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Nursing for common diseases of the elderly _ [PPT courseware]

Updated: 2019-09-12

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Nursing of common diseases of the elderly Nursing of common diseases of the elderly Nursing of common diseases of Huifeng Hospital Huifeng Hospital Geriatrics Section 1 Section 1 Nursing of elderly hypertensive care Nursing of elderly hypertensive refers to spring and autumn Hypertension in the elderly refers to spring and autumn among those over 60 and 60 years of age, in accordance with the World Health Organization standards, in resting mode, according to the World Health Organization standards, in resting mode, systolic pressure, systolic pressure 140mmHg 140mmHg And / or diastolic blood pressure and / or diastolic blood pressure 90 90 mmHg mmHg in patients with hypertension. Of hypertensive patients. I. Nursing care of hypertension paeoniae I. Nursing care of hypertension paeoniae Elderly hypertension often causes stroke, coronary heart disease, myocardial infarction. Elderly hypertension often causes stroke, coronary heart disease, myocardial infarction and heart failure Therefore, it is especially important to do good nursing work. It is especially important to do a good job in nursing care through contact with heart failure. Through clinical inspection, the following points should be done in the nursing work: In bed inspection, the following points should be done in the nursing work: 11. Monitor blood pressure. Monitor blood pressure When measuring blood pressure, measure limbs and body inability to measure; Adjacent cuff to measure blood pressure, measure limbs and body not to move; Rubber tube adjacent to cuff cannot be bent; Rubber tube resting after program is not OK Less than bending; rest for 15min and 15min after the show, because these factors can significantly affect the blood pressure value. Several factors can significantly affect blood pressure values. twenty two. Psychological nursing. Psychological nursing is weak in the elderly, and it is easy to take high blood pressure for stroke and myocardial infarction. It is easy to take hypertension for stroke and myocardial infarction. So waiting tightly along the way, the expression is easily in a bad shape. Therefore, it should be based on the patient's psychological form, and should be given the necessary annotations and comfort, according to the patient's psychological form, to help them establish their determination to defeat the disease. Comfort, help him establish a determination to defeat the disease. 33. Subsistence system nursing. Orientation Nursing Diet Guidance: The elderly should avoid overeating, and should eat a small amount of food. The elderly should avoid overeating, and should eat a small number of meals. Activity guidance: add physical programs, such as walking, meals. Activity guidance: add physical programs, such as walking, tai chi, dancing, etc. The amount of activity should be moderate, no, Tai Chi, dancing, etc. The amount of activity should be moderate. Don't exercise in a large amount of activity in a short period of time. Don't exercise in a large amount of activity in a short period of time when you are active. Don't pant when you are active. Quitting smoking and drinking is breathless and prone to accidents. Guidance on quitting smoking and drinking: smoking and drinking both affect the outcome of antihypertensive treatment, hair pointing: smoking and drinking both affect the outcome of antihypertensive treatment, strokes are more likely to occur, and help Baiji to know that smoking and drinking are more likely to have strokes. Help Baiji recognize the risks of smoking and drinking, formulate a plan to quit smoking and alcohol, try to make the risk of old alcohol as much as possible, formulate a plan to quit smoking and alcohol, and try to make the elderly successfully quit smoking and alcohol. People successfully quit smoking and drinking. 