茶叶末用于2例糖尿病皮肤水疱破溃的效果观察

糖尿病水疱是糖尿病的特异性改变的皮肤并发症，多发生于病程长、病情控制较差和全身营养不佳的糖尿病病人，发病率为1％。我科2006年10月-12月收治2例糖尿病合并水疱病人，发现时水疱均已经破溃，在护理过程中应用加工后的茶叶末进行皮肤护理，取得了良好的效果。现报道如下。     

神经─营养障碍性水疱的治疗与护理

神经─营养障碍性水疱的治疗与护理叶春兰，朱利军１９９０年１月至１９９４年２月，我科收治偏瘫和截瘫患者３５８例，其中３０例（约占８；４％）在瘫痪部位出现数量不等大小不一的无痛性水疱，我们称之为神经─营养障碍性水疱。由于水疱多发于躯干、四肢，易被误认为褥...     

肝癌患者行颈内中心静脉置管致局部水疱的原因和对策

分析56例肝癌患者留置颈内中心静脉导管后，出现局部皮肤张力性水疱的原因，总结护理对策。经导管专科护士会诊处理，总结发生皮肤张力性水疱的原因有：疾病因素、中心静脉导管维护不正确、护理观察不到位、皮肤生理因素。提出护理对策，包括加强营养，纠正肝功能；对导管实施规范化维护；选择合适敷料；加强导管安全宣教和观察等。     

神经-营养障碍性水疱的中医护理

神经-营养障碍性水疱常出现在偏瘫、截瘫且长期卧床的病人，是一种常见的并发症。若处理不及时或处理不当，不仅给病人增加痛苦、加重病情、延长病程，严重可因继发感染而危及生命。我科近4年来收治和处理神经-营养障碍性水疱患28例，我们对此类患采用中医护理方法进行护理，取得了较好的疗效，现将我们的护理经验报告如下。     

过敏性水疱性皮炎患者的临床观察及护理

目的 探讨过敏性水疱性皮炎的临床观察及护理方法.方法 对10例过敏性水疱性皮炎患者严密观察病情变化,合理处理伤口,做好保护性措施,指导正确饮食,做好心理护理等方法.结果 10例过敏性水疱性皮炎患者,2例4 d痊愈,3例7 d痊愈,4例14 d痊愈,1例21 d痊愈,无相关并发症发生.结论 合理治疗和护理,避免并发症及过敏反应发生,有效控制病情,可加快过敏性水疱性皮炎患者的康复.     

糖尿病性水疱病患者的护理

通过对８例糖尿病性水泡病的护理，提出应重视患者的心理防理，防止皮肤及水泡的继发感染，正确处理水疱。     

擦药护理在外用激素治疗大疱性类天疱疮中的应用

目的探讨擦药护理在外用激素治疗大疱性类天疱疮中的效果。方法按擦药操作流程给患者进行擦药,于用药前和用药1周后、2周后、3周后观察每天新发水疱数及全身水疱数。结果用药3周后,患者每日新发水疱数及全身水疱数较用药前明显减少,差异有统计学意义(P<0.01)。结论擦药护理在外用激素治疗大疱性类天疱疮中起重要作用。     

1例复发性老年足部糖尿病性水疱的护理

总结1例糖尿病性水疱致左足大面积溃疡合并感染的老年患者的护理经验。在全身综合支持的基础上,经过动态评估创面的发展与变化、应用水疱内浆液的减压处理技术、采用硫酸银敷料控制创面感染的护理方法,经过35天的全程康复护理,患者左足创面得到修复。     

不完全保留水疱皮治疗糖尿病性水疱的效果观察

目的观察不完全保留水疱皮对糖尿病性水疱伤口愈合情况的影响。方法选取入院时水疱皮完整且直径大于2cm的糖尿病性水疱患者28例，创面34处。按照随机和平衡的原则分为完全保留水疱皮组和不完全保留水疱皮组，完全保留水疱皮组采用目前推荐的完全保留水疱皮方法；不完全保留水疱皮组则在无菌技术下在水疱最有利于水疱液引流的位置用无菌剪刀剪去一长条死皮。比较两组水疱局部的感染率和愈合情况。结果两组比较，感染率无明显差别，P〉0．05，而创面愈合时间明显缩短，P〈0.01。结论不完全保留水疱皮的方法处理糖尿病性水疱，能有效防止水疱的再次出现，缩短糖尿病性水疱的愈合时间。     

输液病人肢体发生水疱的预防与护理

静脉输液是一项侵入性护理操作,可导致发热、静脉炎等输液反应的发生。我院8 432例接受输液治疗的病人中,发现4例病人输液侧肢体意外发生水疱,引起了我们的高度重视,现将输液侧肢体发生水疱的预防及护理措施报道如下。     

Osteosarcoma nursing care guidelines: A tool to enhance the nursing care of children and adolescents enrolled on a medical research protocol

Clinical trials dominate the therapeutic approaches used in pediatric oncology with the majority of pediatric oncology patients receiving treatment on medical research protocols. These protocols detail the medical treatment that enrolled patients will receive. Nursing care is not described in these documents. However, nursing care must complement the medical care as written in the medical research protocol. Administering treatments safely, assessing treatment responses, educating patients and families, and communicating with the entire health care team are some of the essential nursing responsibilities that must be carefully orchestrated. Nursing care guidelines, as described here, were created to provide the careful balance between the medical research protocol and associated nursing care. These guidelines describe the nursing actions and considerations involved in caring for pediatric oncology patients enrolled on a particular medical research protocol. The purpose of this article is to describe the process used to create and evaluate nursing care guidelines.     

