature of headache and dizziness, the changes of symptoms, blood pressure and pulse, make records and accompany patients to do various tests; Assist patients in life care and send water and medicine to the bedside on time; Encourage patients to get out of bed after the symptoms of stable blood pressure are relieved, negotiate with them to make an activity plan, guide patients to carry out slow activities and gradually increase the amount of activities, and carry out repetitive limb circulation exercises to maintain muscle tension; The playground should have sufficient light, no obstacles, no water stains on the ground and no slippage; Patients with dizziness, tinnitus, dizziness, hypertension, rapid pulse and other symptoms should immediately stop activities and stay in bed.
2.4 Dietary care Chinese medicine believes that alcohol addiction and fatty sweetness can accumulate heat in the spleen and stomach and burn spleen and kidney yin; And can damage the spleen and stomach, phlegm and turbid internal resistance, clear yang without rising, and can also induce hypertension; Nursing staff should instruct patients to have a light diet: low in salt, with the maximum daily salt content not exceeding 6g; Diet should be low in fat, avoid greasy, sweet, sticky, spicy and irritating foods such as tobacco and alcohol; Eat less foods with high cholesterol, such as animal offal and egg yolk; Those with severe phlegm and dampness can be given glutinous rice porridge and yam porridge to strengthen the spleen and eliminate dampness; Those with hyperactive liver Yang Can eat more cold dishes such as vegetable oil, celery, laver, black fungus, hawthorn, jellyfish and Malantou, and often eat mung bean soup and shepherd's purse soup; Those who have been ill for a long time and are deficient in qi and blood can eat digestible and nutritious foods, such as pork liver, lean meat, fish and other flesh-and-blood products, or drink tortoise shell soup, sesame paste, walnut kernel, water chestnut paste and other foods; Patients with hyperlipidemia can take notoginseng flowers to soak in water instead of drinking tea; Obese patients should properly control their food intake and avoid overeating. Nurses should guide patients to cultivate good defecation habits and keep defecation unobstructed. In order to prevent complications such as cerebral hemorrhage caused by squatting or defecation for a long time, patients should eat more fresh vegetables, fruits and bananas. And also eat honey water or soak senna leaves in water for oral administration.
2.5 Rehabilitation Guidance Hypertension is a chronic disease, and it takes a long time for patients to recover, but patients cannot be hospitalized for a long time. When the patient's condition is stable and the complications are well controlled, he should be discharged from the hospital, but first of all, blood pressure monitoring should be done well, and blood pressure level can not be estimated according to symptoms. It is necessary to know blood pressure through blood pressure measurement as the basis for adjusting medication. Patients with hypertension should take antihypertensive drugs on time and in quantity according to the doctor's advice, and gradually lower their blood pressure. Do not increase or decrease the dosage and frequency of medication without authorization, so as to avoid serious complications due to excessive blood pressure fluctuation, such as insufficient blood supply to the heart, brain and kidney due to sudden increase in dosage. Long-term hypertension patients can cause renal insufficiency, so urine routine and renal function should be checked regularly; Patients with precordial pain, numbness and weakness of one limb, mouth askew, nocturia or oliguria should go to the hospital in time; In case of sudden increase in blood pressure, accompanied by headache, palpitation and other symptoms, you should relax all over, lie still and rest, take nifedipine 1 tablet or take other antihypertensive drugs orally immediately, and go to the hospital immediately after the symptoms are slightly relieved.
To sum up, careful nursing guidance is the key to patients' rehabilitation.
Take the exam and contribute.
[1] Ping Huang. TCM Nursing and Rehabilitation Guidance for Hypertension, journal of traditional chinese medicine, Yunnan, 2006,27 (1): 6768.
[2] Wang Li. Traditional Chinese medicine nursing care of patients with hypertension. Hubei Journal of Traditional Chinese Medicine, 2007,29 (8): 4748.
Objective: To explore the clinical nursing methods and key points of elderly patients with hypertension.
Methods: 20 1 1 to 20 13 elderly hypertensive patients 168 patients in our hospital were selected, and their blood pressure was controlled through blood pressure observation and nursing, medication guidance, psychological nursing and life guidance.