44. Medication care. Treatment with medications is a secondary treatment for hypertension in the elderly. Drug treatment is the secondary treatment of hypertension in the elderly. Sustained medication, if it is suddenly stopped, it is under stress. Sustained medication, if it is suddenly stopped, is under an impulsive, impulsive environment, it may present a hypertension crisis, a high impulsive environment, etc. It may present a hypertension crisis, hypertensive encephalopathy. Such as high blood pressure emergency, the patient lives. Hypertensive emergency such as blood pressure encephalopathy, patient life. Elderly patients sit up while antihypertensive drugs are being used. When elderly patients sit up and are using antihypertensive drugs, their actions should be as slow as possible. When sitting up, you should be as slow as possible. Try to avoid being late at night. Try to avoid taking medicine from 10 pm to 6 am to avoid low blood pressure. Take medicine from 10 to 6 am to avoid low blood pressure and even cause cerebral thrombosis. Even caused the formation of cerebral thrombosis. Common problems in the treatment of elderly hypertension 2. Common problems in the treatment of elderly hypertension Privately adjust the dose or change medication. . Privately adjust the dose or change medication. Bai Yan should be taking medication under the guidance of the doctor, the first time and changing Bai Dang should be taking medication under the guidance of the doctor, the first time and changing the drug under blood pressure, do not take care of themselves. The medication is being performed under blood pressure, and it is not self-conscious. twenty two. The symptoms are gone and the illness is just fine. . The symptoms are gone and the illness is just fine. After the doctor has formulated the antihypertensive drug treatment plan, the patient must formulate the antihypertensive drug treatment plan, and the patient must be severely administered and take the medicine every day. Even if blood pressure has to be severely administered, take the medicine daily. Even if the blood pressure has been reduced to normal and the symptoms have completely disappeared, it should be reduced to normal every day. The symptoms should completely disappear and daily medication should be used. Medication. Section 2 Section 2 Nursing of Coronary Heart Disease Paeonia lactiflora Nursing of Coronary Heart Disease Paeony For feet, massage the soles of the feet if necessary. Use hot water to soak the feet before going to bed. Massage the soles of the feet if necessary. Keep warm when the weather is cold. When the weather is cold, keep warm. Watch out for the prevention and care of constipation. Urge the elderly to pay attention to the prevention and care of constipation every day. Urge the elderly to cook fiber every day, that is, eat more vegetables, fruits and vegetables, can not cook fiber, that is, eat more vegetables, fruits and vegetables, can not be given since the program to give daily abdominal clockwise massage, constipation from the program to give daily belly Massage clockwise. Do not hold your breath when you are constipated. Don't hold your breath for a while, you can give Kasai Lusai anal. Enteric-coated aspirin, which irritates the gastrointestinal tract than enteric-coated aspirin, which irritates the gastrointestinal tract, so it should be taken after meals; aspirin can cause subcutaneous large, Therefore, aspirin should be taken after meals; aspirin can cause subcutaneous staining and stasis, blood in the stool and vomiting in the digestive tract, and severe staining and stasis in the stool and blood in the digestive tract should be checked closely for bleeding tendency. Adopt close observation before and after medication to see if there is any bleeding tendency. Accurately adopt blood samples before and after medication to detect each coagulation target, such as prothrombin blood samples to detect each coagulation target, such as prothrombin time, coagulation time, bleeding time, fiber. Abumin time, clotting time, bleeding time, fibrinogen, etc. Instruct patients to do as little violent programming as possible and avoid waiting. Instruct patients to do as little violent programming as possible to avoid accidental damage and increased bleeding. External damage and increased bleeding. Section III Section 3 Stroke Sequelae Nursing Care for the Elderly Patients with Stroke Sequelae I. Stroke Stroke Treatment and Nursing Goals I. Stroke Stroke Treatment and Nursing Goals There are two main aspects: one is through rehabilitation and daily routine. Two aspects: First, through rehabilitation and daily self-care ability training to maximize self-care; self-care ability training to maximize self-care; second, correct the cause or factors of stroke; prevent second, correct the cause or factors of stroke (1) Psychological Nursing (1) Psychological Nursing Patients from the "Positive" Irran Department's Limb Program Ability Patients from the "Positive" Irran Department's Limb Program Ability and Speech Ability, Resulting in Self-care and Work Ability, and Speech Ability Those who are self-reliant and capable of working, who lack preparation for thinking and / or poor family economic premise, who lack preparation for thinking and / or poor