Theory - rereading the professional textbook is very important, although the book bought a lot, also read a lot of times, but every time you face a different level of examination and come to see the book, you will find that although it is the same book, you will find a lot of details that previously did not pay much attention to, and those will not only improve your ability to work in the clinic, but also for a solid foundation. find that although it is the same book, but you will find before did not pay too much attention to a lot of details, and those will not only improve your ability to work in the clinical work, but also for the examination to lay a solid foundation. I chose to focus on the textbook of the Master's program, supplemented by the syllabus of the exam.
Practice - the advanced examination has a lot of knowledge that is not in the books, and the form of the examination is a human-computer dialogue, many of the questions can not be returned to modify the answer, simulating the process of clinical disposition, so the knowledge accumulated in the work on weekdays is very important.
The question bank - China's examination is no more than a "sea of questions", do the questions in order to find out whether your revision ideas and the thinking of the questioner is the same, at the same time a part of the questions in the actual examination will have a certain rate of repetition, the appropriate do the questions or have! The first thing I'd like to say is that I don't know how to do this. The green network pioneer examination network one-stop examination resource base - examination software - past years questions - simulation test paper my habit is, after the first round of review slightly do one or two sets of simulation questions, to see the quality of their own review and the idea of whether it is correct, to the end of the second round of the end of a good question, study the topic, and then check the shortcomings to make up
Previous Next Nursing Routine
Internal Nursing Routine
1, Patients into the hospital room, according to the condition of the duty nurse designated beds; critically ill patients with **** arranged in the resuscitation room or guardianship room, and promptly notify the doctor.
2, the room should be kept clean, neat, quiet, comfortable, indoor air should be kept fresh, light to be sufficient, preferably with air-conditioning units to maintain a constant room temperature.
3, critical patients, patients with special tests and treatments need absolute bed rest, according to the needs of the condition can be taken flat position, semi-sitting position, sitting position, low head and feet high position, knee and chest position. The mild disease can be appropriate activities.
4, new patients, should be measured blood pressure, heart rate, pulse, temperature, respiration, weight. Stabilized patients should measure temperature, pulse and respiration once a day in the afternoon, and patients with body temperature over 37.5℃ or critical patients should be measured once every 4-6 hours, and those with high or fluctuating body temperature should be measured at any time.
7, close observation of the patient's vital signs, such as blood pressure, respiration, pupil, mental, heart rate and other changes and other clinical manifestations, but also pay attention to the observation of secretions, excretions, therapeutic effects and adverse reactions to medications, etc., such as the discovery of anomalies, you should immediately notify the doctor.
8, diet according to the doctor's instructions, to the patient to publicize the role of diet in the treatment of disease recovery process. Under the premise of implementing the principles of therapeutic diet to help patients choose tasty food, encourage patients to eat according to need. Feeding and drinking or nasal feeding in critically ill patients.
9, timely and accurate implementation of medical advice.
10, within 24 hours of admission to the hospital, stool and urine specimens, and do a good job of other specimen collection and timely delivery.
11, conscientiously implement the shift handover system, to do a combination of written and bedside shift handover, shift handover content is concise, fluent and application of medical terminology, handwriting is correct.
12, according to the requirements of the condition of life care, basic care and various types of specialized care.
13, for long-term bedridden, wasting, dehydration, malnutrition and coma should be good skin care, to prevent the occurrence of bedsores.
14, according to the needs of the disease, accurate record of the amount of in and out.
15, according to the characteristics of internal medicine specialties prepared rescue items, such as endotracheal tube, mechanical respirator, mouthpiece, electrocardiogram machine, electric defibrillator, double balloon three-lumen tubes, oxygen, venous puncture needles, respiratory stimulants, anti-arrhythmic drugs, cardiotonic drugs, blood pressure medication.
16, understand the psychological needs of patients, psychological support, do a good job of patient and careful explanation, the strict implementation of the protective medical system, and publicize to the patient the importance of mental factors in the treatment of disease and recovery of health, to help the patient to overcome the impact of various adverse emotions, to guide the patient to optimism to treat the condition, in order to better cooperate with the treatment, to be able to restore health as soon as possible.
