1 Introduction: Nursing care of patients with chronic obstructive pulmonary disease. 2. Nursing care of patients with liver cirrhosis

Nursing observation points of patients with chronic obstructive pulmonary disease. Vital signs, breathing patterns. 2. Changes in color, character, viscosity, smell and quantity of phlegm. 3. Dehydration state: the skin is full, elastic and the mucosa is dry. Nursing measures 1. Giving a sitting position or a semi-sitting position is conducive to breathing. 2. Encourage patients to cough, guide patients to cough correctly, and promote expectoration. When there is a lot of sputum that is not easy to cough up, use expectorant or ultrasonic atomization to suck people according to the doctor's advice, and suck sputum if necessary. 3. Rational use of oxygen, low flow oxygen supply, flow rate 1-2l/min, humidification before inhalation. 4. Give anti-inflammatory treatment according to the doctor's advice, and effectively control respiratory infection. 5. Drink plenty of water, give liquid, semi-liquid and soft food with high calorie, high protein and high vitamin, eat more meals and eat less gas-producing food to prevent gas-producing from affecting diaphragm movement. 6. Nurses should listen to the patient's narrative, relieve their psychological pressure, and ask psychologists to assist in diagnosis and treatment when necessary. 7. Use BIPAP ventilator regularly according to the doctor's advice, and see its routine for nursing. Health education 1. Breathing training: Abdominal breathing (supine position, one hand on the chest and the other hand on the abdomen, slowly inhale through the mouth, raise your hand, and slowly exhale with your lips contracted, while contracting the abdominal muscles and abdomen) and lip contraction breathing. 2. Cough skills: lean forward, take a few deep breaths with lip-contraction breathing, and after the last deep breath, open your mouth and cough hard when exhaling, while resisting abdominal muscles. 3. Instruct patients to combine whole body exercise with breathing exercise, such as walking, cycling, qigong, Tai Ji Chuan, homework, etc. The mode, speed and distance of exercise depend on the patient's physical condition. 4. quit smoking. Patients with liver cirrhosis can take part in work when nursing patients with early liver cirrhosis, but they should be urged to pay attention to the combination of work and rest, and rest in bed in the later stage. In short, rest and activities should be arranged according to the condition, so that patients can understand that rest is one of the important measures to protect the liver, and less activity can reduce the burden of liver metabolism and secretion, which is conducive to the recovery of liver cells. Arrange the rest environment, keep the bedroom quiet and comfortable, sunny and well ventilated. The recovery process of this disease is long, so it is necessary to encourage and comfort patients, establish a firm belief in overcoming the disease, and keep patients optimistic and calm in order to facilitate rehabilitation. When eating, let the patient chew slowly. The recipes are diverse. The principles of nutrition are high calorie, high protein, high vitamins and low fat. Avoid irritating, hard food rich in plant cellulose to avoid bleeding from esophageal varices. Do not smoke, drink or drink alcoholic beverages, so as not to increase the burden on the liver and make the illness worse. Appropriately limit animal fat to avoid fatty liver. Advanced patients with significantly decreased liver function should be given a high-protein diet. People with ascites should be given a low-salt or salt-free diet according to their condition. When ascites is serious, the daily drinking water should be limited and placed in a semi-recumbent position to reduce the diaphragm, increase the vital capacity and facilitate breathing. When hyperammonemia occurs, a high-protein diet is prohibited. Pay attention to oral hygiene before and after each meal and rinse your mouth with normal saline. Do skin care. Patients' buttocks, vulva and lower limbs are prone to edema, which can be protected by cotton pads or balloons, and often massaged with hot towels to prevent bedsores. People with itchy skin should try to stop itching and prevent infection caused by skin damage. According to the doctor's advice, patients should take medicine on time according to the order of magnitude, promote liver cell regeneration and play a role in detoxification. People with bleeding tendency should take vitamin K orally or inject vitamin k 1 intramuscular. When you eat too little, you should inject glucose, vitamins and potassium chloride intravenously to supplement your body's needs. When using diuretics, we should pay attention to the balance of electrolytes.