family economic premise, have a longer course of illness and are prone to emotional changes such as anxiety and depression. Longer, prone to emotional changes such as anxiety, depression, moodiness, and even personality changes. Been determined, moody, and even personality changes, determined to get on living, unwilling to take care of common medical treatment. First, family members should be caring and reluctant to heal together for care. First, family members should care for the humble and sloppy aunt, and try to avoid the old-fashioned impulse. The second is to be careful and indecent and try to avoid the old impulse. The second is to carefully observe the psychological reflection of patients. Check the patient's psychological response. (2) Take medicine on time and discipline. (2) Take medicine on time and discipline. Take the medicine as prescribed by the doctor to prevent recurrence of stroke. Promptly take the medicine as prescribed by the doctor to prevent recurrence of stroke. Self-supervised Bai Zhi take medicine. (C) Diet Nursing (C) Diet Nursing Reduce total heat. Try to get into the habit of eating 80% full. . Reduce total heat. Try to get into the habit of eating 80% full. twenty two. Low fat and low cholesterol diet. . Low fat and low cholesterol diet. 33. A balanced diet. . A balanced diet. 44. Low salt diet. Eating too salty can easily lead to high. Low salt diet. Eating too salty can easily cause high blood pressure. blood pressure. 55. Drink more water. Not only can promote defecation, but also conducive to adding small. Drink more water. It can not only promote defecation, but also help to add urination and prevent urinary system infection. Because of inconvenience, it is necessary to prevent urinary system infection. Afraid of urinating too much without drinking water. 66. Quit smoking and drinking. . Quit smoking and drinking. 77. Swallowing hard care. . Swallowing hard care. If it is accompanied by facial paralysis, food should be delivered to the root side of the healthy side. If it is accompanied by facial paralysis, food should be delivered to the root of the healthy side. If the muscles swallowed from the tube are paralyzed, the elderly are eating, especially the muscles swallowed from the tube are paralyzed, and the elderly are eating, especially when drinking water, and coughing, so that food is sprayed from the mouth and nose. When drinking this water, it was coughing, and food was sprayed from the mouth and nose. At this time, pay attention to the patient's inability to force water or medicine. If so, pay attention to the patient's inability to force water or medicine. If food is inhaled into the respiratory tract by mistake, the lighter will cause lung infection and the food will be inhaled into the respiratory tract. Pulmonary infection, aspiration pneumonia; sinker may be due to infarction. For mild aspiration pneumonia; the sinker may be due to an infarction. For light patients, let them sticky food, such as thick porridge, soft rice and so on. Patients can make them sticky food, such as thick porridge, soft rice, etc. Vegetables, minced meat and other side foods are cooked and chopped and mixed in the rice, avoiding vegetables, minced meat and other side foods and chopped and mixed in the rice, and to avoid too thin and dry food, it is easy to swallow. Oral medications that are too thin and too dry can easily be swallowed. If there are no contraindications to oral drugs, they can be ground and mixed in food. If there is no contraindication for patients with Shen disease, they can be ground and mixed in food. Patients with Shen disease need a nasal feeding diet. Foods such as rice soup, milk, and vegetable juice need a nasal feeding diet. Foods such as rice soup, milk, and vegetable juice are injected into the stomach with a needle. The needle is injected into the stomach with enough nutrients. 88. Oral Care. Oral care pays attention to the dental hygiene of the elderly, and assists the patient to gargle or enter into the care of the elderly. . appetite. (IV) Rehabilitation Exercise (4) Rehabilitation Exercise 11. Training goals. Cultivate the target to promote blood circulation of paralyzed limbs, prevent deep venous blood from advancing blood circulation of paralyzed limbs, prevent deep vein thrombosis, promote recovery of muscle strength and joint program, prevent thrombosis, promote recovery of muscle strength and joint program, prevent Limb contracture and deformation, so that patients can achieve self-care or stop contracture deformation, so that patients can achieve self-care or department self-care. The department takes care of