Nursing routine of common diseases in respiratory medicine

Nursing routine of common diseases in respiratory medicine

There are many respiratory diseases, and the care of each respiratory disease is different. The following is the nursing routine of common diseases in respiratory medicine that I bring to you. Welcome to reading.

The first section pneumonia nursing routine

A, general pneumonia care

1, implementation of general nursing routine for respiratory diseases.

2, bed rest, breathing difficulties to give oxygen and take a semi-recumbent position.

3, give a high-calorie, digestible liquid or semi-liquid diet, encourage patients to drink more water, not less than 3000ml a day, to facilitate the discharge of toxins, those who can't eat, intravenous rehydration, dripping speed is not easy to be too fast, so as not to cause pulmonary edema.

4, pay attention to indoor air circulation, temperature and humidity should be appropriate.

5. Pay attention to oral hygiene, rinse your mouth with D'Aubert, apply lubricating oil to chapped lips, and apply 1% gentian violet to those with herpes.

6. Closely observe the changes of body temperature, pulse and blood pressure. For example, people with high fever perform high fever care routine. If there are early manifestations of shock, you should report to the doctor in time and actively rescue them.

1, sputum observation. Prepare to collect sputum samples for routine examination and sputum bacteria culture. Disinfect sputum and sputum cups in time.

2. Constipation can be enema with warm salt water, and abdominal distension can be exhausted by anus.

3, pay attention to observation, such as hyperhidrosis, sudden drop in body temperature, shortness of breath, cyanosis and so on. Report to the doctor immediately and deal with it. When sweating for a long time, you should wipe off the sweat in time and change clothes to prevent catching cold. If coma delirium, perform coma nursing routine.

Section 2 Nursing Care of Shock Pneumonia

1. Carry out general nursing routine for respiratory diseases.

2, nursing by designated personnel, with pillow recumbent. When the body temperature is below normal. You can use a hot water bottle to keep warm and avoid burns.

3. Pay attention to the unobstructed respiratory tract and suck sputum in time for a long time.

4, closely observe the urine volume, and make records.

5, according to the condition every 5? Blood pressure was measured every 65438 05 minutes and recorded. When the blood pressure is lower than 10.6/8kpa(80/60mmhg), the antihypertensive drugs are injected intravenously according to the doctor's advice, and the therapeutic effect is closely observed.

6, pay attention to the water electrolyte balance, such as dehydration, acidosis, low potassium, etc. , should be timely blood, carbon dioxide binding force and determination of potassium, sodium and chlorine. Supplement 5% sodium bicarbonate or 1 1.2% sodium lactate solution according to the doctor's advice. Intravenous 10% potassium chloride should be supplemented when blood potassium is low, but it should be used with caution when urine volume decreases.

The third section pleurisy nursing routine

First, the implementation of general nursing routine of respiratory diseases.

Second, stay in bed at the acute stage. The healthy side of wet pleurisy lies flat, which strengthens the respiratory movement of the affected side and reduces the non-functional damage; Dry pleurisy should make the affected side lie flat to reduce the activity of pleura in the diseased area and relieve pain.

Third, give a high-protein, high-vitamin, high-calorie diet and encourage patients to drink more water.

Fourth, a large amount of pleural effusion caused by dyspnea or cyanosis should be given a comfortable semi-lying position for oxygen inhalation, and doctors should be assisted to extract pleural effusion to alleviate the symptoms of oppression. During the pumping process, closely observe the patient's complexion, breathing and pulse changes. Excessive initial aspiration will lead to mediastinal displacement and circulatory failure.

5. Use antitussive drugs at the moment of severe cough and observe the drug reaction.

Six, pleurisy complicated with tuberculosis, feasible tuberculosis nursing routine.

The fourth quarter pneumothorax nursing routine

First, implement the general routine of respiratory diseases.

