门诊患儿病情突变观察及急救护理

2005年5月～2007年5月,我们收治24例突发病情变化患儿,均给予积极病情观察与急救护理,效果满意。现报告如下。     

加强疗养院疗养员护理安全的探索

疗养安全工作是疗养院的基础和重点工作,护理人员长期在疗养第一线,从疗养员入院到出院及疗养生活的安排,与疗养员接触最频繁、关系最密切,所以确保护理疗养员的安全至关重要.这几年我院在加强疗养期护理安全方面做了一些有益探索,形成一些好的做法,通过实践,效果良好,现报道如下.     

急诊观察病人病情突变的急救护理体会

我院急诊观察室负责全院各专科门诊病人的临时输液和病情观察工作，日平均输液人次达60余人次。由于急诊观察病人多，病种多，病情复杂，用药广，从而病情突变的发生率也多。笔者现将在急诊护理工作中处理病情突变的护理体会报道如下。     

儿科病房病情突变的急救与护理

我院儿科病房负责住院患儿和急诊患儿的输液治疗和病情观察。病区内流动性较大，从而病情突变的发生也较多。我科自2000年1月-2007年7月对40例病情突变患儿成功救治，现介绍如下。[第一段]     

外科急诊观察病人病情突变的急救护理

急诊观察病人出现病情变化多数都是随机性的，计划性诊断、治疗措施相对很少。护士应多巡视、勤观察，及时发现病情变化，并通过敏锐的观察力，快速作出判断，采取有效的科学性强的救治措施，千方百计挽救病人的生命。     

疗养员座谈会的点滴体会

我院是北京军区唯一的一所“疗治”结合的疗养院。以“疗养为中心”做好疗养服务保障工作是暑期全院工作的重点。我科在开展整体护理的同时，围绕以“疗养员为中心”的服务宗旨，重视疗养员座谈会，掌握疗养需求。及时协调解决疗养员提出的问题，最大程度地满足疗养员的合理需求，提高了疗养服务工作的满意度，使我们的疗养工作做的更好更完善。     

高血压病老年疗养员的康复护理

高血压病是老年人的常见疾病，严重威胁老年人的身心健康。我科是以收治离退休干部疗养为主的科室，在来科疗养人员中，许多老年疗养员身患高压病，我们注意在饮食、心理、用药、环境等方面做好康复护理工作，取得较好效果。[第一段]     

急诊病人病情观察及急救护理

急救技术在平时、战时，在病房、手术室以及医院外的各种场合均可出现，作为医护人员，应掌握心跳呼吸骤停抢救的基本知识和方法，才能达到预期的目的。急诊观察病人出现病情变化多数都是随机性的，计划性诊断、治疗措施相对很少。护士应多巡视、勤观察，及时发现病情变化，并通过敏锐的观察力，快速作出判断，采取有效的科学性强的救治措施，千方百计挽救病人的生命。现将本人在急诊护理工作中处理病情突变的护理体会报告如下：     

老年疗养员的安全管理

疗养院服务的对象大多是离退休的老干部。因此对老年疗养员的管理是疗养科护理工作的重点。而老年疗养员的安全管理又是重中之重，护理人员应提高防范意识，并根据现存或潜在的不安全因素。制定有关管理规定，这样很多意外是可以预防的。     

疗养员的心理特征观察及护理探讨

军队疗养院是以军人疗养员为主要服务对象的单位，其中包括功勋卓越的首长和英雄。来院疗养的疗养员，有在职疗养员、离退休疗养员，其中四分之三为60岁以上的离退休老首长。在疗养员的心理护理观察中，发现疗养员在心理上主要存在三种心理特征：优越性心理、自卑心理和平常心理特征。通过观察疗养员疗养期间的心理特征，并采取相应的心理护理对策，收到了比较好的效果，现就疗养首长的心理特征及心理护理作如下探讨。     

Improving the quality of care provided at night

Nurses caring for patients at night need to be aware of the special needs of patients during this time and know how to evaluate the quality of care they provide. Nurses working on night duty should have a clear philosophy on which to base their care and formulate standards.     

