The general nursing routine of orthopedic diseases is: 1.
According to the general nursing routine of surgical diseases and the nursing routine of orthopedic diseases. 2。
After arriving at the hospital, the patients were properly placed according to different diseases and sent to the ward. (1) For patients with mobility difficulties or bedridden, nurses should take the initiative to help or carry them correctly according to their illness.
(2) In the process of changing clothes for emergency trauma patients, nurses should really check the patients' whole body skin and the wounds. Patients with massive hemorrhage should report to the doctor immediately and cooperate with the treatment; Fracture patients should be locally braked according to the doctor's instructions.
(3) Give patients with lumbar spondylosis a hard bed or an air cushion bed, and adjust the hardness to the strongest. (4) The nurse puts the limb in a functional position according to the illness or doctor's advice: for example, the shoulder joint is at abduction 45, flexion 30 and external rotation 65438+05; The elbow joint is located at 90 flexion; Wrist joint is located in dorsiflexion 20-30; The hip joint is located in flexion 15-20 and abduction10-20; The knee joint is located in flexion 5- 10 or extension180; The flexibility of calf joint is 5- 10.
(5) For patients who have been confined to bed for a long time before admission, the risk of pressure ulcers should be assessed after admission, and functional exercise guidance should be given to actively prevent complications such as pressure ulcers, falling pneumonia, urinary tract infection and deep vein embolism, muscle atrophy and joint stiffness. 3。
According to the nursing procedure, collect patients' health information, make admission evaluation, make nursing plan and implement it. 4。
In addition to fasting and drinking water in emergency surgery, other orthopedic patients are given foods with high calcium, high protein, rich vitamins and easy digestion, and patients are encouraged to drink more water. 5。
Inform the doctor in time, assist the doctor to do relevant examinations and understand the diagnosis and treatment plan. Emergency or critically ill patients should immediately cooperate with doctors for rescue treatment.
6。 Closely observe the changes of new critically ill patients or emergency surgery patients, monitor vital signs and consciousness according to the doctor's advice, accurately record the amount of fluid, observe the blood circulation, feeling and movement of the affected limb, and report to the doctor in time if any abnormality is found.
Take appropriate nursing measures and make accurate and timely records. 7。
In the new hospital, the patient's temperature was measured for 3 days, 3 times a day, and those with high temperature were reported to the doctor for treatment. From the second day after admission, all routine preoperative examinations, such as blood routine, urine routine, X-ray chest film, electrocardiogram and echocardiography, were completed according to the doctor's advice.
Carry out various special examinations and treatments, carefully explain the purpose, significance and precautions of the examination to patients, and obtain full cooperation. 8。
Nursing care of wound drainage tube. Correctly fixed to ensure that the equipment is airtight and unobstructed; Accurately record the nature, color and quantity of drainage fluid; Replace the drainage bottle every morning and perform strict aseptic operation; Take the bed as a unit, gently move your limbs to avoid the pipe from being folded or coming out.
24h drainage.
2. What are the nursing care of orthopedic patients?
Psychological care of orthopedic patients is related to factors such as long treatment time, long bed rest time and fear of recovery. There are many psychological obstacles, so nurses should be good at observing patients' psychological state, caring, loving and encouraging patients to exercise.
2。 Early stage of staged exercise (1) (1~ 2 weeks after injury): early local swelling and pain, the main task is to promote blood circulation, eliminate swelling and prevent muscle atrophy.
The focus of exercise is the muscle relaxation and contraction exercise of the affected limb, and the parts outside the fixed range should be exercised without affecting the fixed limb. (2) Mid-stage (2-3 weeks after injury): At this stage, the swelling and pain of the affected limb have disappeared, and there is fiber connection at the fracture. The main task is to prevent muscle atrophy and joint adhesion, and the focus of exercise is the movement of the distal and proximal joints of the affected limb fracture.
(3) Late stage (6-8 weeks after injury): The fracture has healed clinically and the external fixation has been lifted. The task is to promote full functional recovery, with key joints as the main part of the whole body exercise. This stage is the key stage of functional exercise, and the shortcomings of the first two stages are made up in this stage. 3。
Functional exercise method (1) Passive exercise: Exercise completely by external force, suitable for patients with severe paralysis. Driving mainly depends on others or healthy limbs.
The methods of passive exercise include massage, acupuncture, physical therapy, using instruments and passive activities. Passive activities should be gentle, not excessive, to prevent injury, patients should be painless or mild.
(2) Active exercise: Relying on the patient's own strength is the main method of functional exercise, which is suitable for patients with mobility difficulties. Give more guidance and encouragement to patients who actively exercise.
Instruct patients to do exercises conducive to fracture healing and encourage patients to make a little progress. (3) Power-assisted exercise: one's own strength is insufficient, and external assistance is needed, especially at the beginning.
The external force can be others, healthy limbs or exercisers. Guidance, encouragement and help in nursing.
Please check the fitness equipment before using it to ensure safety. External assistance is irreplaceable.
(4) Manual therapy: Although this method is passive exercise, it is generally not passive. Adaptation to intra-articular adhesion has been completely organized, and joint stiffness has been finalized.
In order to create sports conditions, the scar tissue was torn by one-time manipulation. It must be performed under anesthesia, with gentle manipulation, and special attention should be paid to exercise as soon as possible after operation.
