1例宫颈癌患者行卵巢腋下移植手术前后的护理体会

总结1例宫颈癌患者行卵巢腋下移植手术前后的护理。对患者进行多学科联合治疗，实施术前准备、心理护理、术后移植护理（伤口护理、活动指导、卵巢功能监测）、疼痛管理、并发症的预防与护理等护理措施。经过精心的治疗和护理，患者移植卵巢恢复血运，随访至术后4个月，预后良好，无并发症发生。     

高龄糖尿病患者泌尿外科围术期血糖监测管理及术后护理

目的探讨对高龄糖尿病患者进行血糖监测、管理和术后护理,能否降低患者的围术期并发症发生率和病死率。方法总结近年来156例泌尿外科高龄糖尿病患者术前、术后的血糖变化,找出规律,进行血糖管理及术后护理。结果手术当天及术后第1天,患者血糖明显升高,应加强胰岛素应用和术后护理。结论高龄糖尿病患者围术期血糖监测非常关键。掌握血糖变化规律,合理使用胰岛素加强术后护理,能使患者血糖保持稳定,能有效预防并发症的发生,促进伤口愈合,使患者顺利渡过围术期,顺利康复。     

喉癌气管切开术后护理体会

目的：探讨喉癌术后的呼吸道管理。方法：采取各种有效措施，针对性地对患者进行心理护理、气道湿化、清除呼吸道分泌物、控制感染、进行全面监测等方面的管理。结果：17例行气管切开患者，经精心护理，效果满意。结论：喉癌术后呼吸道的综合护理。不仅避免气管切开患者的并发症，以促进其早日康复，同时也提高了患者的生命质量。     

预见性护理干预在预防高龄食管癌患者术后谵妄中的应用

目的探讨预见性护理干预可减少和预防高龄食管癌患者术后谵妄的发生。方法对42例70岁以上高龄食管癌手术患者在围手术期间实施预见性护理，包括术前充分评估、营养干预、术前访视、心理干预及术后严密监测识别、加强呼吸道管理及疼痛控制、管路安全护理等。结果仅2例患者出现术后谵妄，经积极治疗和精心护理，2d后症状控制，未再发谵妄。结论预见性护理干预可有效预防和降低高龄食管癌患者术后谵妄发生的危险，保障患者安全，促进高龄患者康复，提高治疗护理质量。     

老年患者冠脉搭桥术后监护及护理

通过对100例老年搭桥患者的术后监护,总结老年冠心病患者搭桥术后的监护和护理经验,主要包括严密监测呼吸功能、循环功能,加强肾功能管理和引流液的观察,合理使用抗凝药,预防桥血管狭窄及围术期心梗;做好术后护理:如管道护理、出入水量监测、血气结果的监测及处理,加强肺部护理、胸部物理治疗及呼吸功能锻炼,减轻患者肺水肿,改善肺顺应性,预防低氧血症及肺部感染;加强营养支持及消化道并发症的观察及处理,加强术后主被动运动及体温管理。认为术后严密监护和精细护理是保证老年冠心病患者术后康复的重要手段。     

糖尿病患者冠脉搭桥围手术期强化血糖控制的护理

目的探讨糖尿病患者冠状动脉搭桥（CABG）围手术期强化血糖控制的护理措施。方法34例CABG的糖尿病患者手术前后予胰岛素泵、术中予持续胰岛素静脉输注的强化降糖治疗，同时加强围手术期的血糖监测、健康指导、心理护理以及术后的生命体征监测、呼吸道管理、并发症护理等。结果本组89．7％患者围手术期血糖达标，无1例严重低血糖发生，术后均康复出院。结论加强围手术期强化降糖的护理干预，有助于血糖平稳、有效达标，进而提高糖尿病患者CABG的成功率及安全性。     

腹部巨大切口疝行腹膜内置网修补术的护理

目的 针对腹部巨大切口疝行腹膜内置网修补患者，提出合理的护理方案。方法 对10例采用腹膜内置网修补术的腹壁巨大切口疝患者术前、术后护理经验进行总结。结果 所有10例患者经过系统的术前、术后护理及随访均获得良好的治疗效果。结论对于巨大切口疝患者，应加强术前的心理护理、呼吸系统、消化系统的准备及术后生命体征监测、引流管道的管理以及呼吸功能的训练。     

1例Bentall术联合左心室辅助装置植入患者的护理

总结1例Bentall术联合左心室辅助装置植入患者的护理经验，护理要点如下。严密监测心功能，预防右心功能衰竭：目标导向式容量管理，及时调整左心室辅助装置的泵速；间歇性一氧化氮吸入治疗，维持稳定的肺动脉压力；避免电解质紊乱，纠正心律失常。严密监测凝血功能，预防出血与血栓形成。开展早期康复训练；实施个体化心理护理。患者术后13 d顺利转入普通病房，恢复良好。     

1例同种异体单肺移植并同期心内畸形矫治术术后并发症的观察及预防

目的：总结1例终末期先天性心脏病同种异体单肺移植并同期心内畸形矫治术术后并发症的观察及预防措施。方法：术后给予科学的护理管理，严密监测生命体征变化，严格执行各项护理制度，及时发现和处理并发症。结果：本例患者顺利康复，生存质量良好。结论：精心的术后护理和正确地处理术后并发症是手术成功的关键。     

微创胸壁打孔房缺封堵术的术后护理

总结7例微创胸壁打孔房缺封堵术患者的术后护理。术后做好心理护理、一般护理、胸腔闭式引流护理，加强生命体征监测、并发症的观察，配合术后抗凝和抗感染治疗。7例患者均封堵成功，术后1d可下床活动，术中及术后无严重并发症；随访2-3月，心脏彩超复查心脏较术前缩小，未见封堵器脱落、变形及残余分流，心功能良好，患者无不适症状。因此，严密的术后监测和精心的护理是手术成功的重要保证之一。     

高龄耐多药肺结核患者的护理

总结1例高龄耐多药肺结核患者的护理。根据患者的护理难点,我们采取了心理疏导、健康教育、中心静脉置管护理、密切观察生命体征和药物副作用等针对性个体化护理措施。经精心护理,帮助患者完成2年的规范治疗,完全康复。     

Improving care of HIV-infected patients in the outpatient setting with patient data flow sheets.