Second, absolutely stay in bed. Take a semi-recumbent position or a sitting position to avoid excessive movement and unnecessary activities of patients. Don't use force when coughing to avoid spontaneous pneumothorax recurrence. Keep the stool unobstructed.

Third, when you are short of breath or cyanosis, you should take oxygen quickly.

Fourth, cooperate with doctors to perform thoracic aspiration. When inhaled by mistake, patients can avoid excessive exertion and severe cough, and can be given sedative, analgesic and antitussive drugs. In order to avoid coughing hard and promote the recurrence of spontaneous pneumothorax.

Five, continue to observe the situation after pumping. Such as chest pain, shortness of breath, emotional anxiety and other symptoms shortly after pumping. It is suggested that tension pneumothorax should be reported to the doctor in time and the drainage bottle should be closed to continuously exhaust, so that the compressed lung can be opened quickly and the symptoms can be alleviated.

Sixth, prepare closed thoracic drainage. When pumping water, pay attention to the unobstructed pipeline, and check whether the joint of the glass bottle leaks and whether the glass tube in the bottle is below the water level.

Seven, the application of closed drainage should always observe the situation of gas drainage. If the bubble overflows, the patient will cough. If there is no air bubble overflowing, you can assist the doctor to use the artificial pneumothorax box for lateral pressure, and wash the drainage bottle with sterile saline every day during drainage, and replace the sterile saline.

Eight, indwelling suction tube should prevent infection and give antibiotics appropriately. Observe the changes of temperature and pulse.

Section 5 Nursing Routine for Chronic Pulmonary Heart Disease

First, the implementation of general nursing routine for circulatory system diseases.

Second, stay in bed. When heart and lung function fails, you should stay in bed absolutely, and those who have difficulty breathing should take a semi-lying position and continue to take low-flow oxygen inhalation.

Third, give a high-calorie, high-protein and digestible diet, and give a low-sodium and low-salt diet when heart failure occurs.

Fourth, keep indoor air circulation, avoid direct blowing when opening windows for ventilation, and prevent colds and indoor cross-infection.

Five, close observation of breathing, blood pressure, pulse, thermometer consciousness changes.

Six, sputum observation and sputum culture and bacterial drug sensitivity test.

Seven, pay attention to oral hygiene, when the whole body edema, pay attention to skin care, prevent pressure ulcers, use diuretics, strictly record the dosage, to prevent electrolyte disorder.

Eight, keep the respiratory tract unobstructed. Encourage patients to cough and expectorate, often change their positions and pat their backs, which is conducive to sputum discharge. Cough reflex is weak, and those who can't expectorate should suck sputum frequently.

Nine, when the sputum is sticky, it should be atomized and inhaled to relieve bronchospasm and dilute the sputum, which is conducive to sputum discharge.

Ten, tracheotomy, tracheotomy nursing routine.

Eleven, the application of respiratory stimulants, don't use too much or too fast, so as to avoid side effects such as breathing too fast, fidgeting, flushing, sweating, vomiting, muscle tremor.

Twelve, observe the gastrointestinal bleeding and intravascular coagulation, such as abdominal distension, vomiting coffee-like liquid or tarry stool, tooth bleeding, oozing blood, purple spots on the skin, hematuria and vaginal bleeding. , should immediately notify the doctor.

Section VI Nursing Routine of Pulmonary Infarction

First, the implementation of general nursing routine of respiratory diseases.

Second, absolutely stay in bed. Take a semi-recumbent position.

Third, give a nutritious digestive diet.

Four, closely observe the changes in the condition, such as severe chest pain, dyspnea, cyanosis, irritability, hemoptysis, pale face, cold sweat, blood pressure drop, etc. , should immediately notify the doctor and assist in the rescue.

5. Patients with pulmonary infarction are often accompanied by nervousness and fear. Patients should be calm and psychologically concerned.

Six, when breathing is extremely difficult or cyanosis is obvious, you can take a nasal catheter, nasal plug or mask to absorb oxygen with a large flow. After the hypoxia was relieved, it was changed to low-flow oxygen inhalation.

