Model essay on heart disease nursing 1: Nursing of interventional therapy for congenital heart disease
abstract
Objective To explore the nursing measures and clinical effect of interventional therapy for congenital heart disease. Methods 65 patients with congenital heart disease who needed interventional therapy were given comprehensive and meticulous care, including preoperative psychological care and preparation, intraoperative care and postoperative nursing observation. Observe the nursing effect. Results The success rate of 65 patients with congenital heart disease was 65.438 0.00%, and they were cured and discharged in 3 ~ 5d days. Conclusion Strict and meticulous intraoperative monitoring and good postoperative care are the keys to improve nursing quality, reduce complications and achieve successful operation.
Congenital heart disease; Interventional therapy; nurse
Congenital heart disease is a common disease that threatens the physical and mental health of patients. In the past, thoracotomy was often used for treatment, which caused great trauma and long hospitalization time. With the development of medical science and technology and the progress of cardiovascular diagnosis and treatment, interventional therapy has been applied to congenital heart disease. According to X-ray images, operating various catheters in vitro for treatment has the advantages of less trauma, low risk, quick postoperative recovery, short hospitalization time, few complications, high safety and no surgical scars. Interventional therapy is widely used in clinic. Nursing experience is summarized as follows.
1 data and methods
1. 1 general information
From March 20 14 to March 20 15, 65 patients with congenital heart disease were selected, including 22 males and 43 females, ranging in age from 7 months to 55 years, with an average of 9 years. There were 23 cases of atrial septal defect, 28 cases of ventricular septal defect and patent ductus arteriosus 12 cases, including 2 cases of atrial ventricular septal defect. 15 cases under intravenous anesthesia and 50 cases under local anesthesia.
1.2 nursing methods
1.2. 1 Before psychological care, patients were anxious and worried [1]. In order to relieve the mental anxiety of patients and their families, nurses explain the advantages and reliability of interventional therapy for congenital heart disease to patients, introduce and chat with cured patients, and establish confidence in overcoming the disease. Nurses communicate enthusiastically with patients and their families, explain the purpose, methods and precautions of surgery to patients, and eliminate the concerns of patients and their families in easy-to-understand language.
1.2.2 Routine examination before operation ECG, echocardiography, chest X-ray, blood routine, urine routine, liver function, renal function, bleeding and clotting time, and hepatitis B series examination were performed before operation. Routine skin preparation before operation, drug allergy test, bathing and changing clothes as appropriate. Measure and record body temperature, pulse, respiration and blood pressure. If the body temperature rises, treatment should be given, and surgery should be performed 3 days after the body temperature is normal. At the same time, observe the pulse at the distal end of the puncture site. Pre-surgical
1.2.3 After the patient enters the operating room, make him lie on his back on the catheter bed, take oxygen, establish venous access, maintain the access with normal saline, and connect ECG monitoring and blood oxygen saturation instrument. Heart rate, respiration, blood pressure and blood oxygen saturation were closely observed during operation. The intravenous anesthesiologist leans his head to one side to keep the respiratory tract unobstructed and prevent aspiration. Close observation of ECG monitoring, observation of intraoperative arrhythmia, if there is atrioventricular block at any time to inform the doctor, for treatment [2].
1.2.4 postoperative care: after the operation, remove the pillow and lie flat, tilt your head to one side, keep the airway unobstructed, prevent suffocation by inhalation, take oxygen and monitor ECG and blood oxygen saturation, closely observe vital signs, whether there is atrioventricular block and bradycardia, and pay attention to the performance of unintentional stuffing. After operation, observe whether the puncture site is bleeding or not, and the pulse, color, temperature and sensory changes of limb arteries. The puncture site was bandaged with pressure, and the puncture side limb was braked 12h. 24 hours after the operation, straighten the leg on the puncture side, alternate the supine position with the left position, and guide the family members to massage the back and limbs to prevent venous embolism. If there is no bleeding, take off the pressure bandage for 24 hours and exercise properly underground.
1.2.5 observation and nursing of complications If there is residual shunt after occlusion of ventricular septal defect, if the shunt flow is large and the flow rate is fast, hemolysis may occur. Observe closely whether there is soy sauce urine, detect whether there are red blood cells in urine, and report to the doctor in time if there is hemolysis. Patients with ventricular septal defect may have atrioventricular block after operation, so we should pay attention to ECG monitoring and report atrioventricular block to the doctor in time. The occluder may fall off after the operation of atrial septal defect and ventricular septal defect. Observe the changes of heart murmur closely and report to the doctor for examination and treatment.
1.2.6 discharge guidance: keep a good mood, rest properly and gradually increase the activity for 3 months after operation. Follow the doctor's advice after discharge, 1, 3, 6 months, and go to the hospital for regular check-up. Continue to take enteric-coated aspirin for anticoagulation, pay attention to the dosage and check the liver function regularly. Observe whether there is bleeding on the skin and gums, and check the blood coagulation function if necessary. B-ultrasound and chest X-ray were reexamined 6~ 12 months after discharge.