Results: The results showed that 168 elderly hypertensive patients took targeted nursing measures, 153 patients had lower systolic blood pressure, 150mmHg, 15 patients had only 150 mmHg systolic blood pressure due to their age and serious organ damage.
Conclusion: Under the guidance of rational drug use and life, regular blood pressure observation and nursing, supplemented by appropriate psychological nursing, can effectively control blood pressure, reduce the incidence of various complications and significantly improve the quality of life of patients.
Keywords: nursing care of senile hypertension
In 2002, the Ministry of Health of China investigated the health and nutritional status of 270,000 people. The results show that 49% of patients with hypertension in China are over 60 years old, that is to say, 1 person in every two elderly people in China suffers from hypertension. Hypertension, as one of the most common diseases of the elderly, is one of the main factors leading to the increase of morbidity and mortality of stroke, renal failure, ischemic heart failure, aortic disease and coronary heart disease in the elderly, which seriously affects the quality of life of the elderly patients and even threatens their life safety. In this regard, the author selected elderly hypertensive patients from May 20, 2003 165438+May 2065438165438 in our hospital, and implemented measures such as blood pressure observation nursing, medication guidance, psychological nursing and life guidance, which achieved remarkable results. The specific report is as follows.
1 data and methods
Basic information of 1. 1 From May 20 165438 to May 20 168, there were 74 males and 94 females in our hospital with an average age of 67.6? 1 1.7 years old. Among them, there were 3 cases of cerebral hemorrhage, 5 cases of renal insufficiency, 27 cases of mental failure, 34 cases of coronary heart disease and 39 cases of cerebral infarction.
1.2 nursing methods. Patients should regularly check their blood pressure after admission, guide rational drug use, and give relevant health education, as well as psychological and life care, as follows.
1.2. 1 blood pressure observation and nursing. A major feature of elderly hypertensive patients is that their blood pressure fluctuates greatly, mainly due to the simple increase of systolic blood pressure. For such patients with large blood pressure fluctuations, especially during their treatment, blood pressure should be measured several times a day to master the daily blood pressure changes of patients. Nurses need to pay special attention to patients' blood pressure at night, so as to prevent patients' blood pressure from dropping too low at night, and they can know the diurnal variation of patients' blood pressure and its Gu Feng law according to their 24-hour blood pressure dynamics. In addition, because the function of regulating blood pressure in elderly patients is low, blood pressure tends to change with different postures, and postural hypotension may occur. Therefore, nurses must measure blood pressure in different postures and postures when patients are admitted to hospital to eliminate the risk of postural hypotension.
1.2.2 Instructions for use. According to the characteristics of different patients, guide patients to choose antihypertensive drugs jointly or separately. When choosing drugs, we must adhere to the principle of individualization, take small doses first, and then gradually increase the dose according to the patient's age, needs and antihypertensive response, so as to keep blood pressure within the normal range as much as possible. Due to the common atherosclerotic lesions of brain, kidney, heart and other organs in elderly hypertensive patients, coupled with weakened circulatory regulation function and decreased body fluids, excessive hypotension is prone to occur when taking antihypertensive drugs. Therefore, elderly patients with hypertension must be gentle, slow and moderate when choosing drugs. After taking the medicine, observe the effect and reaction of the medicine, gradually increase the dose after a few weeks, and reduce the blood pressure after about 2-3 months. The following three principles must be grasped in guiding the medication of elderly hypertensive patients: ① If there are fewer kinds of drugs, the memory of the elderly will decline, and if there are more kinds of drugs, the elderly will easily miss taking drugs; ② Choose antihypertensive drugs suitable for elderly patients; ③ Strictly instruct patients to take medicine according to doctor's advice and keep blood pressure within a relatively safe range.
1.2.3 psychological nursing. According to the current medical level, hypertension cannot be completely cured. Taking medicine for hypertension is slow and easy to relapse, which leads to fear, tension, anxiety and depression in patients. It is necessary to provide patients with a comfortable living environment, care about their daily life, establish a good relationship with them, patiently listen to their confidences, give psychological counseling in time, encourage them to listen to more music, and adopt relaxation therapy, which has achieved remarkable results. At the same time, actively participating in some sports activities of the elderly, such as painting and playing chess, and keeping an optimistic attitude and mood at all times will also help to lower blood pressure.
