英語醫(yī)療護理查房培訓課件

1、英語醫(yī)療護理查房英語醫(yī)療護理查房1234ContentsCase Report Knowledge of IntussusceptionTherapeutic ManagementHealth Guidance for Discharged Patients2英語醫(yī)療護理查房1234ContentsCase Report Kn Case Report3英語醫(yī)療護理查房 Case Report3英語醫(yī)療護理查房 BIOLOGICAL DATA: Name ：Chen Jingya Sex： female Age： 7-month-old Date of Admission：2015-04-23

2、14:40 Case Report4英語醫(yī)療護理查房 Case Report4英語醫(yī)療護理查房 ChiefComplaint： paroxysmal crying vomiting bloody stool ERX-Ray:Intussusception unable to resetCase Report5英語醫(yī)療護理查房 ChiefComplaint：Case Repo Case ReportAdmission Diagnosis:Acute IntussusceptionPhysical Examination:T:36.9 P:110/min R:20/min Wt:7.5kg6英語醫(yī)

3、療護理查房 Case Report6英語醫(yī)療護理查房Laboratory examination:routine bloodroution urinefull biochemicalfull blood coagulation testHIV,HBV,HCV,RPRDate of Intussusception surgery:2015-04-23Date of discharge:2015-05-05 Case Report7英語醫(yī)療護理查房 Case Report7英語醫(yī)療護理查房 Knowledge of Intussusception8英語醫(yī)療護理查房 Knowledge of Int

4、ussusceptioEtiologySymptoms & SignsDefinitionIntussusception9英語醫(yī)療護理查房EtiologySymptoms DefinitionInt What is intussusception? Intussusceptionis a medical condition in which a part of the intestine has invaginated into another section of intestine.Knowledge of Intussusception-Definition10英語醫(yī)療護理查房 What

5、 is intussusce Children intussusception Intussusception is an common abdominal emergency in children. It is one of the most common causes of abdominal obstruction in infants. 4-10monthKnowledge of Intussusception-Definition11英語醫(yī)療護理查房 Children intussusception ETIOLOGY Knowledge of Intussusception12英語

6、醫(yī)療護理查房 ETIOLOGY KnowlAge: 80%2 years old, most common in infants aged 4-10 months.Sex: the ratio of the male-to-female is approximately 3:1.Season: the seasonal peak is in spring and summer. Incidence:Knowledge of Intussusception-Etiology13英語醫(yī)療護理查房Age: 80%2 years old, most comWhats the reason of the

7、 disease? Why it happens to infants mostly?Knowledge of Intussusception-Etiology14英語醫(yī)療護理查房Whats the reason of the diseaPredisposing factors: caused by disorder of the intestinal peristalsis, such as:Dietary alteration: complementary solid food.Diseases: gastroenteritis, diarrhea, fever,etal.Virus in

8、fections: adenovirus, rotavirus, reovirus, echovirus.Knowledge of Intussusception-Etiology15英語醫(yī)療護理查房Predisposing factors: KnowledgDietary alterationKnowledge of Intussusception-Etiology16英語醫(yī)療護理查房Dietary alterationKnowledge ofThe complementary food of children can not be changed too soon.It is suppos

9、ed to be transformed step by step.Dietary alterationKnowledge of Intussusception-Etiology17英語醫(yī)療護理查房Dietary alterationKnowledge ofPredisposing factors: caused by disorder of the intestinal peristalsis, such as:Dietary alteration: complementary solid food.Diseases: gastroenteritis, diarrhea, fever, et

10、 al.Virus infections: adenovirus, rotavirus, reovirus, echovirus.Knowledge of Intussusception-Etiology18英語醫(yī)療護理查房Predisposing factors: Knowledgfever(acute upper reappiratory tract infection)lost its normal function /enterospasmDiseaseKnowledge of Intussusception-Etiology19英語醫(yī)療護理查房feverlost its normal

11、 function Predisposing factors: caused by disorder of the intestinal peristalsis, such as:Dietary alteration: complementary solid food.Diseases: gastroenteritis, diarrhea, fever, et al.Virus infections: adenovirus, rotavirus,reovirus, echovirus.Knowledge of Intussusception-Etiology20英語醫(yī)療護理查房Predispo

12、sing factors: KnowledgResearchers suspect that infectious agents: rotavirus&adenovirus.Virus infectionKnowledge of Intussusception-Etiology21英語醫(yī)療護理查房Researchers suspect that infecIntussusception causes have not clearly established or understood.They can include infections, anatomical factors, and al

13、tered motility. Studies and analysis have not conclusively established this. Knowledge of Intussusception-Etiology22英語醫(yī)療護理查房Intussusception causes have noA review of sparse data on the possible association: the virus & intussusception has not demonstrated until very recently. Knowledge of Intussusce