Seven, such as thrombosis from the lower limbs, told the patient not to move the lower limbs, so as to avoid thrombosis continue to fall off.

Eight, in order to reduce dyspnea and prevent pain from causing shock, morphine should be used accurately, and pay attention to observe whether there is constipation or urinary retention.

Nine, the application of anticoagulant therapy, drug dosage should be accurate, and pay attention to observe the tendency of spontaneous bleeding. If bleeding is found in mucous membranes, gums, joints and other parts. You should inform the doctor in time.

Ten, ready to rescue drugs, such as oxygen, tracheal intubation, tracheotomy bag, cardiotonic, antihypertensive drugs, etc.

Eleven, encourage patients to get out of bed early after surgery. Those who stay in bed for a long time should massage their lower limbs and do passive or active activities of their limbs.

Section 7 Nursing Routine for Chronic Obstructive Pulmonary Disease

First, stay in bed, raise the bedside when breathing difficulties, and take a semi-lying position or a sitting position.

Second, the ward is ventilated twice a day for 30 minutes each time to keep the indoor air fresh, temperature and humidity.

Third, continuous low-flow oxygen inhalation.

Fourth, the diet should focus on high-calorie, digestible liquid food and semi-liquid food, and encourage patients to drink more water.

Fifth, strengthen oral care, remove dirt and deodorize, and make oral cavity moist and comfortable.

Six, observe the changes of the disease, such as consciousness, breathing depth, frequency, tone, lips and nail bed color. Monitor the changes of blood oxygen.

Seven, guide patients to take sputum samples correctly, and observe the color, character and smell of sputum.

Difficulty in expectoration is feasible by atomizing inhalation or postural drainage.

9. Instruct patients to cough effectively and learn abdominal breathing.

Ten, the recovery period gradually increase the amount of activity.

Eleven, discharge guidance:

1, the rest environment should be comfortable and quiet, and the windows should be ventilated to keep the air fresh.

2, according to climate change at any time to increase or decrease clothing, to avoid catching cold, avoid contact with cold patients, to prevent upper respiratory tract infection.

3. No smoking and reduce passive smoking.

4. Eat more foods with high cellulose (such as green vegetables and fruits) and high protein (such as lean meat, bean products and eggs) and crude fiber (such as celery and leeks), and eat less foods with high animal fat and cholesterol (such as animal viscera).

5. Avoid strenuous exercise, choose the exercise that suits you, such as walking and playing Tai Ji Chuan, and pay attention to the combination of work and rest.

6, insist on breathing exercise, equipped with home oxygen therapy facilities, low-flow oxygen inhalation when necessary.

Section 8 Nursing Routine of Bronchial Lung Cancer

First, the implementation of general respiratory disease care routine.

Second, the whole patient must rest in my bed. If you have difficulty breathing, take a semi-recumbent position.

Third, give a high-protein, high-calorie, multi-vitamin and digestible diet to encourage patients to eat and enhance their disease resistance.

Fourth, observe whether cough is aggravated and obstructive cough characterized by high-pitched metal phoneme.

Fifth, do a good job in psychological care, encourage patients to treat diseases correctly, and establish confidence in overcoming diseases. Know the patient's thoughts in time. Strictly shift to prevent accidents.

Six, patients with hemoptysis do hemoptysis care.

Seven, do fiberoptic bronchoscopy peep and biopsy, pleural puncture drainage and pleural effusion centrifugal precipitation exfoliated cells. Nurses should make good preparations before operation and cooperate during operation. Samples are sent for inspection in time.

Eight, sputum exfoliated cells and sputum specimens must be fresh for inspection, otherwise the cells will dissolve and cannot be identified, which will affect the inspection rate.