Two results
The success rate of 65 patients with congenital heart disease was 100%. He was discharged from the hospital 3 ~ 5 days after operation and followed up for 65438 08 months. No occluder displacement, atrioventricular block and hemolysis occurred.
3 abstract
Interventional therapy is the first choice to treat congenital heart disease. With the progress of science and technology and the improvement of interventional therapy methods and instruments, it is an important measure to gradually improve the therapeutic effect of congenital heart disease, do a good job in psychological nursing and preoperative and postoperative nursing, optimize service attitude, improve nursing quality and reduce complications.
refer to
[1], Wang Li, Gao. Psychological nursing before and after coronary intervention. Xinjiang Traditional Chinese Medicine, 2014,32 (1): 37-38.
[2] Dai Qingyan. Perioperative nursing care of patients with congenital heart disease undergoing interventional surgery. Heilongjiang medicine, 2014 (6):1505-1506.
Model essay 2 on heart disease nursing: the significance of rehabilitation nursing education in the field of pulmonary heart disease
Objective To explore the influence of various forms of rehabilitation nursing education on patients with cor pulmonale. Methods: From April 2065438 to April 2003? A total of 80 patients with pulmonary heart disease/kloc-0 admitted during June 2065 438+ in 2005 were studied and randomly divided into observation group and control group, with 90 cases in each group. The control group adopted the conventional health education model for rehabilitation nursing, while the observation group adopted various forms for rehabilitation nursing, and compared the rehabilitation effect after education. Results It was confirmed by research that the nursing effect and nursing satisfaction of various forms of rehabilitation nursing were higher than those of conventional nursing methods, P
[Keywords:] Rehabilitation nursing education; Pulmonary heart disease; Many forms
Pulmonary heart disease is a common disease, mostly in middle-aged and elderly people. The course of the disease is long and progressive [1]. However, due to the influence of social and economic factors, it is unrealistic for patients to be hospitalized for a long time. Corresponding rehabilitation nursing education should be taken to make patients fully understand the actual situation of their own diseases and take care of themselves after discharge. Health education is the main content of nursing, and the traditional education model is no longer suitable for nursing and can not stimulate the enthusiasm of patients. This study analyzed the significance and influence of rehabilitation nursing education in the field of cor pulmonale, and the report is as follows:
1 data and methods
1. 1 general information
20 13 April in the hospital? 80 patients with cor pulmonale admitted in June 2005 were randomly divided into observation group and control group, with 90 cases in each group. There were 60 male patients and 30 female patients in the control group, all aged between 42 and 84, with an average age of (6 1.5? 1 1.2) years old; There were 62 male patients and 28 female patients in the observation group, all aged between 43 and 85, with an average age of (62. 1? 1 1.8) years old. There is no significant difference in general data between the two groups (P & gt0.05), which is very comparable.
1.2 method
The control group was given conventional education mode. The observation group adopted various forms of rehabilitation nursing education mode. Its educational content is as follows.
1.2. 1 communication guide ① popularization mode. People with cor pulmonale will be anxious about their prognosis because of repeated hospitalization, and they will also worry about the economic situation and aggravate their illness. Educators need to educate them, explain the matters that should be paid attention to in the whole rehabilitation nursing and the main purpose of relevant examinations, and patiently answer the questions raised by the research subjects to eliminate their doubts. 2 is the mode. Pulmonary heart disease is repetitive and cannot be cured for a long time, so people with this disease will have corresponding psychological problems, such as pessimism, anxiety, anxiety and negative emotions related to uncooperative. Therefore, in the process of education, we should add corresponding psychological counseling. ③ Continuous mode. Patients with pulmonary heart disease have the characteristics of recurrent attacks, and the main psychological and physiological characteristics of most patients are from anger to recognition, while the condition gradually recovers or worsens [2]. During the transitional period or cognitive period, patients will gradually form a sense of dependence on educators, and their behavior will be passive and degenerate. Educators should explain the main significance of rest in detail through this period. During the recovery period, patients can take care of themselves without conscious suffocation. ④ Extended mode. In the process of implementing rehabilitation nursing, it is necessary to expand the scope of education, educate the families of the subjects and tell them how to take care of patients. In daily life, guide the patients to form good eating habits, and guide how to use drugs correctly, rest and follow up. In addition, we should also give guidance on how to breathe and quit smoking training. Education is helpful to relieve lung function and improve their quality of life. ⑤ Group meeting mode. In order to prevent the deficiency of rehabilitation nursing education or nursing practice, we should analyze the consistency of illness and carry out rehabilitation nursing education. ⑥ Group aggregation mode. Hold social gatherings from time to time and answer questions patiently. Under special circumstances, you can conduct corresponding free clinic and physical examination to communicate pulmonary heart disease and related health care issues. ⑦ Face to face mode. Because there are some differences in the subjects' actual illness, family environment, economic situation, education level and acceptance ability, it is necessary to communicate with them in education, which is helpful to observe their illness and evaluate their own situation accordingly. When there are unresolved problems, we should re-explore, find out the reasons, re-formulate the nursing plan and implement it.