4。 The form of muscle movement (1) isometric contraction: generally, the form of muscle movement in the fixator is the initial stage of muscle movement, and the nurse instructs the patient on the method of muscle contraction.
(2) Isotonic contraction: a method to guide patients' activities. (3) Isokinetic contraction (isokinetic contraction): Guidance is also needed.
5。 Mastering the principle and functional exercise should follow the combination of static and dynamic; Combination of initiative and passivity; Progressive principle.
3. Common sense that nurses must know
Let me look around for you. It seems that this is more in line with your requirements. 1.2 emergency nurses should have the first aid ability. One of the characteristics of emergency department is that patients have sudden onset, rapid change and critical illness, mostly due to traffic accidents and accidental injuries. Therefore, time is life, so we must react quickly, race against time and deal with it in time to save the lives of patients.
1.3 emergency nurses should have good language skills. Emergency rescue often includes pre-hospital rescue and in-hospital first aid, so its work scope is large, the service population is complex, it involves many related departments and needs a lot of coordination work. Moreover, the situation is very urgent, so emergency nurses must have good language skills and communication skills in order to coordinate and organize large-scale rescue and accident handling.
2 emergency nurses should have the quality
2. 1 The physical emergency department has great responsibilities, heavy tasks, strong randomness, poor first-aid environmental conditions and great physical strength. When dealing with accidents such as large-scale car accidents and critically ill patients, it often involves carrying patients and requires strong physical strength. At the same time, in order to save patients, sometimes it takes a long time to fight. Therefore, without a strong body, it is impossible to do emergency rescue.
2.2 Political Qualities Emergency patients are often sudden and often have no family members or companions. In the process of rescuing and observing patients, only one nurse is present most of the time; There are also some patients who have no money and no owners. At this time, we need the dedication of nurses. Therefore, emergency nurses are required to have high political quality and moral cultivation, good medical ethics, lofty ideological realm, good prudence and independent spirit, and serve patients with full enthusiasm. Regardless of personal gains and losses, the patient's life is above everything else. Put the interests of patients and hospitals first.
2.3 Professional emergency patients are often in a dangerous condition and in a state of emergency, which requires our medical staff to have superb and skilled rescue skills; Able to respond sharply, operate skillfully, cooperate tacitly and methodically; Have a more accurate foresight. Therefore, nurses in the emergency department must constantly strengthen the study and training of business skills, insist on learning from the old age, and all work must be "stable, accurate and fast" in order to race against time and strive to improve the medical quality and rescue level. Master the basic knowledge and skills of pre-hospital first aid, and master the use and storage of rescue equipment; Familiar with the function, usage and precautions of commonly used rescue drugs, and have strong communication skills and skills.
In a word, emergency nurses must have good personal accomplishment and "people-oriented" service concept; We must have the spirit of selfless dedication, and we must have the idea that everything is for patients and everything is for life; There should be a spirit of not being afraid of hardship and fatigue and a professional ethics that patient safety is above all else.
4. What should an orthopedic nurse have?
Specialty Nurse (SN) refers to a registered nurse who has certain conditions, has been trained in a specific field for several months, has the corresponding specialist nursing ability and obtained the qualification certificate of specialist through examination.
The specialized nurses for intravenous infusion have just started in China, but nurses who are not qualified for intravenous infusion abroad are not allowed to engage in venipuncture. At present, the introduction of clinical nurse system in China is still in its infancy, and it is not mature in terms of access requirements, training content and qualification certification.
At present, there are specialized nurses in China, including intravenous infusion nurses, wound nurses, ICU nurses, operating room nurses, oncology nurses, diabetes nurses and so on. Specialist nurses have a great influence on nursing career, and the training of specialist nurses strengthens the nature of nursing specialty and specialty.
The development of specialized nurses is an opportunity for high-quality nursing talents, especially nursing graduate students. With the rapid development of medical science and diagnosis and treatment technology, advanced medical technology and patients' increasing demand for nursing services, in order to improve nursing work synchronously with the level of diagnosis and treatment technology and give full play to the professional technical level and ability of nursing staff, developing nursing specialization has become the strategy and direction of clinical nursing practice in many countries [1].
Our bone specialist hospital is in a leading position in the field of orthopedics in China. How to give full play to advantages, develop disciplines and improve nursing quality, the nursing department of our hospital organized nurses in the whole hospital to carry out specialized training, and achieved initial results.
5. What should surgical nurses pay attention to?
First of all, you should be clear about your duties as a nurse. Second, no matter what you do, no matter which department you are in, you should pay special attention to the vital signs detection of critically ill patients. When infusion and injection, you should fill the medicine according to the doctor's advice. Each liquid bottle should indicate the patient's name, age, bed number and the name and volume of the input liquid.
Ask the patient's name to check when giving infusion to the patient, and ensure that the medicine is right for the person according to the doctor's advice. Third, it is essential for surgical patients in surgery, especially for postoperative care. It is necessary to check the doctor's advice and care for every patient.
For example, those who have baked lamps and inserted catheters do urethral orifice care every day. Sign when you're done, and remember to get the instrument back then.
Fourth, do a good job in succession, which patients are first-class care and which are second-class and third-class care. Which patients should pay attention to? Fifth, it is very important to pay attention to the operation sequence and not pollute the sterile area.