1, mental health guidance
Patients are often depressed and troubled because of language barriers, limb paralysis, incontinence, and inability to take care of themselves, and their psychological burden is heavy. Nurses should pay more attention to patients and actively introduce the hospitalization environment to make them adapt as soon as possible. And introduce the etiology, clinical manifestations, treatment and nursing measures and ideal prognosis of the disease to patients and their families to gain their trust. Make it relieve or eliminate tension and fear, and get up the courage to actively cooperate with the treatment.
2. Dietary guidance
Instruct patients to eat moderately and not to be too full. Choose a diet with low salt, low cholesterol, moderate carbohydrates and rich vitamins. Limit the intake of salt, with an average of no more than 6g per day; Eat less animal fat, cream, egg yolk, animal offal and other foods to prevent obesity and hypercholesterolemia; Increase the intake of high-quality protein, especially fish protein and soybean protein, and eat more fish and shrimp, lean meat, bean products, fresh vegetables and fruits; Drinking tea properly increases vascular toughness and improves blood circulation; Avoiding spicy food, quitting smoking and drinking will help reduce the incidence of cerebral infarction. People with dysphagia should take a sitting position or a lateral position with their heads held high, and give a liquid or semi-liquid digestible diet, chew slowly to prevent coughing; Those who are conscious or unable to eat should be given a nasal feeding diet as soon as possible to ensure nutritional supply.
3, life guidance
3. 1 Strengthening skin care Patients with cerebral infarction often have severe limb paralysis and stay in bed for a long time. It is particularly important to strengthen skin care. The patient should take the supine position with his head tilted to one side or lateral position. People with disturbance of consciousness and irritability should add a bed stall, and if necessary, they can be protected by restraint belts. Turn over regularly every 2 hours, gently massage the pressed parts and apply talcum powder. Mattress should be kept flat, dry and free of slag. When moving the patient, the patient should be lifted off the bed surface, and no dragging is allowed to avoid scratching the skin.
3.2 The nursing of defecation guides patients to keep defecation unobstructed and form a good habit of defecation every day. For constipation, laxatives can be given appropriately to avoid excessive exertion during defecation and increase the burden on the heart and brain.
3.3 Nursing patients who promote the recovery of limb function during bed rest can pad the affected limb to promote venous blood return in order to prevent limb swelling; In order to prevent foot drop, limbs should be kept in functional position. After 2 weeks of onset, the condition improved, and you can do limb function exercise and give passive exercise and massage to paralyzed limbs. From15 to 20min, twice a day. Gradually increase the number and time of exercise, active exercise after functional recovery, bed activities, bed activities, etc. Functional exercise will be carried out on limbs to gradually promote the recovery of limb function. Aphasia patients should be trained in language rehabilitation to gradually restore their language function.
4, discharge guidance
4. 1 Pay attention to the regular ventilation of the bedroom after discharge, keep the air fresh, live a regular life and pay attention to the combination of work and rest. We should insist on physical and language rehabilitation exercises.
4.2 After discharge, strictly follow the doctor's advice, such as oral enteric-coated aspirin and dipyridamole, to prevent recurrence. Maintain a low-salt, low-fat and low-sugar diet on weekdays, avoid spicy food, and quit smoking and drinking. Come to the hospital regularly for reexamination, recheck the indexes such as blood sugar, blood pressure and blood lipid, observe the changes of the disease, and adjust the treatment plan at any time.
4.3 If you feel unwell, seek medical advice in time. If you find symptoms such as dizziness, unsteady gait, elevated blood pressure, numbness and weakness of limbs, vague speech or aphasia, you should see a doctor in time and deal with them in time to prevent further development of the disease.
Rehabilitation guidance: Exercise against cerebral infarction: Cerebral infarction is a common disease among middle-aged and elderly people, with high recurrence rate, high disability rate and high mortality rate. About 60-70%
After emergency treatment, 90% of patients with cerebral infarction can regain consciousness, but generally they have different degrees of sequelae, and hemiplegia is the most common. In addition to reliable comprehensive measures such as drug treatment and acupuncture, the rehabilitation of cerebral infarction also includes appropriate functional exercise to speed up the recovery and improve the recovery degree.
1. Massage and passive exercise For early bedridden patients, their paralyzed limbs are massaged by their family members to prevent muscle atrophy, and passive movements such as knee flexion and extension, elbow flexion and extension, and finger bending are performed. It is performed on the major joints and minor joints to avoid joint stiffness.
2. Gradually start walking and doing upper limb exercises. After the above stages are basically consolidated, you can often do some activities such as lifting things, moving your body left and right, and squatting. You can also stand still, lift your legs in turn, and hold the edge of the table, bed, etc. And move to the left and right, walking forward with a cane in one hand.
3, gradually strengthen functional exercise, realize self-care. After walking by yourself, lift your legs to make a gait, gradually cross the threshold, go up the slope, go up and down the stairs, and gradually lengthen the distance; Patients with better recovery of lower limbs can also run short distances.
After the rehabilitation of cerebral infarction, we should insist on long-term medication and do a good job in secondary prevention. The effective rate of Tianxintai Xueshuanxinmaining tablets in treating cerebral infarction is 965438 0%. Tianxintai is the first Chinese medicine re-developed for the purpose of secondary prevention in China. It has the functions of eliminating internal resistance, dilating blood vessels, improving blood circulation, removing blood stasis, eliminating thrombus and dredging qi and blood, and can effectively prevent disease recurrence.