Emergency department nursing management of patients with orthopedic fractures resulting from motor vehicle accidents

Nursing management of patients with orthopedic fractures resulting from motor vehicle accidents is a frequent challenge for nurses in an emergency department setting. The nurse must have knowledge of the mechanics of injury, the classification of the resulting fracture types, and the usual medical interventions. In addition, emergency department nurses should follow plans of care that are based on nursing diagnoses so that appropriate nursing interventions can be determined and consistently provided. Initiation of these care plans must not be delayed until the patient is admitted to an inpatient nursing unit, but should be begun in the emergency unit setting. This article presents information that the emergency room nurse needs in order to make plans for nursing care, and discusses seven nursing diagnoses that are almost always appropriate for patients seen in the emergency department who are experiencing orthopedic fractures resulting from motor vehicle accidents.     

Congestive heart failure education study.

Nursing staff providing care to patients on a medical/surgical unit must be generalists rather than specialists in disease management. The diversity of illnesses seen among this population requires the nurse to be expert in many disease processes. The complexity of patients who are admitted to a medical/surgical unit continues to increase and is therefore challenging to nurses. Complex patient populations can be attributed to individuals living longer and the advancement of technology and information in treating serious medical conditions. Nursing expertise for different disease processes can vary according to experience, educational level, and knowledge regarding evidence-based practice. Lack of knowledge regarding current practice guidelines and care may result in poor patient outcomes and high cost. Confidence in performing safe and quality nursing care can also be affected by lack of knowledge. Continuing education for nursing must be made a priority for nurses to provide safe and high quality care. Education provided must be current and based on positive outcomes through research-based nursing practice.     

Acute compartment syndrome

Orthopaedic nurses must be continually alert for the dreaded complication of fractures, acute compartment syndrome (ACS). This article reviews the current literature on predisposing factors, pathophysiology (including systemic factors), assessments, various diagnostic methods, and treatments of patients at risk for, or encountering, ACS. A nursing care plan including the pertinent nursing diagnoses for these patients is included, and nursing care before and after fasciotomy is outlined.     

Combining the arts: an applied critical thinking approach in the skills laboratory

The quality of care that nurses provide to patients is strongly influenced by the nurses' ability to think critically and to solve problems. In response to the dynamic changes in healthcare and rapid technological advancements, nursing educators must prepare nursing students to meet the challenges. Baccalaureate nursing students must be taught to utilize critical thinking skills for problem solving during the application of the nursing process. Nursing students who use critical thinking skills will provide high quality and efficient patient care in the acute care and community settings. During the simulated laboratory experience, incorporating creative teaching strategies to promote critical thinking and enhance problem-solving skills can enable nursing graduates to enter the workforce feeling confident and competent.     

Care needs and functional status of older acute care patients

A growing number of older adults are admitted to hospitals, and information is needed on how age-related functional decline affects nursing care needs of this population. This study compared the functional status at admission and total nursing care needs of three age groups of older inpatients. A 12-month retrospective audit was performed on the records of 225 patients in a private metropolitan hospital. The three groups of patients were matched on diagnosis. Findings revealed that older patients were significantly more dependent, had greater total nursing care needs, and were less likely to be discharged to home, indicating that in addition to medical diagnoses, age-related differences of older patients' functional status at admission and inpatient nursing care needs should be factored into staff workloads and funding of nursing care. The finding that significantly fewer of the older patients returned home must be considered when reviewing health care policy and services.     

Developing standards in palliative care.

Palliative care is an area of nursing that demands special skills and deserves standards of excellence. Standards are vital for the monitoring of patient care. Standards ensure that all staff are aware of the level of care to be delivered. Palliative care should be given to all patients who are dying, not just those with cancer. Before standards can be created, a philosophy of care must be written. Time limits must be set and adhered to.     

Telephone triage. Interview by Jennifer K Mitchell

As the care of patients with cancer has shifted from the inpatient arena to the outpatient setting, the traditional role of outpatient oncology nurses has also changed. Outpatient oncology nurses must not only be knowledgeable about disease processes and care of patients in the clinic, but they must also be skilled in telephone nursing triage.     

Assessing tissue oxygenation

Although physical examination remains an important part of the nursing assessment, assessment of tissue oxygenation provides additional vital information. Nurses who are caring for patients with compromised functioning must have a basic understanding of the physiological relationships between oxygen saturation, cardiac output, and acid-base balance and must be able to plan nursing care based on this knowledge.     

Partnership 2000: a journey to the 21st century

Building partnerships is a valuable strategy for achieving success in forming a strong foundation for nursing in the 21st century. The demands of the changing health care environment require that managers and staff change the context in which patient care delivery is accomplished. Managers must be willing to unleash the power of the human capital of staff nurses. Staff nurses must be willing to take a seat at the table and share the leadership role with their manager. Both must engage in building an environment that facilitates continued learning, establishes effective relationships with other health care team members and patients, creates an environment that attracts and retains professional nursing staff, expects professional development from one another, and realizes that collective accountability can be achieved through sharing the leadership.