14、ption-Etiology23英語醫(yī)療護理查房A review of sparse data on theSymptoms and Signs1、General appearance2、Paroxysmal crying3、Bilious vomiting4、Red currant jelly stool5、Sausage-shaped massKnowledge of Intussusception24英語醫(yī)療護理查房Symptoms and Signs1、General Therapeutic ManagementNonsurgical TherapySurgical Therapy25

15、英語醫(yī)療護理查房 Therapeutic ManagementNonsurNonsurgical Therapy Air Enema Barium Enema26英語醫(yī)療護理查房Nonsurgical Therapy Air Enem Nonsurgical Therapy - Barium EnemaNonsurgical Therapy-Barium Enema27英語醫(yī)療護理查房 Nonsurgical Therapy - BariumNonsurgical Therapy -Barium Enemacomplicationchemical peritonitisNonsurgical

16、Therapy- Barium Enema28英語醫(yī)療護理查房Nonsurgical Therapy -Barium EnIntussusception presenting 48 hours.Good general appearance.Without abdominal distention, high temperature and toxicosis . ETIOLOGYNonsurgical Therapy - Air Enema1.IndicationsNonsurgical Therapy- Air Enema 29英語醫(yī)療護理查房Intussusception present

17、ing 4 2.Procedure Restrained the patient, inserted the Foley catheter into rectum, inflated the balloon.Nonsurgical Therapy- Air Enema 30英語醫(yī)療護理查房 2.ProcedureNonsurgical The2.head of intussusceptum located in the hepatic flexure of the colon1.before air clysis3.reduction occur4.reduction go on5.the f

18、illing of numerous loops of intestine31英語醫(yī)療護理查房2.head of intussusceptum 13.Signs of Complete ReductionFree flow of air into several loops of small bowel with simultaneous expulsion of feces.Stop crying, be quiet.Disappear of the abdominal mass. Nonsurgical Therapy- Air Enema 32英語醫(yī)療護理查房3.Signs of Com

19、plete Reduction4.Nursing Care of Post- air enemaCarbon test: take 0.5-1g activated carbon orally, appearing in stool 6-8 hours later.Basic therapy.Dietary guidance.Clinical observation closely. Nonsurgical Therapy- Air Enema 33英語醫(yī)療護理查房4.Nursing Care of Post- aiSurgical Therapy 34英語醫(yī)療護理查房Surgical The

20、rapy 34英語醫(yī)療護理查房 Pure manual reduction Intestinal anastomosis EterostomySurgical Therapy 35英語醫(yī)療護理查房 Pure manual reductionSurgica1.Surgical IndicationEnema failure. Intussusception occuring more than 48-72 hours.Intestinal necrosis. Intestinal perforation.Surgical Therapy 36英語醫(yī)療護理查房1.Surgical Indicati

21、onEnema fai 2.Nursing DiagnosisPainAnxietyHight risk for fluid volume deficitPotencial complicaion: shockSurgical Therapy 37英語醫(yī)療護理查房 2.Nursing DiagnosisPainSurgi3.Postoperative Nursing InterventionMonitoring the vital signs and consciousness state.Oral feeding on a gradual schedule -obeying the doct

22、ors instruction. Surgical Therapy 38英語醫(yī)療護理查房3.Postoperative 英語醫(yī)療護理查房培訓課件 Activity : Passive activity3.Postoperative Nursing InterventionSurgical Therapy 40英語醫(yī)療護理查房 Activity : Passive activityHealth Guidance for discharged patientsAn important way to preventintussusception and finddiseases in time.41

23、英語醫(yī)療護理查房Health Guidance for * Living guide* Disease observation* Diet guide* Special care guide 42英語醫(yī)療護理查房* Living guide42英語醫(yī)療護理查房Living Guide*Let the parents realize the importance of keep moving.*Enough physical activities.*Prevention of intestinal adhesion.EXERCISE43英語醫(yī)療護理查房Living GuideEXERCISE43

24、英語醫(yī)療護理查房INFECTION PREVENTIONAdenovirus infection Intestinal lymoph follicles hyperplasiaExcessive intestinal Stimulate the autonomic nervous systemperistalsisIntussusceptionSo*Prevent colds*Safety foodLiving Guide44英語醫(yī)療護理查房INFECTION PREVENTIONAdenovirusDisease ObservationWOUND NURSING* Take a shower

25、 instead of bath.* Get rid of the risk factors of damaging the wound.* If the wound is red or cracks,please go to hospital.45英語醫(yī)療護理查房Disease ObservationWOUND NURSIDisease ObservationPain nursingAttentions!If the child cries with any paroxysmal,you had better do a timely manner B to exceed cheek,against to rule out the possibility of intussucception.pain3-10 months healthy fat infant *colicky abdominal pain *abdominal swelling or distention *bilious vomiting *“red currant jelly stool *sausage-shaped mass 46英語醫(yī)療護理查房Disease ObservationPain nursinDiet