2.2 Written form When patients are admitted to the hospital, they will get a booklet entitled "Hepatitis Health Education" for patients to read. Set up a column of hepatitis health education in the department and change the publicity content regularly.
2.3 Nursing rounds Through business rounds such as case nursing, the contents of health education are infiltrated and integrated. Both patients and their families feel that they have benefited a lot and can cooperate well.
2.4 In the form of recess, hepatitis patients can bring their own benches and concentrate on their studies, and the head nurse or senior nurse will do publicity and education. Try to speak in simple language. Good results have been achieved.
3 Health guidance content
3. 1 Admission education introduces the ward environment, doctors and nurses in charge, discharge, hygiene, visiting system and how to use bedside pagers to patients and their families. Tell patients to abide by the disinfection and isolation system of the hospital, don't exchange visits to wards, don't share things with others, reduce companionship and prevent cross infection.
3.2 Psychological Counseling Because hepatitis patients lack medical knowledge about the disease, they are afraid of getting hepatitis and being left out by people around them, losing their jobs for fear of being known by leaders, and turning into chronic hepatitis, the prognosis is not good. In addition, patients with chronic hepatitis are often hospitalized because of repeated illness, which has a heavy economic burden. Often manifested as irritability, irritability, depression and anxiety, and even pessimism. Heavy psychological burden is extremely unfavorable to the recovery of illness, and irritability hurts the liver. We explain the common sense of hepatitis to patients, and explain the significance and methods of disinfection and isolation, so that patients can understand the causes of hepatitis recurrence and reduce the chance of recurrence. Make them have a more comprehensive and correct understanding of their diseases. Answer patients' questions in time, try to meet patients' requirements, eliminate ideological concerns and enhance treatment confidence.
3.3 Disease knowledge education Because patients lack medical knowledge about the disease and are troubled by the repeated fluctuations of hepatitis, patients show an urgent desire for knowledge. We should patiently explain the disease-related knowledge to patients and teach them to look at several common laboratory tests. Such as: (1) biochemical test report: check the situation of liver function. The more important items are total bilirubin, alanine aminotransferase and so on. (2) Immunoassay report: Check whether the alpha-fetoprotein is elevated. (3) antigen-antibody detection: check the situation of hepatitis B in two halves. ..
Tell the patients and their families that the test sheet is marked with normal values and can be compared. If there is an exception, there are up and down arrows next to the item. Explain in detail the appearance of "big three yang" and "small three yang" and "antibody" in two and a half halves of hepatitis B and the need to inject hepatitis B vaccine when two and a half halves are negative.
4. Knowledge guidance of communication channels
4. 1 The similarity between hepatitis A and hepatitis E is that it is transmitted through feces and mouth, which is seasonal and can cause outbreaks. Although the patient's blood and saliva are infectious, fecal detoxification takes a long time, so fecal-oral is the main route of transmission of hepatitis A and E, and fecal can pollute water, vegetables, food, hands and utensils. , can lead to spread or outbreak. General daily contact is often the main mode of transmission. If the water source or food is polluted, it will lead to an outbreak of disease.
4.2 The similarity of hepatitis B, hepatitis C and hepatitis D is mainly transmitted through blood sources, which is multiple and has no seasonality. Hepatitis B surface antigen can be excreted through various body fluids, such as blood, semen, vaginal secretions, saliva, milk and so on. However, the frequency of HBV particles in different body fluids is different. Therefore, the infectivity of various body fluids varies greatly. Among them, blood, semen, menstruation and vaginal secretions are more contagious.
Transmission route of hepatitis B: (1) perinatal mother-to-child transmission. (2) Iatrogenic transmission: transmission through blood sources and contaminated medical devices, and transmission between doctors and patients. (3) Sexual transmission and close contact transmission.