1例夜间住院精神分裂症病人的护理

1病例介绍 病人，男，33岁，初中文化，因反复自语、骂人等，不能工作13年。再发1周。于2003年3月11日在亲友帮助下强行送入我院治疗。病人于1990年9月无明显诱因出现精神失常，呈急性起病。主要表现为乱语、骂人、自笑、砸物、夜间不眠等，曾先后15次送我院治疗，诊断为“精神分裂症”，曾用氯丙嗪、氯氮平、甲硫哒嗪等药物治疗后好转出院。由于自行减药，病情复发。病人话少，性格内向，自尊心强，不善交际，酷爱中国象棋，吸烟每日1包，不饮酒。其舅舅、表弟、表妹患有精神病。     

1例夜间住院精神分裂症病人的护理

1病例介绍病人,男,33岁,初中文化,因反复自语、骂人等,不能工作13年。再发1周,于2003年3月11日在亲友帮助下强行送入我院治疗。病人于1990年9月无明显诱因出现精神失常,呈急性起病。主要表现为乱语、骂人、自笑、砸物、夜间不眠等,曾先后15次送我院治疗,诊断为“精神分裂症”,曾用氯丙嗪、氯氮平、甲硫哒嗪等药物治疗后好转出院。由于自行减药,病情复发。病人话少,性格内向,自尊心强,不善交际,酷爱中国象棋,吸烟每日1包,不饮酒。其舅舅、表弟、表妹患有精神病。入院后测体温36.5℃,脉搏84/min,呼吸20/min,血压13.33/8.67kPa,意识清晰,定向…     

胸外科高龄病人围手术期夜间呼吸道护埋

目的：探讨胸外科高龄病人围手术期夜间呼吸道护理的方法与效果。方法：对84例病人术前进行一般护理和心理护理,术后加强病室环境管理、心理护理、充分镇痛、翻身、呼吸道护理、强化超声雾化吸入、吸痰、气管插管或气管切开、严密观察病情变化。结果：84例病人通过夜间严密的护理措施,均顺利渡过手术关。术后有3例病人围手术期发生的肺部并发症,经治疗后痊愈出院,无1例病人围手术期死亡。结论：加强夜间病人呼吸道的护理在高龄病人开胸手术的呼吸道管理中特别重要,能使整体护理质量水平得以明显提高,使病人比较顺利地度过围手术期难关,同时也体现了护理工作的科学性和重要性。     

Evaluation of comprehensive program for diabetes care at primary health-care level

The Swedish National Board of Health and Welfare published its first diabetes health-care program in 1977. The impact of the program was evaluated in the Stockholm County after 4 yr. The results showed that the educational program had reached greater than or equal to 1 staff member in 86% of the 104 primary health-care centers (PHCCs). Several organizational changes had taken place as a result of the program. The 10 "best" PHCCs were compared with a random sample of the centers with regard to patient outcomes. Patients from the 10 best centers had gotten a more comprehensive education, were more knowledgeable about foot care, tested glucose more often, and used less medication. The metabolic control was the same for both groups of patients. The PHCC staffs reported the following roadblocks to change: lack of knowledge of diabetes care, insufficient cooperation between staff members, poor contact with specialists, and absence of guidelines for diabetes care. The staffs in the best centers spent twice as much time in staff meetings and continuing education as those from the random sample of centers. The findings led us to formulate a new strategy for the program. The main objective of the new approach is to create organizational changes within the centers. Thus, local knowledge and creativity can be utilized. Preliminary data demonstrate that 84% of the locally developed plans for reorganization of diabetes care had been accomplished within 1 yr.     

Nursing care for survivors of sudden cardiac death

The development of four new antiarrhythmic drugs offers promise for the treatment of patients who survive an episode of sudden cardiac death. Medical treatment, however, remains somewhat empirical, reflecting continued lack of total understanding of arrhythmogenesis and the pharmacokinetic properties of drugs required for suppression and control of arrhythmias. Further, although the value of such treatment cannot be underestimated, a healthy respect for the potential risk of arrhythmia aggravation by all of these drugs is warranted. The management of these patients presents a tremendous challenge for both physicians and nurses: physicians are responsible primarily for the definition of type, location, and severity of the arrhythmia; nurses focus primarily on the patient's response to illness and treatment in terms of its potential impact on their lifestyle. The clear focus for each discipline is necessary for development of a more purposeful and comprehensive treatment plan for the patient. As survival of sudden cardiac death increases, a number of patient responses, emotional and physical, have been noted clinically. The concept of nursing diagnosis can serve as a frame of reference from which nurses can begin to more scientifically evaluate their impact on patient care. Most importantly, it will contribute to an improvement in the care of patients whose lives have been so disrupted by the unpredictable nature of the arrhythmia and the investigational nature of treatment.