Nursing summary paper model essay 1: nursing care of Langerhans histiocytosis
Clinical data of 1
There are 1 1 cases, with an average age of 2-4 years. The clinical manifestations of 1 1 case are: lymphadenopathy (76%, 19/25), hepatosplenomegaly (72%, 18/25). 13/25), fever (52%, 13/25), pulmonary infiltration (44%, 1 1/25). The blood picture, bone marrow picture and lung X-ray of laboratory examination lack specific performance; Osteolytic bone destruction is the most common bone X-ray lesion. Head CT/MRI is an important method to diagnose skull base bone destruction and sella turcica lesions. The child was diagnosed with Langerhans cell histiocytosis.
treat cordially
This disease belongs to the immune system disease. To treat this disease, we must enhance immunity and inject "immunosuppressant" to treat it.
2 nursing
Make a nursing plan as soon as possible. Children suffering from rare diseases should be diagnosed as soon as possible, actively cooperate with doctors to do various auxiliary examinations, and consult with dermatology and pediatrics departments quickly and effectively. Evaluate this serious disease, get relevant information, discuss with doctors' treatment plans and children's organizations, make detailed nursing plans, conscientiously implement and constantly improve conditions, and make changes according to reasonable and prudent measures.
2. 1 Fever nursing should closely observe the changes of body temperature, and measure it once a day for 3 days after the body temperature returns to normal. After bed rest, supplement nutrition and liquid temperature, change sweaty clothes in time to prevent eczema from dripping.
2.2 Psychological care Children have a strong desire for recovery. Through patient persuasion and treatment, they can eliminate their fears and consciously give spiritual comfort during treatment. Close cooperation with parents for treatment.
2.3 High protein diet and nutrition, high vitamins, good food and reasonable principles to improve health. Increase the body's tolerance to chemotherapy and improve immunity. In special treatment, such as vomiting, it is serious and difficult to consider the elements of high nutritional consumption in diet or vein to ensure that patients have enough calories and improve their nutritional status.
2.4 Before operation, the patient's condition should be carefully observed, and the nature, location, scope, abdominal distension, exhaust and defecation of abdominal pain should be observed, so as to quickly prepare skin and conduct skin test before operation. And painkillers should be banned to prevent the condition from being covered up.
2.5 The patient returned to the ward after the operation, lying flat with a pillow. 6 hours, head side, keep breathing unobstructed, and give oxygen if necessary. Clear before anesthesia, monitor whether there is vomiting, abdominal distension, anal exhaust and defecation, keep the drainage unobstructed, closely observe the vital signs and abdominal symptoms of gastrointestinal decompression, and observe the nature, color and quantity of drainage fluid; It is forbidden to do oral care on food, and supplement water and electrolyte solution reasonably according to the doctor's advice; Early semi-supine position after operation, encouraging early activities and preventing intestinal adhesion will be beneficial to physical recovery; Peristaltic recovery. Diet should be less and diligent, and gradually end, and observe whether there are symptoms such as abdominal pain, abdominal distension and vomiting after eating. If the above symptoms appear, stop eating and see if there are complications such as intestinal obstruction and anastomotic stenosis; Observe the wound without bleeding, exudation and swelling, keep the wound dressing clean and dry, and prevent urine from polluting the wound.
2.6 Adverse drug reactions and nursing observation The gastrointestinal adverse reactions of chemotherapy drugs are common. Diet combined with oral antiemetic drugs before or during chemotherapy can reduce nausea and vomiting, and intravenous injection for 30 minutes should be light and easy to digest. Do three checks and seven pairs. (1) Vincristine causes peripheral neuritis, numbness of skin, muscles, joints and limbs, pain and abdominal pain. The liver and kidney functions should be well protected, and the changes of blood should be paid attention to. Low white blood cell separation has a good protective effect on various infections. (2) The binding time of high-dose methotrexate with 6-MP. Make gastrointestinal reaction, stomatitis and oral ulcer worse. Important bone marrow suppression, members of Congress take orally once a day after dinner for six and a half hours to reduce the reaction and strengthen oral care. Methotrexate infusion may contain ice or cold water to reduce oral mucosa and vegetables. The use of methotrexate (3)VP 16 and ammonia concentration should be closely observed for leakage. Once found, the infusion should be stopped immediately to avoid tissue necrosis and/or. 16 the vice president of infusion will cause postural hypotension, prompting children to lie and slow down intravenous drip.