Nine, radiotherapy or chemotherapy, should pay attention to the reaction of radiotherapy and chemical drugs. Such as fatigue, loss of appetite, nausea, vomiting and leukopenia. , should be symptomatic care. It is necessary to know the dosage, methods and functions of chemical drugs and give them accurately according to the doctor's advice.

Ten, patients with advanced chest pain, mainly spiritual encouragement, it is recommended that patients use less anesthetic to relieve pain, so as to avoid addiction.

Eleven, keep the bed dry, pay attention to skin care, to prevent the occurrence of pressure ulcers.

Twelve, if you have difficulty breathing and cyanosis, give oxygen in time.

Section 9 Nursing Routine of Bronchial Asthma

First, the implementation of general nursing routine of respiratory diseases.

Second, the ward environment should be simple, clean and quiet. Flowers, blankets, etc. To avoid asthma.

Third, closely observe the symptoms of illness and seizures. Symptoms such as itchy throat, chest tightness, poor breathing, dry cough and mental stress should be given a small amount of drugs to relieve bronchospasm immediately to prevent asthma attacks.

Fourth, when asthma attacks, patients are emotional and should be comforted. Relieve tension and give oxygen. Moderate sedatives such as diazepam are given, and morphine and large doses of sedatives are prohibited to avoid respiratory depression.

Five, go to the semi-lying position, or put a small table on the bed, let the patient lie on the table. Fatigue has eased. When sweating for a long time, dry and change underwear in time to avoid catching cold.

Six, asthma attack as soon as possible according to the doctor's advice, to alleviate the pain of patients. Pay attention to drug reaction.

Seven, closely observe the changes of the disease, and actively seek the law and cause of the disease. Understand the inducement of the patient's illness, so as to find the source of allergy.

Eight, closely observe the drug reaction.

1, intravenous injection of theophylline drugs.

2, 0. 1% epinephrine 0.3ml subcutaneous or intramuscular injection, pay attention to whether there is palpitation, headache, elevated blood pressure.

3, asthma, patients can not control the use of the above drugs, hormone therapy can be used. Long-term application should pay attention to the changes of blood pressure.

Section 10 Nursing Routine of Bronchitis

First, the implementation of respiratory diseases. Frontal general nursing routine.

Two, after exercise, fever, pus and phlegm, shortness of breath and other symptoms, should stay in bed. After the fever has gone down, the amount of phlegm and shortness of breath are reduced, and you can exercise slightly and gradually return to work. Old people, young children and infirm patients should extend their rest time.

Third, give a nutritious and digestible diet and encourage patients to drink more water. The daily liquid supply should not be less than 300ml.

Fourth, the air in the ward should be circulated. Maintain a certain temperature and humidity to avoid the stimulation of smoke and flying dust. Pay attention to keep warm and change clothes at any time with the change of weather to prevent catching cold.

Severe cough, sticky phlegm is not easy to cough up, give atomized inhalation of wet sputum solution, hoarseness should pay attention to rest and reduce conversation.

Six, chronic bronchitis is easy to be infected, and respiratory isolation should be carried out.

Seven, smoking habits, to persuade them to quit smoking.

Eight, patients with chronic bronchitis should strengthen physical exercise at ordinary times, pay attention to keep warm in winter, prevent colds, reduce opportunities to go to public places, and avoid contact with patients with respiratory infections.

Section 11 Nursing routine of bronchiectasis

First, the implementation of general nursing routine for respiratory diseases

Second, patients with massive expectoration and hemoptysis should definitely stay in bed.

Third, encourage patients to eat a nutritious diet.

Indoor air circulation, maintain a certain temperature and humidity, avoid flying dust and smoke stimulation.

5. Observe the color, nature and quantity of phlegm. Take sputum for bacterial culture and drug sensitivity test, and choose effective antibiotics for treatment. If the sputum is sticky and should not be coughed up, it can be atomized and inhaled to dilute the sputum.

Sixth, pay attention to oral hygiene. Remove bad breath and increase appetite.

Seven, understand the focus, take appropriate posture drainage.

