论文范文《肝性脑病患者的预见性护理研究进展》早标网
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mso-font-kerning:1.0000pt;”><font face=“宋体”>【摘要】</font></span></b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:10.5000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>通过对肝性脑病患者的预见性护理方面的论文进行阅读与总结,归纳预见性护理对肝性脑病的临床治疗的效果,结果表明,采取预见性护理干预对肝性脑病患者的临床治疗有积极作用。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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<img src=“/image/image?path=group8/M00/27/6F/wKgIO2IUig-AMP_AAAKVHSKIbVc141.png”></p><p class=“MsoNormal” style=“line-height:150%;”><br></p><p class=“MsoNormal” style=“text-indent:21.0000pt;line-height:150%;”><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>肝性脑病(</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”>HE</span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>)是指严重的肝病或门</font>-体分流引起的,一种以代谢紊乱为基础的中枢神经系统功能失调的综合征。在该疾病发展过程中,轻者仅表现为轻微的智力损伤,严重者可表现为意识障碍、行为失常和昏迷等症状。肝性脑病的临床表现因其原有肝病的性质、肝细胞的损伤程度和诱因不同而很不一致,临床护理的难度较大,所以及早识别并去除肝性脑病发作的诱因是护理的要点。预见性护理干预是指护士根据疾病的发展与病情的变化规律,预测患者可能出现的问题,提前预知存在的护理风险,及时规避并采取有效的护理措施,最大限度的减少患者的痛苦。近几年,预见性护理干预应用于肝性脑病的临床护理,对于治疗肝性脑病具有很好的疗效。本文将就预见性护理干预对于肝性脑病患者的疗效进行总结。</span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>1肝性脑病的临床表现</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>1</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>前驱期的临床表现</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>肝性脑病的临床表现一共分四期,前驱期的临床表现一般无特征性,在临床上特别容易被忽略,所以了解前驱期的表现对于提前发现肝性脑病患者具有重要意义。在肝性脑病早期,即肝性脑病前驱期,可无明显神经精神异常,仅表现为轻度性格改变和行为异常</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>。患者的神志可表现为焦虑、异常欣快,可有扑翼样震颤,这是肝性脑病前驱期的主要表现。脑电图检查多数表现为正常,特别容易被忽略,所以护理人员要对前驱期患者加强观察。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>1</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>昏迷前期的临床表现</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>昏迷前期患者的临床表现较多,此期间为护理工作人员的工作重点。患者在此期间病情变化多且复杂,主要以行为异常的表现为主,有肌张力增高、腱反射亢进和扑翼样震颤等症状。此期间的患者病情进入到一种较为严重的阶段,对于护理人员来说,如果不加强工作力度,会对患者产生严重的影响。此期间患者的脑电图表现为特异性异常,护理工作人员可通过这项检查做出判断,对病人进行更好的护理。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>1</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.3</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>昏睡期的临床表现</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>昏睡,顾名思义是指病人处于深睡眠状态,需要给予强刺激才能醒来,能够简单的回答问题,但是刺激消失后又很快入睡。此期间患者不仅伴有昏睡的症状,同时还存在着严重的精神错乱,患者仍可出现扑翼样震颤和脑电图的异常。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>1</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”>.4</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>昏迷期患者的临床表现</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>此阶段进入到患者病情发展最严重的时期,患者仅表现为昏迷。昏迷又分为浅昏迷和深昏迷,浅昏迷患者对于某些强刺激会有反应,但是对于深昏迷的患者来说,各种腱反射消失,肌张力降低。护理人员在此期间工作任务也极其繁重,需要</font>2</span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”>4</span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>小时观察患者,以防病情变化。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>2肝性脑病的诱因</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>肝性脑病常有明显的诱因,所以了解患者患病的诱因是做好护理工作的前提。肝性脑病的诱因包括上消化道出血、高蛋白饮食、大量排钾利尿和放腹水、催眠镇静药和麻醉药、低血糖、便秘、尿毒症、感染、外科手术等。这些诱因是常见导致肝性脑病的,护理工作人员需要对有肝性脑病的易发人群进行健康宣教,如对肝硬化患者建议不要高蛋白饮食,以减少肝性脑病的患病率。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>3肝性脑病的护理要点</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>3</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”>.1</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>常规护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>肝性脑病患者的常规护理包括病情观察和生活护理,因为肝性脑病的发病较为迅速且发病导致患者异常的表现较多,所以护理工作人员要随时注意肝性脑病的早期征象。要定期对患者进行生命体征与病情检查,以便随时掌握患者的病情变化。患者患病的常见诱因为上消化道出血,所以护理工作人员要注意对此类患者进行生活护理。在治疗期间,患者应绝对卧床休息</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”>7天,充足的休息有利于改善患者的肝循环,促进肝细胞再生,避免出血</span><sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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vertical-align:super;”><font face=“宋体”>【</font>2】</span></sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>在住院期间护理工作人员应加强巡视,随着患者病情的发展,患者可能出现烦躁和意识障碍,所以必要时要对患者进行约束,如床挡和约束带等防护措施。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>3</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><font face=“宋体”>心理护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
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mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“text-indent:24.0000pt;line-height:150%;”><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>随着病情的发展,患者可能会产生焦虑、恐惧和厌烦等情绪,特别是经过漫长的治疗过程,病情并没有好转,患者可能还会产生厌弃治疗的情绪,不配合治疗。这些都是临床中患者常见的心理问题,护理人员要格外注意与患者的沟通交流,对于患者提出的问题,要耐心的解答,尽量与患者产生治疗性的信任关系。与患者有信任关系,使患者共同参与到治疗当中,会提高患者的治愈率。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>3</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.3</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>用药护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“text-indent:24.0000pt;line-height:150%;”><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”>HE由于其发病机制的复杂性,临床上目前对于HE的治疗首先要求及时清除诱因,尽快纠正患者精神神经异常,并强调对该症的预防</span><sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;