Close observation of the changes in the condition can win more rescue time. Close observation of vital signs. Activate multi-functional ECG monitor, closely monitor the changes of respiration, heart rate and blood oxygen, so as to rescue in time when oxygen drops. Closed body temperature, high body temperature, timely physical cooling, low temperature, warm and strengthen, observe and keep body temperature in the normal range, warm limbs. Observe the general conditions. Skin children, all important organ injuries, serious diseases, rapid and close observation of skin bleeding, herpes is better or worse than before; The liver tends to increase or decrease; Observe face, lips, body color, reaction and urine color; Observation of gastrointestinal bleeding: indwelling gastric tube, observing the bleeding situation, the effect of soda water gastric lavage and nasal feeding thrombin after the brown stomach contents in children receded by 0.6 percentage points, but the condition was repeated. Because of gastrointestinal bleeding, occasionally fasting children are at risk of hypoglycemia, and blood sugar monitoring and tracking can correct hypoglycemia in time. Blood biochemical examination shows that serum calcium is low, so it takes time to supplement calcium to prevent calcium convulsion. Skin and mucous membrane nursing. With body skin, hair, hands, bleeding, purpura covering feet, children scattered in herpes, herpes damages individuals, daily 1: 15000 potassium permanganate solution scrubbing, gentle movements, wearing soft clothes, so as not to aggravate skin lesions, damaged skin smear 100 countries. Routine oral care with sterile saline to reduce infection. Children fidgeting easily scratch their heels, so they should be bandaged with sterile gauze. Strengthen hip care, change diapers with good hygroscopicity and softness in time after defecation, and keep the whole body skin clean and dry. Turn over in time to avoid local long-term pressure.
3 abstract
The incidence of Langerhans cell histiocytosis is about 65,438+0/200,000. The patients are mainly infants, adults and even the elderly, and most of them are men. The disease belongs to the blood system disease. The bones, lungs, spleen and liver of severely ill children have different degrees of pathological changes. The disease often invades the alveolar wall, alveolar duct, bronchus and surrounding tissues of the lung, and may cause bleeding and necrosis; The original structure was destroyed, fibrous tissue proliferated, or the lung changed in a honeycomb shape. About 20% patients have no symptoms, which can only be found during chest X-ray examination. The nursing of this disease should mainly focus on the observation and nursing of children's fever, psychology, diet and nutrition to prevent more complications. At the same time, do a good job in health education and guidance when leaving the hospital, let parents know the relevant knowledge of diseases in easy-to-understand language, master simple nursing methods, take medicine correctly and on time, and regularly check blood picture and liver and kidney function.
Model article 2 of nursing summary paper: "Talking about respiratory medicine nursing"
1 data and methods
1. 1 general information
72 critically ill patients from 20 12 to 20 13 and 12 were randomly divided into two groups. There were 465,438+0 cases in the observation group and 365,438+0 cases in the control group. Among them, chronic respiratory failure 13 cases, severe lung cancer 6 cases, bronchitis 39 cases, bronchiectasis 14 cases. There were 48 females and 24 males. The age ranged from 27.2 to 865438 0.3 years old, with an average age of (565438 0.39? 5.07 years old. There was no significant difference in sex, age and clinical symptoms between the two groups (P & gt0.05).
1.2 method
Patients in the control group were given basic routine nursing mode, and after symptomatic treatment, the changes of symptoms were closely observed. The patients in the observation group adopted careful clinical nursing mode, and carried out nursing intervention in view of the patient's hospitalization environment and treatment. The specific implementation is as follows.
1.2. 1 environmental psychological intervention
Respiratory medicine patients have high requirements for air quality. In order to ensure good air circulation in the ward, an air purifier can be installed in the ward. And clean the ward every day, especially the dust, try to clean it with a vacuum cleaner to keep the ward clean and tidy. It is forbidden to place flowers and plants, visit the bouquets brought by patients, explain the reasons and bring them back to avoid aggravating the patient's condition due to pollen allergy. Because of the long illness time, patients are prone to fidgety and other emotions, especially severe patients, who feel hopeless for treatment and are prone to despair and negative psychology. Nurses should do a good job in patients' psychological work according to their different emotions, so that patients can establish the courage to overcome the disease.
1.2.2 therapeutic intervention
After giving symptomatic treatment to patients with different diseases, we should closely observe their vital signs and pay special attention to their breathing frequency and rhythm. Once there are symptoms such as hemoptysis and expectoration, report to the doctor in time for rescue. At the same time, according to each patient's condition and short-term treatment results, making corresponding rescue plans and making basic preparations can buy time for rescue. Explain the basic information such as drug name and curative effect to patients, and accurately grasp the dosage and concentration of patients. Establish two venous pathways, namely, the input of general drugs and the input of specific drugs. Another way of administration is atomizing inhalation, which can ensure the safety of drug treatment.
1.2.3 ventilation intervention
Timely ventilation treatment can improve the symptoms of respiratory disorders in patients. In the process of treatment, it is necessary to keep the patient's respiratory tract unobstructed and remove the secretions in the respiratory tract and oral cavity in time, which can reduce the occurrence of infection. Patients with severe illness can't breathe spontaneously, so they can use a ventilator to assist breathing. During assisted breathing, the changes of various parameters on the ventilator should be carefully implemented, and if there is any abnormality, it should be handled and corrected in time.