1.2.4 life guidance. Bad living habits are one of the main factors leading to the increase of blood pressure in patients. Therefore, forming a good habit of going to bed early and getting up early, reasonably arranging daily activities, paying attention to the combination of work and rest, not being excessively tired and nervous, and always maintaining a stable mood and a good mental state can effectively maintain blood pressure. In addition, smoking and drinking will increase the arterial pressure of systemic circulation and the fragility of vascular wall, so elderly hypertensive patients must quit smoking and avoid drinking. Finally, pay attention to the low-salt diet, and the daily salt intake should not exceed 3-5g. Patients' families must actively cooperate, try not to use some pickled foods with high salt content, and encourage patients to eat vegetable oil instead of animal oil.
Two results
Elderly hypertensive patients 168 were admitted to our hospital. After nursing in our hospital, the systolic blood pressure of 148(88. 1%) patients dropped below 150mmHg, and only 20 (1/.9%) patients were over-aged.
3 Conclusion
With the joint efforts of nurses in our hospital, the blood pressure of elderly hypertensive patients in our hospital has been well controlled. Therefore, according to the different characteristics and pathogenesis of elderly patients with hypertension, it can effectively control the blood pressure of patients, improve their quality of life and reduce mortality by formulating personalized treatment and nursing programs and strictly implementing them.
refer to
[1] Mao Xiaorun. Study on comprehensive nursing intervention of elderly patients with hypertension and diabetes in community [D]. Shihezi University, 20 13
[2] Du. Study on the application of nursing procedure in home visits of elderly hypertensive patients in community [D]. Shihezi University, 20 13
[3] Luo. Investigation and nursing care of elderly patients with hypertension [J]. chinese medicine guides, 20 13, 28: 264-265.
[4] Xie Jianxiu, Chen Shuiqiong, Ye Cuihua, Hu Yanping. Analysis on the influence of community nursing intervention on the quality of life of elderly patients with hypertension [J]. Contemporary Medicine, 2013,09:1120.
[5] Li Qingqing. Effect of evidence-based nursing on compliance of elderly patients with hypertension [A]. Henan province nursing association. Proceedings of the Symposium on Multiple Needs of Elderly Patients and Continuous Nursing Services in Henan Province [C]. Henan Nursing Association: 20 13.
Objective: To explore the nursing countermeasures of hypertension. Methods: 48 patients with hypertension in our hospital were studied, and the use of antihypertensive drugs and nursing measures were discussed. Results: 48 cases of hypertension were relieved, and reasonable nursing can effectively control blood pressure. Conclusion: In addition to medical treatment and nursing, patients' self-monitoring also plays an important role in their condition.
Hypertension; Nursing; Countermeasures; Self - monitoring
Hypertension patients are mostly middle-aged and elderly people, which seriously harms the health of patients. The pathological feature of hypertension is the increase of systemic arterial pressure. The symptoms of patients in the early stage of illness include dizziness, headache, tinnitus, inattention, insomnia, irritability and so on. Hypertension can cause serious damage to important organs of human body, even cause cerebral hemorrhage, accelerate cerebral atherosclerosis, make patients have cerebral ischemia and even form cerebral thrombosis. The continuous increase of blood pressure will increase the load on the left ventricle and cause left heart failure. Long-term hypertension can also lead to renal failure. If the patient has complications, the symptoms of hypertension will be more obvious, such as finger stiffness and lower limb pain. 5% of hypertensive patients have hypertensive emergencies, and the common hypertensive emergencies include cerebral hemorrhage, clonine acute withdrawal syndrome, rapid malignant hypertension and acute left heart failure. The main factors of hypertension are age, occupation, heredity, weight and salt content. With the improvement of people's living standards in China, the incidence of hypertension is getting higher and higher. Many patients with hypertension find themselves suffering from hypertension only after their own cardiovascular and cerebrovascular accidents, so they should take active prevention and effective nursing.
1, data and methods
1, 1, data
There are 48 patients with hypertension in our hospital, including 40 males and 8 females. The patients ranged in age from 43 to 80, with an average age of 65.
