1例儿童糖尿病酮症酸中毒并发急性胰腺炎的护理

总结1例儿童糖尿病酮症酸中毒并发急性胰腺炎的护理经验,护理要点主要包括:严格饮食管理、正确合理用药、密切监测血糖、心理护理、健康宣教。该患儿住院期间能配合治疗,住院28d后病情好转、血糖控制平稳出院。     

儿童烧伤并发高热惊厥的临床护理

目的 探讨儿童烧伤并发高热惊厥的临床护理方法及预防对策.方法 对我院收治的25例烧伤并发高热惊厥患儿的临床资料进行回顾性分析,总结临床护理方法.结果 本组患儿住院期间发生高热惊厥1～3次(平均1.2次),经及时治疗护理后均控制,无其他并发症发生.住院天数21 ～76 d(平均42.5d),均好转出院.结论 烧伤患儿发生高热惊厥较为常见,注重预防、加强护理可降低高热惊厥的发生率.     

传染性单核细胞增多症并发心肌损害患儿的观察及护理

总结20例传染性单核细胞增多症并发心肌损害患儿的护理。护理重点是加强病情观察,早期发现心肌损害的表现,及时进行早期护理干预,同时做好用药护理、基础护理,重视出院指导,促进患儿康复。经治疗及护理,20例患儿均治愈,平均住院14.5 d。     

小儿流行性腮腺炎并发急性胰腺炎28例内科治疗的护理

目的：探讨小儿流行性腮腺炎并发急性胰腺炎内科治疗及护理对策。方法：对28例流行性腮腺炎并发急性胰腺炎患儿内科治疗进行细致的观察与护理。结果：28例患儿住院后经过精心治疗和细心的护理,均治愈出院。结论：对流行性腮腺炎并发急性胰腺炎患儿进行严密的观察和细致的护理是治愈的关键。     

预防新生儿黄疸并发胆红素脑病的临床护理

目的 总结预防新生儿黄疸并发胆红素脑病的临床观察护理经验.方法 通过观察2008年至2010年我院收治的67例新生儿黄疸患儿,分析新生儿黄疸的发生原因,采取相应的治疗护理措施来预防并发胆红素脑病.结果 新生儿生理性黄疸占71.64%,病理性黄疸占28.36%.经护理治疗后45例新生儿黄疸患儿在1周内,肉眼观察皮肤黄疸消退,血清胆红素下降,平均降至(42.1±20)μmol/L以下;22例新生儿黄疸患儿2.5周内均痊愈;未发生新生儿黄疸并发胆红素脑病的情况.67例患儿住院时间5～14 d,平均住院(6.7±1.0)d.结论 加强新生儿黄疸的观察及护理,有助于尽快找出原因及时治疗,防止胆红素脑病的发生.     

手足口病并发病毒性脑炎的护理分析

选择我院于2012年1月~2015年12月收治的手足口病900例,其中46例并发病毒性脑炎,根据手足口病并发病毒性脑炎患儿特点,给予消毒隔离、密切观察患儿病情变化、控制体温、配置高热量、高蛋白、富含维生素、易消化吸食的流质饮食等护理。46例患儿住院时间8~21d,平均住院(11.2±5.8)d。全部治愈,无后遗症发生,无1例死亡。在手足口病并发病毒性脑炎患儿的康复中,精心护理是不可或缺的重要一环,护士应加强观察,制订相应的预见性护理干预计划,及时发现HFMD并发脑膜脑炎,从而减少其从重症向危重症发展,降低死亡率。     

先天性腰疝嵌顿肠穿孔后致腰背部软组织感染并发肠瘘患儿的护理

总结1例先天性腰疝嵌顿肠穿孔后引起右侧腰背部感染并发肠瘘患儿的护理经验.采取局部充分引流,持续负压吸引,保护切口周围皮肤,实施正确的体位护理、抗感染治疗、营养支持及心理疏导等措施,患儿腰背部创面愈合,住院34d后痊愈出院.     

伤寒并发心肌炎患儿26例的护理

总结26例伤寒并发心肌炎患儿的护理.认为护理重点是安置患儿卧床休息,实施消化道隔离,防止交叉感染,加强饮食护理,密切观察病情,对患儿及家长做好心理护理.经积极治疗及护理,26例均治愈出院,平均住院12.5 d.     