1.2.2 Text publicity ① Publicity column mode. The subjects and their families should also be organized to introduce the relevant knowledge of pulmonary heart disease, such as how to adjust breathing, correct breathing training methods, the main purpose of oxygen inhalation and matters needing attention in the process of oxygen inhalation. (2) newspapers and manuals. Distribute relevant popular science newspapers and manuals to guide them to carry out rehabilitation nursing education.
1.3 observation index
Self-made nursing satisfaction questionnaire was used to investigate. The score is divided into very satisfied, satisfied and dissatisfied, with a full score of 100. The higher the score, the higher the nursing satisfaction. At the same time, comparing the effects of nursing education between the two groups, the contents of nursing effect include: understanding of disease knowledge, self-psychological adjustment ability, self-health care ability and behavior of following doctor's advice [3].
1.4 statistical method
In this study, SPSS 19.0 statistical software is selected to analyze and process the relevant data. The final result of the study is counting data [n(%)] and measuring data (x? S) to represent and choose? 2 and t value, p
Two results
2. 1 effect of rehabilitation nursing education for two groups of subjects
After nursing, 88 patients (97.78%) in the observation group have improved their understanding of the disease, 85 patients (94.44%) have improved their psychological adjustment ability, 82 patients (91.1%) have improved their health care ability, and their compliance with doctor's orders has improved. The number of patients with improved disease awareness was 7 1(78.89%), the number of patients with improved self-psychological adjustment ability was 68 (75.56%), the number of patients with improved self-health care ability was 72 (80%), and the number of patients with improved medical behavior was 65 (72.22%), with statistical significance (P < 0.05).
2.2 Compare the nursing satisfaction between the two groups.
The nursing satisfaction of the two groups was compared. In the observation group, 78 cases were very satisfied, 8 cases were satisfied and 4 cases were dissatisfied, and the satisfaction rate was 95.56%. In the control group, nursing satisfaction was very satisfactory in 62 cases, satisfactory in nursing 12 cases and unsatisfactory in nursing 16 cases, with a satisfaction rate of 82.22%. 2=8. 1000, p < 0.05 was statistically significant,
3 discussion
Health is an attitude determined by psychological, socio-economic and biological reasons and one's own behavior. When sick, medical staff only help patients to improve their physical function, which can't be eliminated fundamentally, and rehabilitation education can make patients get good physical, psychological and emotional state. People care about their own health, but the main disseminator of health education is educators. When carrying out health education for patients, educators need to adopt diversified educational methods, demonstrate and explain patients in languages that patients can understand, so that patients can cooperate with treatment and nursing happily, and at the same time fully understand the prevention of diseases and correct bad living habits, so as to improve their health care ability, gradually cultivate patients' good living and eating habits and achieve the goal of health. In the whole hospitalization process, various forms of health education patterns run through it [5]. Educators timely educate patients, give corresponding help, gain patients' trust in themselves, help to establish the nurse-patient relationship, improve the doctor-patient relationship, and accumulate certain intangible assets for the hospital. Practice has proved that the main content of education is effect rather than form. At the same time, education varies from person to person. In the process of sex education, personality education should also be added. In the process of guiding patients, we should not only provide them with relevant knowledge, but also let them change their bad living habits. In order to change their behavior to achieve the purpose of self-protection and control, in order to achieve the effect of rehabilitation. To sum up, for pulmonary heart disease, various forms of rehabilitation nursing education should be added in the treatment process, and the rehabilitation effect is good.
[References]
[1] Shang Yanhua. Effects of various forms of rehabilitation nursing education on patients with cor pulmonale [J]. Qilu Nursing Journal, 201,17 (18): 64-65.
[2] Liu Xiaoping, Li Hongyan. Observation on the effect of TCM evidence-based nursing in the care of cor pulmonale [J]. China Contemporary Medicine, 20 12,19 (33):122-123.
[3] Zeng Shuyuan. Application of Individualized Nursing in Hemodialysis Treatment of Corpulmonale Heart Failure in Qualcomm [J]. Application of Modern Drugs in China, 2015,9 (13): 234-236.
Huang Qiongxia, Deng, He Liyan, et al. Observation and nursing care of patients with refractory heart failure due to cor pulmonale treated with ambroxol, phentolamine and dobutamine [J]. China Medicine, 2012,2 (13):121.
Yang Fengju, Meng Xue. Clinical Study on Evidence-based Nursing and Chinese Medicine Atomization Inhalation in Treating Acute Exacerbation of Pulmonary Heart Disease [J]. Journal of Chinese Medicine Emergency, 2015,24 (6): 965-966, 1035.
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