Surgical Nursing Routine
Pre-operative Nursing:
1. Understand the patient's health problems, understand the body temperature, pulse, respiration, blood pressure and coagulation time, as well as the heart, liver, kidney function, but also includes the surgical site, the skin with or without suppurative foci, a variety of laboratory reports, the date of the girl patient's menstrual period as well as the patient's mood, and so on.
2, skin preparation: 1 day before the operation, the patient should bathe, haircut, shaving, nail clipping, dressing, can not take care of the person assisted by the nurse. According to the surgical part of the surgical field to do a good job of skin preparation.
3, follow the medical advice to check the blood type, blood preparation, complete the routine drug skin sensitivity test, such as penicillin, procaine.
4, intestinal preparation: intestinal surgery according to medical advice for intestinal preparation, generally 12 hours before surgery fasting, 4-6 hours before surgery water ban.
5. Preparation for intraoperative use: special medicines, X-ray film, CT film, MRI film, chest belt, abdominal belt, and so on.
6, preoperative guidance: patients do in bed urination and defecation exercises, bed turning exercises as well as deep breathing effective coughing exercises to prevent postoperative complications.
7, the morning of the day of surgery to measure temperature, pulse, respiration, blood pressure, remove dentures, eyeglasses, hairpins, jewelry, watches and valuables to family members or the head nurse, according to the doctor's orders to give preoperative medication.
8, organize the bed unit: including anesthesia beds, infusion racks, suction devices, oxygen devices, drainage tubes (bags) and a variety of monitoring equipment.
9, to explain to the patient the importance of this operation, intraoperative and postoperative situations that may arise, as well as precautions, to obtain the patient's cooperation.
Postoperative care:
1, accept the anesthesiologist's shift, understand the intraoperative situation and postoperative points of attention, according to a variety of postanesthesia routine care.
2, correctly connect all kinds of infusion tubes and drainage tubes and oxygen tubes, pay attention to fixation, and keep the catheter open.
3, the correct implementation of postoperative medical advice.
4, position: general anesthesia after surgery at the end of awake patients given prone position, head to one side, awake, neck, chest and abdominal surgery patients given semirecumbent position, scrotum, inguinal surgery should be lying down or low semirecumbent position, spine, buttock surgery should be taken after prone position.
5, pay attention to keep warm, prevent accidental injury. If the patient is agitated, he should be protected with a restraining belt or bedrail to prevent falling out of bed. Keep the respiratory tract clear, observe whether there is respiratory obstruction phenomenon, to prevent tongue falling back, phlegm crusts blocking the airway caused by hypoxia, asphyxia.
6, closely observe the changes of vital signs, observe the incision with or without oozing, oozing blood, such as incision dressing appearance of moisture, should promptly notify the doctor to change the medication, the use of chest and abdominal belt should be appropriate tightening, and observation and recording of the color, nature and amount of drainage fluid, in order to early detection of bleeding, gastrointestinal diseases and other complications.
7, diet: local anesthesia or minor surgery patients can eat after surgery, general anesthesia patients fasting the same day, the next day can enter the fluid, and then gradually semi-liquid, general food, depending on the situation. Gastrointestinal surgery, to be restored to gastrointestinal motility, anal defecation to give a small amount of fluid, 2-3 days after the full amount of fluid, and then 1-2 days after the change to semi-liquid, after 2 weeks can be changed to soft food or ordinary diet.
8, fasting, gastric tube, patients who can not take care of their own life, oral care, indwelling catheter perineal care, and to help turn over in bed, knocking the back, to prevent the respiratory tract, urinary tract, bedsores and other complications.
9, pain: take comfort patients, distract the patient's attention, change position, promote effective ventilation, relieve abdominal distension and other measures to relieve pain, such as severe pain, postoperative 1-2 days can be used in appropriate amounts of sedative analgesic drugs.
10, activity: encourage patients to turn over in bed, lift the buttocks, in order to promote gastrointestinal motility. If there is no contraindication, the first day of postoperative activities in bed, the second day to sit up, the third day in the nursing staff to assist the bedside sitting or bedside activities, the fourth day to help go to the toilet, and then gradually increase the amount of activity.
11, the critical condition of the person set up critical illness from the record sheet, to provide a basis for treatment.