8. Smokers should be advised to quit smoking.

Section 12 Nursing Routine of Bronchiectasis Hemoptysis

First, pay attention to the premonitory symptoms of hemoptysis: such as chest tightness, burning sensation in chest area, palpitation, dizziness, itchy throat, foul smell in mouth or bloodshot sputum. If the above symptoms appear, please inform the doctor. Pay attention to observation and timely treatment to prevent massive hemoptysis.

Second, let the patient be quiet, give spiritual comfort, eliminate fears and concerns, and prevent emotional fluctuations from causing hemoptysis again.

Third, do a good job in basic nursing and nursing records. Lie flat quietly or lie flat on the affected side. When lying flat, your head should be tilted to one side and the ice pack should be placed on the affected side.

Fourth, let the patient cough up phlegm or blood clots as much as possible, breathe gently, and don't hold your breath. Keep the respiratory tract unobstructed and prevent suffocation.

Five, prepare an ambulance, medicine, oxygen, tracheotomy bag, fiberoptic bronchoscope, aspirator, blood transfusion and blood preparation.

Six, according to the doctor's advice to use hemostatic drugs. Pay attention to the dropping speed when intravenous infusion of pituitrin, and inject it slowly (10u dissolved in 10-20ml physiological saline) for at least 10min, and observe whether there are any side effects such as nausea, defecation, abdominal pain and elevated blood pressure. Patients with angina pectoris, hypertension and pregnancy are prohibited.

Seven, pay attention to observe the state of consciousness, blood pressure, pulse, breathing, body temperature. Pay close attention to the occurrence of hemorrhagic shock, notify the doctor in time, and carry out nursing according to the shock situation.

Eight, the patient suddenly chest tightness, fidgeting, dyspnea, hemoptysis, should immediately raise the patient's hips, head down. Pat the healthy back to discharge blood clots and keep the respiratory tract unobstructed.

Nine, give sedatives appropriately. Use antitussive drugs with caution. Morphine and codeine are forbidden, so as not to inhibit the respiratory center and cough reflex, make it difficult for blood clots to be discharged, and cause suffocation.

Ten, bleeding period should be given high calorie, digestible food. Fasting stimulating food. Reduce the exertion, keep the stool unobstructed, and avoid severe cough.

Eleven, hemoptysis asphyxia emergency care:

1. When there is jet hemoptysis, inform the doctor immediately. In the process of hemoptysis, if hemoptysis suddenly stops, and a small amount of blood is ejected from the nasal cavity, breathing is shallow, cyanosis or blood clots remain in the blood vessels, causing suffocation, you should immediately adopt antegrade drainage, head down, tilt 45-90o, and pat the patient's back to help the blood clots cough up. If it doesn't work, immediately cooperate with the doctor to do tracheal intubation or bronchoscopy to suck the bleeding block.

2. Give oxygen quickly.

3. Klamming and Lobelin are infused alternately.

4. Pituitrin is injected by closed vein.

5, blood transfusion when necessary.

Twelve, discharge guidance:

1, go to public places less. Pay attention to keep warm and add clothes at any time to prevent colds. Pay attention to ventilation and keep the indoor air fresh.

2. Prevent strenuous exercise and avoid severe cough. You can do some appropriate physical activities to enhance your physical fitness and disease resistance.

3, such as respiratory tract infection, should be early diagnosis, early treatment, timely medication.

4, pay attention to diet adjustment, avoid spicy, salty, rapid overheating, hard, fried food, try to eat some cool, nutritious food.

5. Get rid of your bad habits, try not to smoke and drink (especially violent alcohol and tobacco), do not go to places where there are many people and people smoking, prevent coughing, and eat without talking to prevent foreign bodies from entering the trachea.

6. Keep a happy mood and take part in some sports activities suitable for your physical strength. Exercise improves lung function.