itself. twenty two. Refining content. Training content ((11) Passive activities. Training of upper limb function: nursing people) Passive activities. Upper limb function training: the nurse sits on the affected side of the patient and holds the wrist on the affected side; the staff sits on the affected side of the patient and holds the wrist on the affected side with one hand; the other hand is placed slightly above the elbow joint, and the affected limb is moved up, Place the lower and other hands slightly above the elbow joint, and move the affected limb up, down, left, left, flexion, and twisting activities; the nursing staff left, left, flexing, and twisting activities; the nursing staff hold the wrist of the affected limb with one hand, Do your fingers with your other hand. Hold the wrist of the affected limb and do the activities of the fingers with the other hand. Lower limb function training: Nursing staff hold the lower limb function of the affected limb with one hand. Nursing staff hold the ankle joint of the affected limb with one hand, and hold the knee slightly below with the other hand, so that the hip and ankle joints are held with the other hand. Below, the hip and knee joints are stretched, flexed, twisted on the front and back, and adducted and abducted. Knee joint extension, flexion, torsional twist, adduction and abduction. The nursing staff held the arch of the affected limb with one hand, the other hand held the arch of the affected limb with one hand, and the toe was performed with the other hand. A toe show. ((22) Automatic refining. Turn over exercise, seat exercise, lifting) Automatic refining. Turn over exercise, seat exercise, get up exercise, etc., gradually transition to the elderly to help the bed sit up exercise, etc., and gradually transition to the elderly helper sit, walk. Or support Bai Zhi walking slowly in the ward, standing, walking. Or support Bai Zhi to walk slowly in the ward, after a period of time, the ward can be turned to the corridor or outdoor programs. After a period of time, the ward can be turned to corridors or outdoor programs. Those who are able to walk or have unstable steps still need to support walking. Those who can walk or have unstable steps still need to support walking. After the steps are stable, let them walk, but someone needs to be walking and then let them walk. , But someone needs to be on the side, you must pay attention to peace and moderate work and rest during refining, and you must pay attention to peace and moderate work and rest during refining Tolerance is the degree. Patients who exercise automatically are subject to consciousness. Do not overwork or refrain from treating patients with consciousness. Do not overwork or it may cause fatigue and make the condition worsen or relapse. It is easy to cause fatigue, making the condition worsen or relapse. (5) Prevention of pressure ulcer care Causes skin ulceration to constitute "bedsore". Forced for too long without knowing it, easily cause skin ulceration and constitute "bedsore". Occurs secondarily in the occipital tuberosity, scapular region, hip, zygomatic tail, and feet secondarily in the occipital tuberosity, scapular region, hip, zygomatic tail, heel and other bones. To prevent bedsores: use soft pillows or sea pads such as heel bumps. Prevent bedsores: Use soft pillows or sea pads to place bulges, and set up turn-over cards, and set up turn-over cards at each bulge, and turn over every 22 ~~ 3h 3h, and remember to turn over and record. Avoid procrastination, pushing, etc. , The connecting bed is flat, clean, and recorded, avoiding dragging and pushing, and the connecting bed is flat, clean, dry, and free of slag. Scrub the skin with warm water daily and use dry, scum-free. Scrub the skin with warm water every day, and quietly massage the pressed part with alcohol or Shifang Fang, especially bone alcohol or Shifang Fang quietly massage the pressed part, especially the raised part of the bone. Once a pressure ulcer occurs, it may be caused by infection of the raised part of the fever. Once a pressure ulcer occurs, it may cause cerebrovascular disease due to infectious fever. Severe patients may also induce sepsis and cause cerebrovascular disease. Severe patients may also cause sepsis. Speak to medical staff as soon as you notice skin ulceration. If you notice any skin ulceration, talk to medical staff in time to deal with it. Dispose early. (6) Health care (6) Health care Pee and urine care. Toilet care ((11) When incontinence, padding guesses the middle order, men use fresh-keeping bags light) When incontinence, padding guesses the middle