Gynecological Nursing Routine
1, gynecological care before and after surgery
Pre-operative preparations:
(1) Abdominal surgery preparations
Abdominal surgery mainly includes salpingo-oophorectomy, total uterine excision, extensive hysterectomy and pelvic lymph node dissection, and so on.
①Ideological preparation: warmly caring for the patient, patiently and carefully explaining to the patient in order to relieve his nervousness and fear.
②General care: observe whether the vital signs are normal, to prevent complications; for major surgery patients and elderly patients, should be trained to use the bedpan and postoperative turning; check the bleeding, clotting time and liver and kidney function; to do the skin test of procaine, etc.; to give high-calorie, high-protein diet.
3 vaginal preparation: do transabdominal total hysterectomy, need to wash the vagina, 3 days before the operation of the vaginal douche once a day, such as vaginal bleeding can not do vaginal douche, instead of disinfectant scrub, such as 0.5% chlorhexidine tincture scrubbing the vagina once a day,***3 times.
④Skin preparation: skin preparation 1 day before surgery. Abdominal surgery should pay attention to clean the umbilicus, with a cotton swab dipped in gasoline to wipe the umbilicus hole dirt, scrub the abdominal skin with soapy water, shave the abdominal pubic hair and sweat hair, and then use hot water to wipe clean and check whether the sweat and pubic hair is clean shaving, abdominal surgery preparation of the skin range on the upper part from the lower part of the rapier protuberance, both sides of the axillary line to the midline, and the lower part to the mons veneris and the upper thighs in the upper 1 / 3 place.
⑤ Preparation 1 day before surgery: dinner is reduced, soft food, fasting after midnight, giving soap and water or saline enema once before bedtime to defecate, and oral sedative sleeping pills can be taken at night.
6 surgery day preparation: measure T, P, R, BP. transabdominal total hysterectomy need to do vaginal douche, douche and dry, and in the cervix or fornix coated with 1% gentian violet, indwelling urinary catheter, on time to give preoperative medication, check the bed number, name, send the patient into the operating room and to the nurse detailed shift.
(2) Preparation for vaginal surgery
①②③Same as abdominal surgery.
④Preparation of the skin 1 day before the operation shave the pubic hair, wash the skin with soapy water and water. The area of skin preparation was 250px above the pubic symphysis and 250px below the anus, including the inguinal area, vulva, and the upper third of the thighs.
5. Vaginal preparation for perineal Ⅲ-degree laceration repair, rectovaginal fistula repair, and so on. 3 days before the operation, enter a less crumbly semi-liquid diet for 2 days and a liquid diet for 1 day, give intestinal antimicrobials, and give an enema on the evening of the 1st day before the operation or early in the morning of the day of the operation.
6 Other preparations are the same as for abdominal surgery.
(1) Room preparation: the surgical patients should be concentrated in one room, in order to strengthen the observation and care.
(2) Post-anesthesia care: general anesthesia should be set up before waking up special care. The patient should lie flat on the floor with the head tilted to one side. Epidural block anesthesia and lumbar spine anesthesia patients should be depillowed and lie flat for 6 hours after surgery to avoid headache.
(3) Postoperative observation: understand the surgical situation and treatment, measure blood pressure once in 15-30 minutes, and measure T, P, R once every 4 hours until normal. Pay attention to the wound for blood seepage, internal bleeding and other abnormalities.
(4) Position: semi-recumbent position can be taken on the second day after the operation, and encourage the patient to leave the bed as soon as possible to promote recovery.
(5) Diet: generally fasting on the day of major abdominal surgery, 1-2 days after the operation into the fluid, and then day by day to semi-fluid and ordinary diet, vaginal surgery into the fluid 6 hours after the operation, 1 day after the operation can be into the semi-fluid, in the period of can't eat or insufficient to eat, should be by intravenous rehydration.
(6) Wound pain: sedatives or analgesics can be injected within 24 hours according to medical advice.
(7) Abdominal distension: generally 48 hours after surgery can be self-exhaustion, such as abdominal exhaust, can be given to anal exhaust, 1, 2, 3 solution enema, abdominal acupuncture, etc., such as ineffective intramuscular injection of neostigmine 0.5-1mg.
