骨科二区胸椎内固定术术后护理查房课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,PPT,模板下载：, PPT,素材下载：, PPT,图表下载：, PPT,教程：, Excel,教程：, PPT,课件下载：, case of thoracic vertebral internal fixation surgery patients after nursing care rounds,一例胸椎内固定术术后患者的护理查房,Speaker & Physical examination,& PPT production,：石彩兰,Advisor,：王莉,2017.04.07,Guangzhou medical university,PPT模板下载： information,（一般资料）,Name:,Huang lixuan,（黄李轩）,Age:,53-year-old Sex: male,bed number:,GK2017,Date of admission:,March 23th, 2017,Chief complaint,（主诉）,:,Low back pain three months, increased with numbness of both lower limbs a month.,（腰痛三月，加重伴双下肢麻木一月）,Diagnosis :,Thoracic tumor(,胸椎肿瘤,),General information（一般资料）Name:,Patient,s condition,（病情汇报）,Admission:,T 37.0 C, P 70 times / min, R 20 times / min, BP 120/60 mmHg.,Surgery: 2017-03-24, general anesthesia with thoracic spine tumor resection (,全麻下胸椎肿瘤切除,)+ thoracic internal fixation,（胸椎内固定术）,Patients condition（病情汇报）Ad,Auxiliary check,（辅助检查）：,（,2017-02-15,，广州市番禺区第二人民医院）腰部,CT,提示：,L3/4,、,L4/5,椎间盘膨出，,L5/S1,椎间盘突出，腰椎退行性病变，胸,12,椎体骨质破坏。,（,2017-03-21,，解放军第四五八医院）腰椎,MR,提示：,1,、胸,9,、,12,椎体及椎旁异常信号影，考虑肿瘤，骨髓瘤可能性大；胸,3,、,8,椎体异常信号影，脂肪沉积与血管瘤鉴别；,2,、腰,2,、,4,椎体占位性病变；,3,、腰,3/4,、,4/5,椎间盘膨出；,4,、腰椎退行性病变,Auxiliary check（辅助检查）：（2017-02,Auxiliary check,（辅助检查）：,（,2017-03-24,，我院）全身骨显像：第,10,胸椎骨代谢异常局灶性增高活跃。结合病史，考虑肿瘤性病变与椎体压缩性骨折相鉴别。,（,2017-03-24,，我院）胸部正侧位：,1,、双肺及心膈未见异常。,2,、,T9,椎体压缩性改变胸,Auxiliary check（辅助检查）：（2017-03,Auxiliary check,（辅助检查）：,项目名称,结果,参考范围,单位,提示,癌胚抗原,5.71,0-5,ug/L,细胞角蛋白,19,片段,3.36,0-3.3,ug/L,白细胞计数,22.7,3.59.5,10,9,/L,血红蛋白,158,130175,g/L,正常,总蛋白,63.1,6585,g/L,尿素,/,肌酐,30.71,1524,Ratio,补体单体,0.14,0.160.38,g/L,白蛋白,35.3,4055,g/L,总胆汁酸,17.1,09.67,umol/L,Auxiliary check（辅助检查）：项目名称结果参考,Auxiliary check（辅助检查）：,项目名,项目名称,结果,参考范围,单位,提示,丙氨酸氨基转移酶,205,950,U/L,-,羟丁酸脱氢酶,205,72182,U/L,天门冬氨酸氨基转移酶,69,1540,U/L,乳酸脱氢酶,294,120250,U/L,-,谷氨酰基转移酶,74,1060,U/L,肌酸激酶同工酶,MB,活性,26,025,U/L,总胆固醇,5.85,3.005.18,mmol/L,高密度脂蛋白胆固醇,2.09,1.161.42,mmol/L,Auxiliary check（辅助检查）：项目名项目名称结,Basic treatment & medication,（,基本治疗,&,用药）：,PO,：,多烯磷脂酰胆碱胶囊（易善复）、丁二磺酸腺苷蛋氨酸肠溶片（喜美欣）；,IV,：,注射用帕瑞昔布钠（特耐）；,IM,：,鼠神经生长因子注射剂（恩经复）；,Ivgtt,：五水头孢唑林注射剂（新泰林）、醒脑静、注射用丹参多酚酸盐、地塞米松磷酸钠注射液,&,甘露醇注射液、小牛皮提取物注射液（斯普林）、骨肽注射液（鼓键）、甲泼尼龙琥珀酸钠针（甲强龙）、（申捷）单唾液酸四己糖神经节苷脂钠注射液、头孢曲松他唑巴坦针（优他能）。,Limb brake,（制动）, analgesic,（止痛），,nutritional support,（营养支持）,and other symptomatic treatment,Basic treatment & medication（,床边体查,床边体查,Results of physical examination (,体查结果,),Current condition:,patients with thoracic internal fixation on the 15th day after surgery, lower limb numbness(,下肢麻木无力,), postoperative,（术后）,wound dressing clean, no bleeding exudate,（渗液）,no waist pain, dizziness,（头晕）,and other symptoms , and consciousness is clear,，,appetite(,食欲,) is well and have a good spirit .His sleep is well now, and defecate and urinate is normal,.,T,、,P,、,H,、,R,、,Bp,Specialty,（专科情况）,:,Double lower limbs tactile,（双下肢）,feel normal. The strength of lower limbs level,。,The operative wound dressings is dry and clean, no bleeding, drainage(,渗液,).,Results of physical examinat,Nursing diagnosis（护理诊断）,1,、,Risk of falls: associated with long bedside lower limb muscle weakness,（下肢肌无力）,3,、,Lack of knowledge: related to lack of disease-related knowledge,2,、,decline of self-care ability: related to long bed rest,Nursing diagnosis（护理诊断）1、Risk,Risk of falls: associated with long bedside lower limb muscle weakness,（下肢肌无力）,Nursing measures:,1,Tell the patient and family members to stay with patient all the time , and if need help ring that call nurses.,2,change the position should obey with the three steps, that is lying 30 seconds, sit up 30 seconds, and stand 30 seconds before the walk in order to avoid orthostatic hypotension(,体位性低血压,), especially at night.,3,When walking dizziness, lower limb weakness, and gait instability and can not move, immediately sit down in situ(,原地,), and call help.,4,wear anti-skid slippers,（拖鞋）,and the appropriate,（合适的）,clothes