order, men use light-keeping bags to gently bind, women do not wet urine or Change diapers in a timely manner. Lightly bind. Women should not change their diapers or diapers in a timely manner. Wash and clean the perineum to keep them dry and fresh. Wash the perineum and keep it dry and fresh. ((22) Insert a urinary catheter during urinary retention, pay attention to aseptic operation, every four hours) Insert a urinary catheter during urinary retention, pay attention to aseptic operation, once every four hours, disinfect the urethral orifice once a day, and change it every week Once a urinary catheter, disinfect the urethral opening once a day, and change the urinary catheter once a week ((33) Constipation, eat more fruits and vegetables, press the belly clockwise every day) Constipation, eat more fruits and vegetables, Press the abdominal two groups clockwise daily to defecate on time; or add tea with senna leaves for oral administration, or increase the defecation time for both groups of yellow; or add tea with senna leaves for oral administration, or increase yellow 10 10 ~ 40 40 g G // day, decoction. I used to have a hard bowel movement. Once had a hard bowel movement, you can use Kaisai Lusai anus, do not hold your breath to force defecation. Anal, do not hold your breath to force bowel movements. twenty two. Clean and hygienic. Wash your face and hands, and shave your beard. The bed unit cleans the face and hands, while shaving the head and beard. The connected bed unit is clean, the room is cleaned and disinfected, ventilated, and the temperature and humidity are adjusted. Cleanliness, room cleaning and disinfection, ventilation, temperature and humidity conditioning. Tianliang pays attention to the addition of clothing and quilt, and it is hot to prevent heatstroke and diarrhea. Keep an eye on adding clothes and quilts, and beware of heatstroke and diarrhea. (VII) Preventing Fallout Pneumonia (7) Preventing Fallout Pneumonia should always turn over and pat on the back to motivate patients to cough, and connect the room to turn over and pat on the back to encourage patients to cough. Twice, the connection air is novel, the window is open and ventilated, and the mop is moistened twice. The connection room temperature is 18 18 ~ 22 22, and the humidity and humidity are 50% 50% ~~ 70% 70%. . (8) Inspection of the condition (8) Inspection of the condition for bleeding points on the skin and whether there is melena; Paralysis of the muscle strength of the limb with or without melena; Changes in the muscle strength of the paralyzed limb for atrophic environment; Changes in the atrophic environment; Morphology: presence or absence of drowsiness, malaise, impetuousness, and sadness. God is weak, impetuous, and sad. Section 4 Section 4 Nursing Care for Alzheimer's Disease ((11) Daily Subsistence Care. Watch TV frequently and frequently) Daily Subsistence Care. Watch TV often, and exercise memory frequently. Perform memory and other exercises. ((22) Recalling obstructive care. There should be more attention to forgetfulness.) Recalling obstructive care. When looking at forgetfulness, you should be more motivated and avoid loud voices. Use shiitake often and motivate to avoid loud voices. Often use Bai Yi and happy words to stimulate, show humble and love, get happy speech stimulation, show humble and love, gain Bai Yi's trust, and improve memory. Bai Yan's trust improves the recall. ((33) Behavioral care. Behaviors common to dementia and amaranth) Behavioral care. The common behavior of dementia Baijiu is expressed as aggression very much, and the motivation of Baijiu is expressed as aggression very much, which motivates Baijiu to fulfill the mission. And command words, not to be able to brake the patient while the aggressive behavior is being held or the patient is being braked while the aggressive behavior is being placed or in the room. This may add the patient ’s psychological pressure to the condition room, and may add The patient's psychological pressure makes the condition worse. Sink. ((44) Psychological nursing. Alzheimer's patients, understanding ability) Psychological nursing. Alzheimer's patients, the ability to understand decline, should be automatically talked about, with patience enough, fall, should be automatically talked with, enough patience, slow wording, short sentences, if the patient once worded Be slow, and the sentence should be short. If the patient does not understand it once, it can be repeated and not understood, and it can be repeated 22 to 33 times, until the patient understands it. So far.

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