(8) To maintain the catheter clear and perineal cleanliness: postoperative retention of catheter for 1-2 days, vaginal total hysterectomy and anterior-posterior wall repair of the vagina It is left in place for 3-5 days, and 5-7 days for extensive total hysterectomy and pelvic lymphatic drainage.
(9) Characteristics of postoperative care after vaginal surgery: general care is the same as before. Those who have gauze inserted in the vagina need to remove the gauze within 24 hours after the operation, and pay attention to observe whether there is bleeding.
2, all kinds of abortion nursing routine
(1) a priori abortion and habitual abortion need to keep the fetus
① bed rest, good psychological care, relieve the patient's ideological concerns, and actively cooperate with the treatment.
② prohibit enemas, diarrhea drugs and drugs that cause fetal malformation.
③ Pay attention to the observation of vaginal bleeding and abdominal pain, keep the perineal pad to estimate the amount of bleeding.
(4) Report to the doctor if the preeclampsia develops into an inevitable miscarriage.
(2) Inevitable and incomplete abortion
①Measure BP, P, R and observe the patient's reaction to prevent shock. Prepare for scraping the uterus and give fluids, blood distribution, blood transfusion and oxygen if necessary.
②After scraping the uterus, pay attention to the vaginal bleeding, if necessary to give the uterine contraction agent, pay attention to the vulva clean, prohibit sitz bath.
③Send specimens for pathologic examination.
(3) Expired abortion
①Take blood routine and blood type examination.
②Other with the inevitable abortion routine.
(4) Infectious abortion
①Bedside isolation, semi-recumbent position.
② Pay attention to the vulva clean, change the perineal pads.
③ Closely observe the changes of T, P, R, BP, and then scrape the uterus after the infection improves.
④After curettage, continue anti-inflammatory treatment according to general post-abortion care.
3, acute pelvic inflammatory disease nursing routine
(1) According to gynecological routine care.
(2) Semi-recumbent bed rest is conducive to the pus cavity gathering uterorectal depression and make the inflammation limited.
(3) Physical hypothermia is used in case of high fever.
(4) Try to avoid all kinds of unnecessary tests, so as not to cause the spread of inflammation.
(5) Closely observe the changes of T, P, R, BP and keep records.
(6) Closely observe the condition, report any changes to the doctor in time, and be prepared for resuscitation.
4. Nursing routine of vulvar trauma
(1) Rinse the vulvar skin, clean the wound, and cooperate with doctor's examination.
(2) If the range of vulvar hematoma is not big, give local cold compresses and observe whether the hematoma is enlarged or not, if the hematoma is stable after two days, give local physiotherapy or P.P sitz bath.
(3) Hematoma range is large, for incision and ligation of hemostatic suture, postoperative should be given to the gauze, thong belt compression hemostasis, vaginal gauze 12-24 hours to take out, pay attention to the observation of the local gauze situation.
(4) Hematoma postoperative indwelling catheterization, protection of perineal wounds clean and dry, perineal scrubbing twice a day.
5, gynecological abdominal surgery nursing routine
(1) psychological care: patiently explain the operation, eliminate the patient's fear.
(2) the whole body preparation, improve the preoperative examination, strengthen the nutrition.
(3) Skin preparation: skin preparation (up to the lower part of the raphe, down to the upper 1/3 of the thigh, including the mid-axillary line on both sides of the vulva), shower, and so on.
(4) Digestive tract preparation: semi-liquid diet in the evening before the operation, fasting and water after midnight, clean enema according to the need for surgery, such as ectopic pregnancy, ovarian cysts, tibial torsion of the ovarian cysts and other acute abdominal conditions, prohibit enema.
(5) Vaginal preparation: for total uterine excision and other surgery, use 1:5000P.P vaginal douche, once a day, ***3 days, with vaginal bleeding, line vaginal scrub, and apply gentian violet.
(6) Bladder preparation: preoperative indwelling catheterization.
(7) Other preparations: one day before the operation, follow the doctor's instructions to do drug allergy test, blood matching. The night before the operation was given to take sedatives, 1 hour before the grams of basic anesthesia, remove dentures, jewelry, and prepare the medical records, lap belts and other necessary supplies to bring to the operating room.