Statistical analysis of 1.3
The experimental data obtained in this paper are tested by SPSS 14.0 statistical software, the measurement data are tested by t, the counting data are tested by X2, and the data are tested by P.
Two results
After nursing 4/kloc-0 patients in the observation group, 38 patients got better, their vital signs returned to normal, 3 patients were ineffective, and the improvement rate was 92.68%. After timely rescue, 3 patients have basically recovered their vital signs; No dead patients. In the control group, 3 1 case, 23 cases were improved and 8 cases were ineffective, and the improvement rate was 74. 19%. Eight patients were rescued in time, 6 patients were rescued successfully, and 2 patients died suddenly, with a mortality rate of 6.45%. The overall curative effect of the observation group was significantly better than that of the control group (P
3 discussion
For severe patients in respiratory medicine, if effective rescue plan is not implemented in time and nursing intervention is given, it is likely to aggravate the patient's condition, lead to respiratory failure and even death. In the treatment, making an effective rescue plan for each patient can shorten the preparation time for saving patients' lives and improve the rescue efficiency of patients. In the whole nursing, the nursing staff should observe the different psychological changes of each patient in detail and pay attention to the care of tiny details. Diet should be mainly digestible and nutritious liquid food or semi-liquid food, and pay attention to the safety and hygiene of diet. Strengthening the knowledge explanation of diseases and letting patients understand the treatment process can alleviate the worries of patients. And carry out health education for patients, so that patients can pay attention to the cleanliness of personal hygiene and change clothes frequently to prevent unnecessary infection. In this study, after careful clinical nursing, the improvement rate of patients in the observation group was 92.68%, and there were no deaths. The overall curative effect was significantly better than that of the control group (P
4 conclusion
To sum up, applying meticulous clinical nursing to critically ill patients in respiratory medicine will greatly protect patients' lives and improve the efficiency of rescue. .
Model of Nursing Summary Paper Part III: On the Effectiveness of Traditional Chinese Medicine Nursing in Community Nursing
In order to develop the community service in China extensively and deeply, better serve the community residents and truly meet the health needs of the community residents, it is necessary to vigorously develop the traditional Chinese medicine nursing method with China characteristics, and make use of its simple, efficient and unique advantages in prevention, health care, medical treatment, health preservation and rehabilitation to adapt to the community health service function.
Keywords: Traditional Chinese Medicine Nursing Community Nursing
The origin of community nursing and western countries, 1978, who defines it as community residents? Accessible, acceptable and affordable? Health service institutions [1]. Community nursing not only emphasizes the prevention of diseases, but also emphasizes the care of diseases, and finally achieves the purpose of promoting and maintaining health. It is a key link to promote the development of community nursing to construct a community nursing model that conforms to China's national conditions, meets the needs of community health and has China characteristics. Compared with the origin of western medicine, there are many profound Chinese medicine theories and therapies in community nursing that are worth learning and developing.
1 Development prospect of TCM nursing;
Traditional Chinese medicine nursing is a method of dialectical nursing, preventive health care and health rehabilitation under the guidance of basic theories of traditional Chinese medicine. It is an important part of Chinese medicine system with a long history and rich contents. TCM nursing system consists of the following five aspects: basic theory of TCM, TCM diet nursing, TCM nursing technology, TCM health care and TCM emotional nursing. Traditional Chinese medicine nursing has unique advantages in the community. According to different community service objects, the whole Chinese medicine nursing system can be mobilized to complete the corresponding community service functions such as preventive health care, rehabilitation care and disease care. In particular, the nursing technology of traditional Chinese medicine is favored by the broad masses of the community because of its simplicity, experimentation and cheapness, which meets the requirements of low income, high efficiency, low cost and wide coverage, and has broad application prospects in the community health service system. In the relevant documents of the Ministry of Health, state administration of traditional chinese medicine and other ministries and commissions, it is clearly pointed out that: Community health service institutions should actively adopt appropriate technologies of traditional Chinese medicine, integrated traditional Chinese and western medicine and ethnic medicine, and give full play to the characteristics and advantages of traditional Chinese medicine in community health service? [2]。
2 development goals of TCM nursing:
The application of traditional Chinese medicine nursing in community home nursing has unique application value in China. As a developing country, the distribution of medical resources in China is still unbalanced. With the development of economy and the gradual formation of an aging society, traditional Chinese medicine nursing is constantly enriching the connotation of home nursing with its high quality, obvious effect and simplicity. Besides, in Chinese medicine theory? Cure the symptoms? The essence of the concept can be achieved through the combination of traditional Chinese and western medicine, learning from each other's strengths, so as to achieve unexpected results.
