Western medicine nursing plan for lumbar disc herniation
Syndrome of blood stasis and qi: violent waist and leg pain, painful fixation, stiff waist, pitching program, dark purple tongue, or ecchymosis, thin white or yellow tongue coating.
(2) Cold and dampness obstruction: coldness and pain in the waist and legs, turning to the side of qi, although it does not diminish or increase instead, the pain in the cold increases, the fever decreases, the program of the lower limbs is restricted, and the tongue is fat Light and greasy.
(IV) Liver and Kidney Deficiency Syndromes: Pain in the back and legs persists for a long time, and it is frequently done, fatigue, fatigue, labor, and lie down, including liver and kidney yin deficiency and liver and kidney yang deficiency. See yin deficiency syndrome: upset and insomnia, bitter mouth and dry throat, red tongue and less Jin. See Yang Deficiency Syndrome: limbs are not warm, cold and cold, and tongue is fat.
2. Posture care: Severe bed rest in the acute stage, lying on a hard bed, connecting the spine flat curve. During the recovery period, wear a lumbar support and support when getting out of bed. Pay attention to the posture of getting up. You should first turn over on your side, and then slowly get up with your arm support.
4. Follow the doctor's advice to apply traditional Chinese medicine to the waist, traditional Chinese medicine hot ironing, cupping, traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis and other treatments. Check the results after treatment and report back to the doctor in time.
5. Pelvic traction is given. The traction component is 1/3 to 1/2 of the body sink of the patient. The traction component can also be adjusted according to the patient's tolerance.
1. Assess the muscle strength and gait of both lower limbs of the patient. For those who have decreased muscle strength and unstable gait, do a good job of safety protection measures to prevent uncontrollable servants and other unexpected events.
4. Three days after resetting, the medical staff was instructed to get out of bed while wearing a lumbar support. When you get out of bed, you are in the prone position, turning your body on the bed, getting up slowly after your feet land, and vice versa. Support the patient after getting out of bed, check for dizziness and other discomforts, avoid squatting for a long time when entering the toilet, to prevent the occurrence of orthostatic hypotension.
2. According to the doctor's advice, choose the appropriate body position (tri-curved position, supine position, prone position), traction component, and traction angle. The upper and lower clothes are separated during traction, and the fixing straps are suitable to make the patient comfortable and durable.
3. Ask the patient to relax their muscles during traction to reduce the muscle contraction of the trunk, and patients who are more prone to sorrow and sadness can use a triangular pillow under the knee to relieve discomfort.
4. Ask the patient about infection at any time during the traction process, check whether the patient has chest discomfort, palpitation and other discomforts, and adjust in time. Appear pain, sorrow, and inappropriateness, such as improper treatment, curb treatment, and notify the doctor to deal with it.
(1) The patient should be properly placed after the operation. When the patient is being transported, connect a curve of the spine to prevent distortion. When turning over, adopt the axis) According to the different anaesthesia, accurately point the patient, nutrient-rich and easily digestible food.
(4) Check the leakage environment of the mouth dressing, connect the negative pressure drainage tube at the mouth, and pour the drainage fluid on time, and strictly perform aseptic operation. Observe the changes in the color, quality, and quantity of the drainage fluid, and accurately record it. If the drainage fluid is light, you should notify the physician to dispose of it in a timely manner, empty the drainage ball negative pressure, and suspend negative pressure drainage.
(5) Point the patient to automatic programs such as toes and ankles to promote blood circulation. Evaluate the patient's lower limb pain and sorrow to improve the environment, and gradually instruct the patient to perform functions such as kicking, bending legs, five-point support, and flying swallow.
(6) According to the surgical system, help the patient to wear a lumbar support to take a semi-sitting position or sit beside the bed 1 to 3 days after the operation. After conforming to the posture change, slowly walk down, walk with an accurate posture, and hold his chest up and abdomen. , Good safety protection in nursing.
For patients with constipation, use moxibustion shrine, Tianshu, Guan Yuan, etc., or perform abdominal massage 4 times a day for morning to morning, wake up after siesta, 1 to 3 hours after breakfast and dinner. Massage clockwise for the purpose of Promote defecation. (9) Assist the patient to make good living care during bedridden, and meet the needs of the feet.
(1) Feiyan exercise: The patient is in a prone position, with both lower limbs flexed, his hands resting on both sides of the body, his lower body still, and his upper body extended backwards when he holds his head up. Do three times a day, 10 times in each group. Gradually add as the upper half of the head is stretched, and the lower limbs are bent and the legs are stretched simultaneously. The waist is stretched as far as possible like a flying swallow, 5 to 10 groups per day, 20 times per group.
(2) Five-point support training: The patient takes a supine position, with his hands on his hips as support points, with his legs half bent at 90 ＜, the feet on the bed, the back of the head and elbows to support the upper body, and the feet to support the lower body in half. Arch-shaped, when the trunk is bridged, the knees are separated slightly to both sides, the speed is slow and fast, 3 to 5 groups per day, 10 to 20 times per group. After compliance, add to 10-20 groups daily, 30-50 times per group. To exercise the muscles of the waist, back and abdomen.
(1) Selection and wearing of the lumbar support: The size of the lumbar support should be consistent with the length and circumference of the waist. The upper edge must reach the lower edge of the ribs and the lower edge to the gluteal cleft. The elasticity is appropriate so that no discomfort occurs.
(2) Wearing time: The wearing time can be controlled according to the condition. It should be worn at any time when the waist symptoms are heavy. Mild patients can use it when they are out or sitting for a long time and sitting in a fixed posture, and take it off during sleep and rest.
According to the patient's nutritional situation and the differences in syndrome types, scientific and reasonable guidance of diet to achieve the maximum degree of recovery of patients, while patients are being instructed to dynamically monitor changes in the patient's gastric appetite environment and tongue coating, and change diet plans at any time.
(1) Those with liver and kidney yin deficiency should be filled with essence and liver and kidney products, such as Chinese wolfberry, black sesame, edible fungus, etc. Medicinal diet: lotus seed lily soup with lean broth. Avoid spicy nose spray products.
(2) Those with liver and kidney yang deficiency should warm the kidney and yang to supplement the essence, such as black beans, walnuts, almonds, cashews, black sesame and so on. Therapeutic side: dried ginger lamb. Avoid cold fruits and cold food.