6, gynecological abdominal surgery after care routine
(1) anesthesia bed, hospital room ultraviolet air disinfection.
(2) Understand the surgical situation when receiving the surgical patient, and measure T, P, R once, observe the general condition of the patient, measure blood pressure once every two hours, measure four times, those with abnormalities continue to measure in accordance with the medical advice, measure T, P, R every four hours for three days after the operation, and those with fever continue to measure.
(3) Eight hours after the operation, go to the pillow lying down, to help turn over, 12 hours after the semi-recumbent position, to lift the abdominal distension.
(4) Observe the urine volume, retain the urinary catheter time according to the type of surgery, such as total hysterectomy requires 24 hours, adnexectomy requires 12 hours, after the removal of the urinary catheter, urge to drink more water, 8 hours to urge self-cleaning urination.
(5) Observe whether there is wound bleeding and bleeding symptoms, wound healing.
(6) Prevent postoperative complications, perineal scrubbing twice a day, keep the vulva clean, prevent retrograde infection, for those who have cough, help cough out the sputum, if necessary, give nebulized inhalation.
7, general vaginal surgery nursing routine
(1) preoperative preparation: in addition to the following points, the other and abdominal surgery preparation.
①Skin preparation range: up to 250px above the pubic symphysis, down to the perineum around the anus and up to the inner upper third of the thigh.
②No urinary catheter is inserted and no lap band is prepared before surgery.
(2) Postoperative care: except for the following points, other than the same as abdominal surgery care.
①Flat or lateral position.
②Vaginal gauze to detailed shift, follow the doctor's orders to remove the gauze to check the number.
③ Retention of urinary catheter more than 5 days, after removing the urinary catheter, if necessary, to measure the amount of residual urine.
④ Perineal wipe twice a day, change perineal pads diligently.
5 Encourage the patient to drink more water, three days without defecation, give laxatives to keep the bowel clear.
8, ectopic pregnancy surgery nursing routine
(1) patients hospitalized in a timely manner to notify the physician, cooperate with the physician to do the posterior fornix puncture, according to the doctor's orders to give fluids, if necessary, to give oxygen, blood distribution.
(2) The preoperative and postoperative care of patients needing surgery is the same as the gynecological abdominal surgery nursing routine.
(3) Conservative treatment, absolute bed rest, pay attention to warmth, measure T, P, R, BP every 2-4 hours, closely observe the changes in abdominal signs.
(4) Give high-nutrition, high-vitamin diet, and keep the bowels open.
(5) Ask the patient to avoid sudden change of position and increase abdominal pressure, if there is abdominal pain and symptoms of internal hemorrhage should be immediately reported to the physician.
(6) Pay attention to vaginal bleeding and discharge, if necessary, save the perineal pad for observation.
(7) Keep morning urine specimen in time to check the dynamic changes of urine HCG.
9, gynecology commonly used nursing techniques
(1) sitz bath
For gynecology commonly used local treatment, commonly used in vaginitis, vulvar itching, urethritis, vulvar infections, uterine prolapse, etc., as well as vulvar and vaginal swelling surgery of the preoperative preparation. Commonly used drugs 1:5000 potassium permanganate, 0.5% acetic acid,4% soda.
Methods: The patient empties the bladder. Sitz bath must be the entire buttock vulva immersed in the liquid, the water temperature of about 40 degrees, pay attention to prevent scalding, generally immersed in 20-30 minutes, adjust the water temperature at any time. Where menstruation, vaginal bleeding, pregnant women within ten days after delivery is prohibited sitz bath.
(2) vaginal douching
Vaginal douching has a cleansing and heat therapy effect. Commonly used in routine cleaning and douching, chronic cervicitis, vaginitis local treatment, transabdominal total hysterectomy or preoperative preparation for vaginal surgery. Commonly used solutions are 1:5000 potassium permanganate, 1:2000 neosporin, 1% lactic acid, 0.5% acetic acid.