in order to avoid tripping, and take bed bar when sleep at bed.,Nursing target:,the patient did not fall,Nursing evaluation:,patients did not fall during hospitalization,.,Risk of falls: associated with,2,、,decline of self-care ability: related to long bed rest,Nursing objectives:,patients can adapt to the state of decline of self-care ability , and Life needs can be satisfied during hospitalization.,Nursing measures:,(1) explain the importance of cleaning-care to the patient.,(2) do morning care in order to increase the comfort of patient: wash face, wash hands, oral care, warm water wipe,（擦）,back, etc.,(3) keep warm while operation, and avoid exposure to the patient too long to prevent colds.,(4) Keep the bed clean and dry.,(5) help patient eating, dressing, into the toilet and other life care.,Nursing evaluation:,patients adapt to the state, and,The decline of self-care ability during hospitalization has improved .,2、decline of self-care ability,3,、,Lack of knowledge: related to lack of disease-related knowledge,Nursing Objective:,The patient can describe the disease-related knowledge,Nursing measures:,(1) confirm the patients concerns about the disease and future lifestyle by talking, and explain or guide the patients concerns.,(2) use easy to understand language to the patient to introduce the course and treatment.,(3) Distribute health education prescription regularly . Provide the necessary learning materials for the patient.,(4) encourage patients to ask questions, and answer to patient patiently .,Nursing Rating:,Patients can describe disease-related knowledge during hospitalization,3、Lack of knowledge: related t,health education,（健康教育）,1, functional exercise: Teach patient turn the body like axis turn(,轴线翻身,), raising straight leg exercise,（直腿抬高运动）, quadriceps femoris isotonic contraction exercise,（股四头机等长收缩运动）,and the correct way to get up and lie down.,2, prevent lung infection: change the position constantly, and encourage patients to do an effective cough action, turn back to shoot,（翻身拍背）,regular, promote lung secretions,（分泌物）,and accumulation of sputum,（积痰）,discharge.,3 early exercise: to prevent soft tissue adhesions,（粘连）,and spine joint,（脊柱关节）,activity decreased, and affecting the spine movement, which resulting in chronic pain in the waist(,腰,) and low back muscle atrophy,（腰背肌废用性萎缩）,.,4, the prevention of pressure sores: In order to prevent the formation of pressure sores, it need to do a good job on mission work, and teach patients and their families to master the turning skills . And do not plug when use the potty(,便盆,),in order to avoid to damage the skin.,health education（健康教育）1, funct,Discharge instruction（出院指导）：,4, regular outpatient review, if the lower back discomfort or lower limb numbness timely treatment,1, Tell patient to exercise insistently after discharge , but should avoid fatigue(,劳累,), and prevent trauma,（外伤）,.,2, Tell patient to strengthen nutrition intake, and enhance physical fitness(,增强体质,), to guide the high protein intake, high vitamin diet.,3, Explain the importance of the time to activities in detail , in order to ensure the stability of the internal fixation(,内固定,), and get out of the ground to activities must wear brace(,支具,) , and standing walking time should not be too long. Practice the exercise of bending bent flexion(,弯腰前屈,) after 3 months,，,and sleep at a hard bed.,Discharge instruction（出院指导）：4,Thank you,！,Thank you ！,后面内容直接删除就行,资料可以编辑修改使用,资料可以编辑修改使用,后面内容直接删除就行,主要经营：网络软件设计、图文设计制作、发布广告等,公司秉着以优质的服务对待每一位客户，做到让客户满意！,主要经营：网络软件设计、图文设计制作、发布广告等,致力于数据挖掘，合同简历、论文写作、,PPT,设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求,致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划,感谢您的观看和下载,The user can demonstrate on a projector or computer, or print the presentation and make it into a film to be used in a wider field,感谢您的观看和下载The user can demonstr,