41例重症手足口病患儿的护理

总结41例重症手足151病患儿的观察及护理经验。对于入院时未诊断为重症手足口病患儿注重经系统症状观察．及时发现病情变化;做好并发症的护理,并发脑炎患儿注重用药的观察与护理,积极预防及处理药物不良反应,并发心肌损害的患儿根据体质量换算血管刺激性药物滴注速度,采用微量泵控制强心药物漓速,并发肺炎患儿注重协助排痰的护理;轻重症患儿分开收住,加强消毒隔离;高热患儿降温同时注重液体的补充,抽吸疱疹液促进疱疹愈合,根据患儿情况选择口腔护理方法;出院注重消毒隔离及预防接种的健康宣教本组患儿住院5～17d,平均7．73d,40例临床治愈,1例好转出院。     

小儿先天性心脏病术后乳糜胸的护理策略

【目的】分析本院小儿先天性心脏病术后并发乳糜胸护理的治疗经验,探讨综合性的护理策略和方法在乳糜胸保守治疗中的效果。【方法】回顾性分析本院2013年6月至2014年6月之间18例小儿先天性心脏病术后并发乳糜胸保守治疗中护理治疗的相关临床资料,观察综合性的护理策略和方法在乳糜胸保守治疗中护理效果。【结果】患儿出现乳糜胸时间为术后0～8（2±3）d ,胸腔引流管引流5～46（15±9）d ,住院时间12～57（22±15）d。所有患儿均通过保守治疗,护理康复痊愈。无切口或胸腔感染等并发症。【结论】及时有效的综合性护理策略和方法可促进乳糜胸患儿的愈合和康复,降低并发症的发生率,避免再次手术。     

护理程序在流动人口妇幼保健管理中的应用

目的 探讨为流动人口提供妇幼保健服务的管理模式.方法 应用护理程序对杭州市下城区石桥街道的流动人口妇幼保健管理进行评估、诊断、计划、实施和评价.结果 和实施计划前3年相比,流动人口妇幼保健管理得到了加强,如孕妇建卡率增加了208.82%,系统管理率提高了32.70%,儿童保健建卡率增加了931.73%,系统管理率提高了31.85%.结论 正确应用护理程序可以有效促进流动人口自觉纳入社区妇幼保健管理.     

护理程序在流动人口妇幼保健管理中的应用

目的探讨为流动人口提供妇幼保健服务的管理模式。方法应用护理程序对杭州市下城区石桥街道的流动人口妇幼保健管理进行评估、诊断、计划、实施和评价。结果和实施计划前3年相比,流动人口妇幼保健管理得到了加强,如孕妇建卡率增加了208．82％,系统管理率提高了32．70％,儿童保健建卡率增加了931．73％,系统管理率提高了31．85％。结论正确应用护理程序可以有效促进流动人口自觉纳入社区妇幼保健管理。     

The role of child life in pediatric pain management: a survey of child life specialists.

Pain management is often described as a component of child life specialists' work. No research has described the specific pain management strategies used by child life specialists. The objectives of this study were to determine child life specialists' use of nonpharmacological strategies, to describe the perceived efficacy of these strategies, to determine how much training child life specialists had in these various strategies, and to determine what demographic characteristics predict the use of evidence-based techniques. Six hundred seven child life specialists from hospitals and health centers across North America responded to an online survey (response rate: 85.4%). Results indicate that child life specialists use a variety of techniques with varying degrees of perceived efficacy. The most commonly endorsed techniques were providing information/preparation, comforting/reassurance, and positive reinforcement. Respondents reported receiving substantial training in some techniques (eg, providing information/preparation, medical play) and high interest in receiving additional training in all techniques. Certification status, the proportion of patients for whom participants reported providing pain management services, and participants' perceived levels of knowledge and skill emerged as significant predictors of the use of evidence-based strategies. The results of this survey suggest that child life specialists are actively involved in pediatric pain management. PERSPECTIVE: American and Canadian child life specialists were surveyed to assess their involvement in managing the pain of pediatric patients. Findings of the survey indicate that child life specialists are involved in the management of pediatric pain and are receptive to additional training in evidence-based techniques.     