Methods: The patient takes the bladder lithotomy position, spreads the rubber cloth under the buttocks, puts the potty on the cloth, rinses the vulva first, then inserts the douche head into the deep part of the vagina, rotates the douche head in the vagina while rinsing, or exposes the cervix with a speculum and then rinses again, rotates the speculum while rinsing in order to rinse the vagina around the wrinkled wall, when the rinsing liquid will be drained out, clamps the skin tube, removes the douche head and the speculum. Ask the patient to sit up, dry the vulva with a dry cotton ball, organize the supplies, such as unmarried women, available catheter douche. Menstruation, pregnancy, puerperium, vaginal bleeding is prohibited vaginal douche.
(3)Vaginal and cervical medication
Treatment of various vaginitis and acute and chronic cervicitis.
Methods: first do vaginal douching, use a speculum to expose the cervix and wipe away secretions. Depending on the choice of drugs, the use of rubbing, spraying or incorporation and other methods.
(4) Perineal rubbing (flushing) method
Cleans the perineum and prevents infection. It is generally used for those who retain catheters after gynecological abdominal surgery, as well as after perineal and vaginal surgeries, within a week after childbirth and for women with wounds on the perineum. Scrub (flush) 1-2 times a day, and should also be scrubbed (flushed) after defecation.
Methods: the patient bends the knees and lies on the back, exposing the vulva, rubber cloth under the buttocks, placing the curved disk next to the perineum, using hemostatic forceps to take the cotton ball soaked with medicine, scrubbing from the inside out according to the labia, mons veneris, the inner thighs, the anus in the order of 1-2 times. If there is a wound in the perineum, it should be scrubbed outward with the wound as the center, and after washing, the wound should be fixed with sterile gauze. If perineal douche, you need to increase the douche pot, douche with a cotton ball to block the vaginal opening, do not make the douche into the vagina. Whether scrubbing or rinsing, the water temperature should be moderate, pay attention to keep warm.
(5)Cold and hot compresses on the perineum
Cold compresses: mostly used for small vulvar hematomas. Early cold compresses can make blood vessel contraction, peripheral nerve impulse conduction is blocked, so there is a hemostatic and analgesic effect.
Methods: put ice in water, into a small ice bag, plus a cloth cover on the affected area, fixed with a thong belt; or wet cold compress with ice water, 2-3 minutes for a change. Cold compresses are applied for about 20 minutes each time.
Hot compresses: mostly used for vulvar edema, inflammation, can promote the dissipation or limitation of inflammation, eliminate pain. Wet heat is more effective than dry heat. With 50% magnesium sulfate solution gauze on the affected area, pay attention to prevent burns, covered with cotton pads, fixed with a thong belt, every 4 minutes to change the dressing once, each time the dressing 20-30 minutes, 2-3 times a day. Perineal edema can also be used 95% sprinkle essence wet compress.
Urology nursing routine
1, encourage patients to drink more water, keep the bed sheets clean, dry, urine pollution timely replacement.
2, all kinds of drainage tubes should be properly fixed to prevent dislodgement, regular replacement of drainage tubes and drainage bottles.
3, should keep the drainage tube open, if necessary, do intermittent or continuous flushing.
4, pay attention to the observation of the amount, nature, color of the drainage material, and timely record, if abnormal, timely treatment.
5, after surgery, should be rotated to place the drainage material, to prevent urine, blood accumulation caused by infection, the dressing soaked should be changed at any time.
6, prostate and bladder after surgery or long-term indwelling catheterization of patients, generally 2-3 times a day bladder irrigation.
Catheterization nursing routine
1, do a good job of psychological care of patients, reduce the psychological burden.
2, to ensure adequate sleep, pay attention to the regularity of life, do not overwork, guidance for a reasonable diet.
3, the patient was asked to prohibit urination within twenty minutes after the operation.
4, ask the patient to drink more water, observe the 24-hour urine volume, urine color, urine flow rate and urethra condition.
5, pay attention to warmth, avoid colds; every two catheters for a prostate massage.
6, ask the patient about the improvement of symptoms, timely response to the physician in charge.
Prostatitis nursing routine
1, the selection of effective antimicrobial agents, strengthen the systemic supportive treatment, to prevent the occurrence of complications.
2, most patients have changes in sexual function, so it is necessary to do a good job of psychological care, so that patients actively cooperate with the treatment.
3, to ensure adequate sleep, avoid tobacco and alcohol, to develop regular living habits, guidance for a reasonable diet.