The main purpose of community nursing is to provide health services with health promotion as the goal, giving priority to health promotion, disease prevention and disease stabilization, which coincides with the theory of TCM nursing. The preventive concept of TCM nursing is branded with the traditional culture of China, emphasizing the idea of fitness and disease prevention with strengthening physique as the core, and formulating the principle of health preservation that adapts to natural changes externally and promotes the coordination ability of disease resistance internally. Organic combination of traditional Chinese medicine nursing and community nursing. On the basis of making full use of the theory, mode, procedure and implementation method of modern nursing health education, TCM nursing knowledge and technology are continuously infiltrated into the content of community health education. Environmental health care, daily life health care, diet guidance, psychological adjustment, sexual health care, medication guidance, sports health care, etc. In terms of self-care for women, children, middle-aged and elderly people and rehabilitation care for patients with chronic diseases, the connotation of community nursing health education has been continuously broadened. If properly used and skillfully combined, TCM nursing will be perfectly integrated with community health education.
It can be seen that the holistic view and preventive view of TCM nursing have been fully reflected in the modern concept of community nursing, which has laid a theoretical foundation for establishing a community nursing system with China characteristics.
3. Advantages and functions of TCM nursing in community nursing:
The basic theory of TCM, TCM diet nursing, TCM nursing technology, TCM health care and TCM emotional nursing together constitute the TCM nursing system. Traditional Chinese medicine nursing has its own system in theory and skills, and has unique advantages in health care, disease care and rehabilitation care, which is consistent with the health needs of the community. Moreover, TCM nursing is developed under the background of traditional culture in China, some TCM concepts have been well known to the people, and some health care campaigns are being widely carried out among designated people. All these indicate that Chinese medicine nursing has a good public foundation in China, close to public life, and easy to be recognized and accepted by community residents. In addition, TCM nursing technology is cheap, simple, convenient and effective. In areas with weak economic foundation in China, TCM nursing has unique advantages in community development [3].
For different people, the focus of TCM nursing is different. For healthy people, the service function of TCM nursing is mainly preventive health care. The service function of disability, disease sequelae, postoperative population and traditional Chinese medicine nursing is mainly rehabilitation nursing; For acute and chronic patients, the service function of TCM nursing is mainly disability nursing. No matter what kind of people TCM nursing is aimed at and what kind of nursing function it plays, it is applied to a variety of TCM nursing theories, knowledge and skills at the same time, that is, to mobilize the whole TCM nursing system. For example, patients with paralysis caused by common cerebral thrombosis need TCM nursing techniques such as diet adjustment, massage, Chinese medicine application, health care exercise guidance, and emotional care.
4. On the significance of vigorously developing TCM nursing at this stage:
Compared with developed countries, China's community service started late and is still in its infancy. Only big cities in China have relatively perfect community nursing service institutions, which mainly focus on drug administration and treatment, basically a continuation of hospital nursing treatment, and community health education, health consultation and behavior intervention are not developed. Personalized services for residents' characteristics and needs are still lacking, and traditional Chinese medicine nursing has not been widely carried out.
Community nursing is an important direction of nursing career development. Although TCM nursing has been applied to community nursing, due to the lack of practice system of TCM nurses, the serious shortage of TCM nursing manpower in the community, the low level of TCM nursing knowledge and technology, and the imperfect health education system of TCM nursing, the pace of TCM nursing integrating into community nursing is slow. Therefore, China's community nursing should actively introduce foreign advanced management models and service models, and establish and improve the community health service system and regulations of traditional Chinese medicine; Multi-channel training of community TCM nursing professionals; Strengthen publicity and actively carry out various forms of community Chinese medicine nursing services; Give full play to the characteristics of traditional Chinese medicine nursing, make use of the advantages of traditional Chinese medicine in prevention, health care and rehabilitation, realize the modernization of traditional Chinese medicine nursing, create a community nursing model suitable for China's national conditions, and promote the simultaneous development of China's nursing cause and the international community.
In addition, developing TCM nursing in the community is not only conducive to promoting people's health, but also conducive to popularizing TCM culture among the people, promoting people's interest in traditional culture, and enhancing national pride and self-confidence. Today, when we advocate returning to tradition and building a harmonious society, it also has far-reaching social influence.
References:
Wang Hongyun, Zhao Yanli. Present situation and prospect of TCM nursing research [J]. Family Nurses, 2008,6 (3): 665.
[2] Zhao. Community nursing [M]. Beijing: People's Health Publishing House, 2006: 8.
[3] Xu Shuli, Chen Jigen, Wang Liping. Investigation and analysis on the demand and application of TCM nursing service in community [J]. China Modern Doctor, 2008,46 (6):16.
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