Medical management of pediatric/adolescent HIV has become increasingly complex, requiring a multidisciplinary approach to care. Close clinical monitoring is needed to minimize opportunistic infections, initiate appropriate antiretroviral therapy, and ensure optimal health care to the patient. Monitoring should include evaluation of efficacy and side effects of therapy, early detection and treatment of HIV-associated complications, and maintenance of current immunizations. Tracking clinical data in chronically ill patients is a difficult task without an effective monitoring system. A patient data flow sheet was created to assist in planning care and monitoring disease progression by consolidating clinical information into an organized, one-page summary for each patient. One year after the patient data flow sheets were instituted, there was a significant improvement in the consistency of obtaining and monitoring routine HIV labs as well as serologies, and other recommended tests. The flow sheets have increased effectiveness of patient care and have been used to assist with quality assurance monitoring and quality improvement in the clinic setting.     

血流动力学导向的感染性休克治疗一例

本例感染性休克患者同时合并基础心脏疾病,液体复苏对血流动力学的支持可能会造成呼吸功能的进一步下降。在诊断、监测及治疗的过程中,以血流动力学为导向的重症超声的监测评估为治疗的方向和治疗强度的把握提供了实时、动态、准确的依据。也为个体化血流动力学治疗,提供了方向。在血流动力学导向的治疗指导下患者康复痊愈。     

7例甲状旁腺功能亢进患者围手术期护理

目的总结甲状旁腺功能亢进患者围手术期护理体会。方法回顾7例原发性甲状旁腺功能亢进患者围手术期护理,包括心理护理、体位锻炼、饮食护理及术后监测等。结果 7例患者中有2例术后出现轻微手足抽搐,四肢麻木,经补钙治疗后好转;1例患者术后血PTH高于正常,转内分泌科继续治疗。其余均无并发症。结论甲状旁腺功能亢进患者并发症危害性大,因此在手术前后要加强病情观察,进行正确而耐心的护理及健康指导。     

Hemodynamic monitoring modalities in pediatric cardiac surgical patients

Transthoracic monitoring lines yield vital information in the care of the pediatric postoperative cardiovascular surgical patient. It is the critical care nurse, in the holistic care of the patient, who integrates this data into the daily plan of care. Invasive monitoring carries risks; therefore, guidelines for care must be followed. The care of these critically ill infants requires a multifactoral approach. Hemodynamic monitoring is one of many avenues that we follow in the intensive care unit.     

Current issues related to home monitoring

Physiologic monitoring is no longer confined to the critical care unit. Home monitors connect patients with clinics, physician offices, disease management programs, and home care agencies for the purpose of streamlining care delivery, maintaining a close patient connection, and promoting early identification of patient status changes. The advent of telehealth technologies offers a wide range of options for home monitoring. The goal of home monitoring is to promote patient comfort and avoid disruption of daily activities. To accomplish this, however, nurses must address issues such as, technology compatibility with patient capabilities, compatibility with nurses' practice beliefs, cost of home monitoring of overall care, and the physiologic parameters that will measure early decompensation.     

7例囊性纤维化患儿的护理

总结7例囊性纤维化患儿的护理经验。护理要点：采集汗氯试验标本,协助诊断;促进气道廓清,改善患儿呼吸功能;加强电解质监测,及时纠正电解质紊乱;合理用药,缓解患儿症状;制订营养方案,改善患儿营养状况;加强出院宣教,提高患儿出院后生活质量。7例患儿经过积极治疗及精心护理均好转出院。     

1例剖宫产术后阵发性睡眠性血红蛋白尿症患者继发脾破裂的护理

总结1例剖宫产术后阵发性睡眠性血红蛋白尿症患者继发脾破裂的护理经验。包括脾破裂后快速建立静脉通路,密切监测血压、腹内压变化;减少输血时的溶血反应并做好栓塞的观察与预防;血浆置换的管理;依库丽单抗注射液的应用,避免不良反应的发生;进行保护性隔离,降低感染风险;做好患者的心理护理及健康宣教,帮助其树立战胜疾病的信心。经过精心的治疗及护理,患者于入院后16 d出院。     

Quality assurance: monitors in special care

Special care units need to establish economically feasible and meaningful monitors to evaluate patient care needs. High-cost areas, such as special care, monitor appropriate use of resources in high-risk, high-volume, and problem-prone areas. The monitoring process needs to provide information regarding the quality of care in the special care unit without greatly decreasing time spent by staff in direct patient care. This chapter discusses development of efficient monitoring tools for quality assurance indicators in the special care unit.     

Introduction to hemodynamic monitoring

This article discusses nursing care of the patient who requires hemodynamic monitoring. This will include care of the patient who requires intra-arterial pressure monitoring, central venous pressure (CVP) monitoring, left atrial pressure (LAP) monitoring, and monitoring of left heart pressures, cardiac output, and systemic vascular resistance using a pulmonary artery (PA) catheter.