4, ask the patient to drink more water, observe the 24-hour urine volume, urine color, urine flow rate and the urethral opening with or without secretion and its nature.
5, acute prostatitis avoid doing prostate massage, hot water sitz bath.
6, patiently explain the patient put forward a variety of questions, timely treatment of the patient's response and thought dynamic feedback to the doctor.
7, good discharge guidance.
Prostate enlargement surgery nursing routine
1, according to the surgical pre and post-surgical nursing routine and urology general nursing routine implementation.
2, combined with urinary retention, urinary tract infection, uremia, chronic renal insufficiency, should be preceded by indwelling catheterization or suprapubic cystostomy.
3, follow the doctor's instructions to take estrogen, so that the prostate contraction and hardening, easy to operate and reduce intraoperative bleeding.
4, avoid constipation, avoid drinking alcohol, so as not to induce acute urinary retention; appropriate activities to increase the tolerance of surgery.
5, postoperative lying down for 3 days, reduce turning to avoid induced bleeding.
6, good care of the urinary drainage tube, strict clots blockage. The flushing rate depends on the color depth of the drainage fluid, and stop flushing 2 days after the visual observation of no hematuria.
7, the use of antimicrobial and hemostatic drugs to prevent infection and bleeding, intestinal function recovery before eating.
8, 5 days after the operation, prohibit enema, anal tube exhaust, prohibit the use of new period of the Ming class drugs. Abdominal distension, constipation, can take laxatives or external corkscrew.
9, incision pain, urethral spasm can cause abdominal muscle tension and induce bleeding, may be appropriate to use painkillers.
10, bladder irrigation stopped, the patient should be encouraged to drink more water, in order to achieve the purpose of its own flushing.
11, after removing the catheter, pay attention to any difficulty in urination or incontinence, and instruct the patient to perform sphincter contraction exercises.
12, the prevention of decubitus ulcers and keep the bowel clear.
TURP postoperative care routine
1, after the operation of the pillow lying down for 6 hours, closely observe the T, P, R, BP and mental changes, if any abnormality timely notify the doctor.
2, control the speed of intravenous infusion, prostate hyperplasia patients are mostly elderly, heart, lungs and kidneys compensatory capacity decline, so the speed of infusion can not be too fast, too much to prevent the circulatory load aggravation of the situation.
3, observe the urine volume, urine color, continuous bladder irrigation, to prevent the trauma of blood seepage and formation of blood clots blocking the drainage tube, the speed and time of irrigation can be decided according to the color of the irrigation fluid until the removal of the tube.
4. Accurately record the amount of in and out, in order to know whether the patient's body fluids are balanced.
5. Observe the color of the drainage fluid to know whether there is active bleeding in the surgical wound.
6, pay attention to the urethral opening for secretion and redness, swelling, and regular disinfection to prevent retrograde infection.
7. After the operation, the patient should be allowed to get out of bed as early as possible according to the condition or take the semirecumbent position, encourage and guide the patient to cough correctly, and if there is any difficulty, the patient should be given patting on the back, nebulized inhalation and the use of symptomatic drugs.
8, after extubation should pay attention to observe the patient urination is smooth, changes in the thickness of the urine line, timely detection of urethral stenosis;
If there is hematuria, we should know the amount of hematuria, color and time, and report to the doctor for treatment in a timely manner.
9, ask the patient to drink more water, to be patient gastrointestinal function recovery, can be asked to enter the light, liquid diet, in order to avoid stool
dry appear post-stool trauma bleeding.
Nursing routine after general anesthesia
1, specialized nursing, observation of vital signs, every 15-30 minutes to measure BP, P, R.
2, to maintain a clear airway, before waking up to go pillow lying down, head to one side or lateral lying, to prevent vomitus aspiration, Qingbian prepared suction and tracheotomy bag, in case of asphyxia when the first aid.
3, to ensure that the infusion of fluids to maintain circulatory function.
4, to maintain normal body temperature, body temperature is too low to keep warm, too high to cool down.
5, to prevent accidental injury, need to add restraint, to prevent the patient unconsciously pull out the infusion tube and drainage tube, to prevent falling out of bed.
Non-gastrointestinal surgery patients awake, if there is no vomiting, after 4-6 hours can drink a small amount of water, the next day to start eating.