1, 2, method
To detect the pathogenic factors of hypertension patients, including diabetes, smoking, obesity, heredity, cerebral hemorrhage, hyperlipidemia and social factors. Record the patient's highest blood pressure and treatment effect, including the effect of antihypertensive drugs before and after treatment, and determine the acquired factors affecting hypertension. Whether the patient's posture is sitting or lying needs to be measured three times to get the average. Patients in doubt need to be observed for some time before they can draw a conclusion.
Diagnostic criteria; The ideal blood pressure is 1 20/80mmhg (1mmhg = 0.133kPa), the normal blood pressure is below130/85mmhg, and the critical hypertension is130 ~/kloc-0. 140 ~159/90 ~ 99mmhg in primary hypertension and160 ~179/100 ~109mmhg in secondary hypertension. At this time, the kidneys, heart, brain and other organs have been damaged, high blood pressure.
2. Results
The blood pressure of 48 patients with hypertension was well controlled and no complications occurred in the near future.
3. Characteristics of hypertension
3, 1, Insufficient understanding: Many patients know little about the factors affecting blood pressure and the harm of hypertension, and think that hypertension is a chronic disease, and they are not prepared for long-term treatment, which makes patients and their families feel scared. Some patients' symptoms are not obvious, and they have high blood pressure only after physical examination, so it is necessary to measure their blood pressure regularly.
3, 2, unreasonable diet: diet has a great influence on hypertension, patients with hypertension should eat a low-salt diet, most patients can not control the intake of sodium salt well because of long-term eating habits. Most patients in this study have the habit of smoking and drinking. Smoking can cause bronchitis, drinking can hurt the liver and stomach, and smoking and drinking can cause high blood pressure.
3, 3, not following the doctor's advice: Hypertension is a chronic disease that needs long-term treatment, but many patients can't take medicine according to the doctor's advice, and often reduce the dose according to their own judgment, which affects the treatment effect. Some patients are worried that long-term medication will have side effects, and they will stop taking the drug after the condition is relieved, causing serious consequences.
4. Nursing countermeasures of hypertension
4, 1, reasonable diet
Excessive salt intake will raise blood pressure, sweets and overeating will make people fat, and obesity will also raise blood pressure. The daily intake of salt should not exceed 5 grams. The control of sodium salt needs the cooperation of patients and their families. Patients and their families should understand the significance of controlling sodium salt: the increase of sodium ion will increase the volume of extracellular fluid, increase blood circulation, increase the content of sodium ion and water in vascular smooth muscle cells, and increase blood pressure. Patients should be encouraged to eat more vegetable oil instead of animal oil. In diet, things must have enough fat, calories, calcium, iron, zinc, etc., but they must not be excessive. Patients with hypertension are suitable to eat high-protein things, such as bean products, beef and mutton, fish and chicken, and eat more fruits and vegetables. According to patients' eating habits, guide them to eat, pay attention to the color and fragrance of food, and let patients consciously accept low-salt food.
4, 2, cultivate good living habits
Hypertensive patients should form the good habit of going to bed early and getting up early, combine work and rest, arrange their lives reasonably, maintain a relaxed mood and a good mental state, do some outdoor exercises appropriately, promote vasodilation, improve cardiovascular function, control their weight and enhance their resistance. However, they should choose proper exercise instead of strenuous exercise. It is better to do aerobic exercise, and the amount of exercise should be determined according to their age, hobbies and health. Pay attention to the combination of work and rest to avoid excessive tension and fatigue. Early patients should rest properly, and those who are overworked, hypertension, obvious symptoms or accompanied by organ damage should rest fully. Proper rest and adequate sleep are conducive to lowering blood pressure. Keep the ward quiet and the light soft, minimize visits and ensure adequate sleep; The nursing operation is also relatively concentrated, and the action is light, so as to avoid excessive interference and aggravate the discomfort of patients.
4, 3, psychological care
Eliminate tension and fear, and stabilize mood. Patients are often depressed, afraid and anxious when they are admitted to hospital. Practice has proved that people who are cheerful and optimistic live longer. Minimizing mood swings is of great significance to keep blood pressure stable and reduce complications. Mental tension, emotional excitement, psychological stress, etc. Will raise blood pressure. Therefore, as a nurse, we should have a high sense of responsibility and compassion, care and understand the patient's thoughts, life and work. When nursing patients, we must observe carefully, communicate with patients more, collect patients' psychological information at any time, and give guidance according to patients' different psychological States and characteristics, so that they can actively cooperate with treatment and nursing, avoid emotional excitement and irritability, and create the best psychological state for patients to receive treatment.