Section 13 Nursing Routine of Respiratory Failure

First, acute respiratory failure must definitely stay in bed. In the compensatory period of chronic respiratory failure, you can get out of bed properly.

Second, give a nutritious, high-protein and digestible diet. In principle, people who can't eat by themselves should be fed by nose to ensure enough calories and water.

Third, observe the condition. In addition to regularly measuring body temperature, pulse, respiration and blood pressure, observing pupil changes and cyanosis of lips and nails, we should also pay special attention to the following indicators:

1, Consciousness: For patients with hypoxia and carbon dioxide retention, we should closely observe the slight changes in consciousness and whether there is respiratory depression during oxygen inhalation.

2. Breathing: Pay attention to the rhythm, speed and depth of breathing. If you find anything unusual, you should inform the doctor in time.

3. Sputum: Observe the amount and characteristics of sputum. If the amount of sputum is large and yellow, it means that the infection is aggravated. You should inform the doctor in time and send six samples for examination.

Fourth, oxygen therapy. According to the condition, pathology and physiological characteristics, different oxygen supply methods were given. In a short time, the oxygen partial pressure was higher than 50mmHg and the oxygen saturation was above 80%.

Fifth, keep the respiratory tract unobstructed. Conscious patients are encouraged to expectorate, passively change their posture, turn over and pat their backs, and promote expectoration. Those who can't expectorate by themselves should aspirate sputum in time, and the time of sputum aspiration should not exceed 15 seconds each time to prevent hypoxia and suffocation.

Six, observe the role of respiratory stimulants. If the drug is given too much or too fast, it may cause breathing too fast, flushing, sweating, vomiting, irritability, muscle tremor, pulsation and strong excitement of the respiratory center, and then turn to inhibition, so it should be reduced or stopped.

Seven, correct acidosis. When using 5% sodium bicarbonate, pay attention to whether the patient has carbon dioxide retention.

Eight, correct pulmonary edema application dehydrating agent, diuretic, pay attention to observe the curative effect. Cardiac insufficiency, intravenous drip should not be too fast and too much.

Nine, critically ill, long-term bed rest, should do a good job in skin care, life care. Do a good job in nursing records and accurately record the amount of entry and exit.

Ten, ready to first aid items. Such as tracheal intubation, tracheotomy bag, artificial respirator, sputum aspirator, oxygen, cardiotonic agent, respiratory stimulant, etc.

XI. Application of Ventilator Patient Care:

1, be familiar with the performance of the ventilator, and take effective first-aid measures when the ventilator fails or the condition changes.

2. Close observation: ① Observe the recovery and uniformity of patients' spontaneous breathing, so as to properly adjust the breathing frequency, tidal volume and breathing time ratio; (2) Whether there is spontaneous breathing and whether it is synchronized with the ventilator. Whether irritability is caused by insufficient ventilation or airway obstruction, pay attention to whether the pipeline joint leaks; ③ Observe the changes of body temperature, pulse, respiration, blood pressure, consciousness and pupil. Positive pressure inhalation reduces cardiac output and blood pressure. If the heart function is improved, the heart rate and blood pressure are stable, the limbs are warm, the skin is rosy and there is no sweat, which indicates that the ventilator is used properly.

3, keep the respiratory tract unobstructed, master the appropriate oxygen concentration, generally below 40%, timely sputum suction, prevent the formation of sputum thrombus, pay attention to prevent the casing from falling off.

4. Prevention of complications: ① Pay attention to the humidification of respiratory tract to prevent foreign body obstruction and suffocation; ② Monitor the changes of blood gas and electrolyte, and pay attention to the occurrence of hypoxia, hypotension and shock.

Twelve, discharge guidance:

1, pay attention to rest, live a regular life, quit smoking and drinking, and go to crowded places less.

2. Take proper physical exercise and avoid strenuous exercise.

3. Strengthen nutrition and eat a high-protein, high-calorie and low-fat diet.

4, insist on breathing exercise, improve lung function.

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