vertical-align:super;”><font face=“宋体”>【</font>3】</span></sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>。对于治疗肝性脑病,根据患者的发病情况而选用不一样的药物去治疗,而且在用药过程中还要注意药物的副作用,如服用新霉素不宜超过一个月,而且在用药期间还要注意监测患者的听力和肾功能;在大量输注葡萄糖的过程中,必须警惕低钾血症、心力衰竭。在护理工作中,要注意监督患者按时按量的用药,也要注意药物所产生的副作用。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>3</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.4</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>饮食护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“text-indent:24.0000pt;line-height:150%;”><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>在对患者进行饮食护理时,要根据患者患病时不一样的诱因,为患者制定合理的饮食计划。患肝性脑病的患者肝功能不全,体内的氨不能及时排出,抑制脑的功能是导致肝性脑病的重要原因</font></span><sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;
vertical-align:super;”><font face=“宋体”>【</font>4】</span></sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>。在患病期间,患者极易营养失调,使机体的能量不足以供应身体所需的能量,所以在对患者进行饮食护理时要注意给予患者高热量饮食和限制蛋白质的摄入。患者禁止补充维生素</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”>B</span><sub><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;
vertical-align:sub;”>6</span></sub><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>,因为维生素</font>B</span><sub><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;
vertical-align:sub;”>6</span></sub><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>可减少中枢经系统的正常传导递质</font></span><sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;
vertical-align:super;”><font face=“宋体”>【</font>5】</span></sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>。对于患者的蛋白质摄入,应尽量选用植物和奶制品。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>4肝性脑病的预见性护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>4</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.1</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>成立预见性护理干预小组</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”> </span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”> </span></b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>在上述护理措施中加入预见性护理,首先就应该在成立一个预见性护理干预小组。在护理人员中选择其中几名成员,对其进行该疾病的培训,包括疾病的发生发展过程,保证小组成员对疾病的高度了解,这对接下来的预见性护理干预尤为重要。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>4</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.2</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>意识与行为的预见性护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”> </span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”> </span></b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”> </span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>患者在肝性脑病前期将出现波动性意识障碍与行为反常的特点,因此,护理人员应灵活运用多种沟通技巧对患者进行有关人物、时间、地点等内容的询问,以了解其是否答题准确</font></span><sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;
vertical-align:super;”><font face=“宋体”>【</font>6】</span></sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>。患者前期的临床表现较多,护理人员要对其表现的症状了解清楚,对于突发的症状要及时处理。要密切观察患者的临床表现,对于患者可能或即将发生的症状要提前预知,并跟医生做报告,提前诊治与治疗,预防发生更严重的并发症</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>4</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.3</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>水、电解质紊乱与酸碱失衡的预见性护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”> </span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”> </span></b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>在患病期间,患者由于治疗的项目和自身所应对疾病产生的代谢紊乱,护理工作人员要格外注意。早期预防是护理的重点,因此要注意患者的各项生命体征,包括血压、脉搏、体温等,更要注意患者的水、电解质的平衡,详细记录患者的出入量,并观察患者有无出血、脑水肿等生命症状。掌握患者的生命体征,提前预见性的护理,减轻病情发作时患者的痛苦</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>4</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.4</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>出血的预见性护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“text-indent:24.7500pt;line-height:150%;”><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>肝性脑病患者病情发展最常见的诱因就是上消化道出血,预防上消化出血,在治疗过程中对于肝性脑病患者要尽量减少应用甾体抗炎药物,患者出现便血、呕血症状时,护理人员要立即告知主治医生进行止血治疗</font></span><sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;
vertical-align:super;”><font face=“宋体”>【</font>7】</span></sup><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>。加强观察患者可能发生出血的前驱症状,如恶心呕吐等,也要备好急救物品,防止发生出血症状后抢救不及时。对于出血患者,也要密切观察患者本身症状,如头晕、心悸、出冷汗等症状,防止患者发生休克。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>4</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”>.5</span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>昏迷的预见性护理</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><o:p></o:p></span></b></p><p class=“MsoNormal” style=“text-indent:24.0000pt;line-height:150%;”><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>昏迷作为肝性脑病临床表现当中最危险的症状,护理工作人员理应对其提高重视,在疾病早期,应提前发现导致疾病的诱因,做好准备。昏迷患者在卧床期间还特别容易发生压疮,所以要定时为患者翻身,为患者按摩,预防压疮的发生。要为患者做肢体的被动运动,防止患者的静脉血栓的形成和肌肉萎缩的发生。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p><p class=“MsoNormal” style=“line-height:150%;”><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
mso-font-kerning:1.0000pt;”><font face=“宋体”>5结论</font></span></b><b><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-weight:bold;font-size:12.0000pt;
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</w:LatentStyles></xml><![endif]–></p><p class=“MsoNormal” style=“text-indent:24.0000pt;line-height:150%;”><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><font face=“宋体”>综上所述,预见性护理干预对于临床治疗肝性脑病有积极的作用,预见性护理具有前瞻性的特点,可以有效地预防护理工作中的不良事件的发生,提高护理的效率与质量。对于患者来说,预见性护理可以提高患者的治疗效果,有效预防了病情的加重,提高了患者的生存质量与护理满意度。预见性护理还临床中有较大意义,值得广泛推广。</font></span><span style=“mso-spacerun:‘yes’;font-family:宋体;mso-bidi-font-family:‘Times New Roman’;
line-height:150%;font-size:12.0000pt;mso-font-kerning:1.0000pt;”><o:p></o:p></span></p>