Guide to disinfection and isolation measures
Hepatitis A and E are isolated from the digestive tract for at least 1 month. Hepatitis B, hepatitis C and hepatitis D are isolated as blood sources. The isolation time should be appropriately extended. Patients' toothbrushes, razors and towels should not be used with their families, and chewed food should not be given to children. The patient's tableware and utensils should be separated from others. Tableware can be soaked in disinfectant containing available chlorine 1000mg/L for 30 minutes or boiled for 30 minutes, or disinfected with a disinfection cupboard. Wash your hands before and after meals. Clothes can be soaked and cleaned with detergent with disinfection and sterilization function, and books, newspapers and bedding used by patients can be exposed to the sun for 4-6 hours for disinfection. Disinfectant containing effective chlorine can be used to spray and wipe the ground, toilet and object surface. At the same time, close the screen window to eliminate flies and cockroaches. Strengthen personal hygiene.
6. Guidelines for drug use
6. 1 drug instruction for infusion: Gan 'an injection should not be used too quickly, which may cause nausea and vomiting, and should be maintained at about 20 drops/minute. When using Guladine and Casilad, individual patients may have a rash. If the liquid is input too fast, the infusion reaction will occur. After the nurse has adjusted the number of drops, the patient should not adjust the speed privately.
6.2 Instructions for Interferon Injection (1): Interferon is divided into 1 10,000 international units, 3 million international units and 5 million international units. Please check carefully before injection to avoid misuse. (2) Dosage and usage: Use according to the doctor's advice. Especially after discharge, you should follow the doctor's advice and don't increase or decrease or stop taking drugs at will, so as not to affect the curative effect. (3) 1 day, interferon can cause fever, fatigue and other discomfort. Individual patients have headache, myalgia, joint pain, loss of appetite and so on. Please don't panic.
6.3 Drug guidance harmful to the liver, such as morphine, barbiturates and chlorpromazine, is harmful to the liver and should be banned. Tell the patient to read the instructions carefully when buying medicine outside. If it is suggested that drugs with liver damage should be used with caution and must not be used indiscriminately. Drug treatment should be carried out under the guidance of a doctor.
7 diet guidance
(1) acute hepatitis should be given a light diet, liquid or semi-liquid suitable for the patient's taste, and nutritious food after the appetite improves. Encourage drinking more water to promote the excretion of metabolites and toxins, eat more fruits and fresh vegetables, supplement enough vitamins and carbohydrates (such as sugar, cereals, bread, fruits and beans), and the diet is easy to digest. (2) Chronic hepatitis should eat more protein, avoid a high-calorie diet and prevent liver steatosis. It is not advisable to eat too much sugar to avoid diabetes. You can take foods that help digestion, such as yeast, multi-enzyme tablets and hawthorn tablets, to reduce bloating. Smoking and drinking are prohibited, because ethanol, the metabolite of alcohol, will directly damage the liver. (3) Patients with severe hepatitis and premonitory symptoms of hepatic coma should limit the intake of protein to reduce the sources of ammonia in the intestine. Patients with ascites should limit the intake of sodium salt and water and eat less gas-producing foods, such as milk and bean products.
8 rest guide
(1) Early bed rest should be emphasized in acute hepatitis. When symptoms and liver function are obviously improved or jaundice subsides about 1 month, you can gradually increase your activity, but you should avoid fatigue. Bed rest can increase liver blood flow by 40%, which is beneficial to liver recovery. (2) Chronic hepatitis should adopt the principle of combining static and dynamic activities, taking bed rest as the main activity period, and doing light labor and appropriate physical activities during the static period. (3) For severe hepatitis, absolute bed rest should be emphasized, and patients should be instructed to minimize physical exertion.
9 emission guidelines
(1) Popularize the knowledge of viral hepatitis prevention and control, and reduce the incidence of hepatitis. (2) Emphasize the importance of complete cure of hepatitis and publicize the harm of persistent hepatitis to human body. Give specific guidance on rest, diet, medication and other issues, and ask patients to review on time in order to find recurrence as early as possible. (3) Patients with chronic hepatitis should be made aware of the causes of recurrence, such as alcoholism, fatigue, irrational drug use, bad mood, etc., and should be avoided as much as possible to reduce the chance of recurrence. In the stable period of illness, strengthen physical exercise appropriately to enhance physical fitness. (9) If you have the following symptoms: anorexia, fatigue, yellow sclera, tea urine, etc. Please see a doctor in time.