Pediatric burns

The burned child requires a management that is different from that employed in the burned adult because of physiologic and psychological dissimilarities, although basic principles of management are the same. Particular problems and treatment of the burned child are highlighted.     

基层托幼机构消毒质量监测结果

目的了解县级城镇基层托幼机构卫生消毒工作状况,为加强托幼机构卫生管理提供资料。方法采用现场查看和细菌检测方法,对海盐县部分托幼机构消毒工作状况进行监测与调查。结果 2年内对21所托幼机构共采样1350份,总平均合格率为76.81%。2009-2011年各年度监测合格率依次为72.92%、76.61%和81.88%。公办托幼机构合格率为81.69%,民办托幼机构合格率为71.03%。结论海盐县托幼机构卫生质量呈逐年上升趋势,但工作人员手和餐具的消毒合格率较低,应有针对性地采取相应措施,加强管理。     

先天性肥厚性幽门梗阻合并先天性喉软骨发育不良患儿手术的麻醉管理

目的 探讨先天性肥厚性幽门梗阻(CHPS)合并先天性喉软骨发育不良患儿手术的麻醉管理方法,为易发生呼吸道塌陷患儿的麻醉管理提供参考.方法 选择2016年3月15日,于四川大学华西医院儿外科收治的1例CHPS合并喉软骨发育不良患儿作为研究对象.对其采取喉面罩通气道(LMA)全身麻醉复合超声引导下骶管阻滞麻醉,并拟对其进行腹腔镜下幽门环肌切开术治疗.由于考虑腹腔镜的气腹压力,可增加胃内容物反流误吸的风险,故修改手术方案为开腹幽门环肌切开术.回顾性分析本例患儿的临床特征及开腹幽门环肌切开术麻醉管理经过.结果 本例患儿的麻醉效果满意,顺利完成开腹幽门环肌切开术.手术结束10 min后,患儿清醒,遂拔除LMA导气管,无不良事件发生.患儿术后于重症监护病房(ICU)接受治疗期间,无呼吸道问题发生,术后7d出院.术后1年电话随访,其父诉患儿喉鸣症状于患儿6个月龄左右时逐渐消失,患儿生长发育良好.结论 LMA全身麻醉复合超声引导下骶管阻滞麻醉,可以满足本例CHPS合并先天性喉软骨发育不良患儿的手术麻醉需求,并减少其呼吸道不良事件的发生.     

Child abuse and neglect

The professional who must deal with child abuse has to resist the urge to punish the offenders and concentrate instead on seeking the best solution for the child. Guidelines for distinguishing child abuse from accidental injury are presented and management of the sexually abused child is detailed.     

Acute management of seizures in children

Seizures in children are not uncommon, and more than half of these seizures have no known cause. This discussion and review of seizures covers three types of presentations: the child who presents following an initial seizure; the child who presents with serial seizures or continuous seizures (status epilepticus); and the child who presents following a febrile seizure. The nurse practitioner can play a critical role in the assessment and management of children presenting with each of these three types of seizures. A review of drug management of childhood seizures and a comprehensive review of the critical areas to cover in counseling the child, family and community are included.     

Promoting Normalization in Families With Preschool Children With Type 1 Diabetes

issues and purpose. The family environment is the most important influence on child adaptation to type 1 diabetes. A plan of care assists parental adaptation in families with a preschool child with type 1 diabetes.
conclusions. The family environment is affected by the family's progress toward normalcy. Normalization can be facilitated by nursing interventions that promote parental mutuality in management and the development of a parental support system.
practice implications. Nurses can provide education about Type 1 diabetes and its management in preschool children to fathers, other family members, and family friends to encourage their involvement in caregiving. Parental mutuality in management and an adequate parental instrumental support system facilitates normalization and affects the family environment, thus promoting child adaptation.     

Exercise programs for asthmatic children

The role of exercise in the management of the asthmatic child is now understood to be essential for the child's overall health. With the medications available today, a child, even with complicating EIA, can expect to perform as well as his nonasthmatic peers. In fact, with appropriately set expectations, adequate medical management, and supportive parents, coaches and teachers, the asthmatic child can hope to achieve a physical fitness level compatible with a high quality of life. The physician's role is a key one requiring basic knowledge of medical management, as well as supervising the overall effort. One cannot overlook the satisfaction a doctor experiences when assisting the patient in functioning normally, despite underlying disease.