4, 4, popularize knowledge of hypertension
Apply medical knowledge and nursing psychology knowledge to educate patients and their families about hypertension. What is blood pressure? What is hypertension, factors affecting blood pressure, etc. It can be easily understood and accepted by patients and their families with vivid metaphors. With the transformation of modern medical model and the development of medical science, health education of clinical diseases has become more and more important and valuable. Medical staff must have vivid language, rich expressions, scientific medical theoretical knowledge, as well as knowledge of diet, nutrition, psychology and ethics, so as to better alleviate the pain of patients and make people reach the best health state. Avoid mood swings and reduce emergencies. Emotional excitement, especially anger and anger, can affect the endocrine and immune systems through the nervous system, leading to an increase in heart rate and blood pressure, so patients with hypertension should keep their emotions relaxed and stable.
4, 5 rational use of antihypertensive drugs
Explain to patients or their families the importance of long-term lifelong treatment and health care for hypertension, take antihypertensive drugs regularly and adjust them under the guidance of doctors to prevent blood pressure from rebounding. In the process of taking antihypertensive drugs, it is necessary to explain to patients that they should stand up when sitting or lying flat, and move as slowly as possible, especially when getting up at night to urinate, so as to avoid suddenly standing up, so as to avoid syncope and accidents caused by sudden drop in blood pressure. Instruct patients to use drugs rationally according to the doctor's advice, and do not add or stop drugs without authorization, so as not to cause adverse reactions.
4, 6, according to the doctor's advice, regular blood pressure measurement.
Explain carefully to patients and their families the importance of medication principles to treatment, and explain the interest relationship between adherence to medication and disease control. Let them realize that correct and reasonable medication depends not only on doctors, but also on the cooperation of patients. In addition to patients insisting on standardized medication, family members are also required to supervise and care for patients' medication, so as to ensure the smooth progress of treatment, improve the compliance rate and achieve the purpose of treatment. Let them realize the long-term and importance of taking medicine, which is an important link to control blood pressure at the target level and delay the damage of target organs.
Teach patients or their families to measure blood pressure. At present, the electronic wrist sphygmomanometer on the market is a convenient, fast and accurate sphygmomanometer. Patients can measure the changes of blood pressure and heart rate by themselves, and can accurately record the time and blood pressure value of the previous measurement 2 1 time. It is suggested that patients with financial ability buy this electronic sphygmomanometer, which can accurately detect blood pressure at any time and guide patients to come to the hospital regularly to check whether there is any target organ damage.
The patient's family members and medical staff are in the same mood, and they all hope that the patient will recover soon. However, due to the lack of medical knowledge and nursing psychology knowledge, it is difficult to get good results. Strive for the active cooperation of family members, and provide them with basic technical operation guidance such as medical knowledge, health care, medication nursing knowledge and correct blood pressure measurement, so as to obtain the active and effective cooperation of family members. It has played a positive role in the early recovery of patients.
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[3] Hou Pihua, Chen Gailing, Li Ge, Li, Shi Zaixiang. Clinical research progress of hypertension in the elderly in traditional Chinese medicine [J]. Journal of Cardiovascular and Cerebrovascular Diseases of Integrated Traditional Chinese and Western Medicine.2012 (01)
[4] Hou. Effect of nursing intervention on sleep quality, bad mood and compliance behavior of elderly patients with hypertension [J]. China Medical Innovation.2013 (24)
[5] Lu, Xu Bin, Geng Guiling, Li Suyuan,. To explore the influence of family fixed partner intervention on healthy lifestyle knowledge, attitude and behavior of hypertensive patients [J]. Chinese health service management.2013 (06).
[6] Diao Sujun, Lu, Zhou Cailian. Causes and countermeasures of incompatible use of insulin refills and injection pens in diabetic patients [J]. Dr. China Hyundai.2013 (17).
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