英语护理查房

英语护理查房第一页，共52页1234ContentsCaseReport

Knowledge

of

IntussusceptionTherapeutic

ManagementHealth

Guidance

forDischarged

Patients第二页，共52页

CaseReport第三页，共52页

BIOLOGICALDATA:

Name：ChenJingyaSex：femaleAge：7-month-oldDateofAdmission：2015-04-2314:40

CaseReport第四页，共52页

Chief

Complaint：

paroxysmalcrying

vomitingbloodystool

ERX-Ray:IntussusceptionunabletoresetCaseReport第五页，共52页

CaseReportAdmissionDiagnosis:AcuteIntussusceptionPhysicalExamination:T:36.9℃P:110/minR:20/minWt:7.5kg第六页，共52页Laboratoryexamination:routinebloodroutionurinefullbiochemicalfullbloodcoagulationtestHIV,HBV,HCV,RPRDateof

Intussusception

surgery:2015-04-23Dateofdischarge:2015-05-05

CaseReport第七页，共52页

Knowledge

of

Intussusception第八页，共52页EtiologySymptoms&SignsDefinitionIntussusception第九页，共52页

Whatisintussusception?

Intussusception

isamedicalconditioninwhichapartoftheintestinehasinvaginatedintoanothersectionofintestine.Knowledge

of

Intussusception--Definition第十页，共52页

Childrenintussusception

Intussusception

is

ancommonabdominalemergencyinchildren.Itisoneofthemostcommoncausesofabdominalobstructionininfants.4-10monthKnowledge

of

Intussusception--Definition第十一页，共52页

ETIOLOGY

Knowledge

of

Intussusception第十二页，共52页Age:80%<2yearsold,mostcommonininfants

aged4-10months.Sex:theratioofthemale-to-femaleis

approximately3:1.Season:theseasonalpeakisinspringandsummer.

Incidence:Knowledge

of

Intussusception--Etiology第十三页，共52页What’sthereasonofthedisease??Whyithappensto

infantsmostly??Knowledge

of

Intussusception--Etiology第十四页，共52页Predisposingfactors:

caused

bydisorder

ofthe

intestinal

peristalsis,

suchas:Dietaryalteration:complementarysolidfood.Diseases:gastroenteritis,diarrhea,fever,etal.Virusinfections:adenovirus,rotavirus,reovirus,echovirus.Knowledge

of

Intussusception--Etiology第十五页，共52页Dietary

alterationKnowledge

of

Intussusception--Etiology第十六页，共52页The

complementary

food

of

children

can

notbechanged

too

soon.Itissupposedtobetransformedstepbystep.Dietary

alterationKnowledge

of

Intussusception--Etiology第十七页，共52页Predisposingfactors:

caused

bydisorder

ofthe

intestinal

peristalsis,

suchas:Dietaryalteration:complementarysolidfood.Diseases:gastroenteritis,diarrhea,fever,etal.Virusinfections:adenovirus,

rotavirus,reovirus,echovirus.Knowledge

of

Intussusception--Etiology第十八页，共52页fever(acuteupperreappiratorytractinfection)lostitsnormalfunction/enterospasmDiseaseKnowledge

of

Intussusception--Etiology第十九页，共52页Predisposingfactors:

caused

bydisorder

ofthe

intestinal

peristalsis,

suchas:Dietaryalteration:complementarysolidfood.Diseases:gastroenteritis,diarrhea,fever,etal.Virusinfections:adenovirus,rotavirus,reovirus,echovirus.Knowledge

of

Intussusception--Etiology第二十页，共52页Researcherssuspectthatinfectiousagents:rotavirus&adenovirus.Virus

infectionKnowledge

of

Intussusception--Etiology第二十一页，共52页Intussusceptioncauseshavenotclearlyestablishedorunderstood.Theycanincludeinfections,anatomicalfactors,andalteredmotility.Studiesandanalysis

havenotconclusivelyestablishedthis.Knowledge

of

Intussusception--Etiology第二十二页，共52页Areviewofsparsedataonthepossibleassociation:thevirus&intussusceptionhasnotdemonstrateduntilveryrecently.Knowledge

of

Intussusception--Etiology第二十三页，共52页SymptomsandSigns1、Generalappearance2、Paroxysmalcrying3、Biliousvomiting4、Redcurrantjellystool5、Sausage-shapedmassKnowledge

of

Intussusception第二十四页，共52页

TherapeuticManagement

NonsurgicalTherapySurgicalTherapy第二十五页，共52页NonsurgicalTherapy

AirEnemaBariumEnema第二十六页，共52页

NonsurgicalTherapy-BariumEnemaNonsurgicalTherapy---

BariumEnema第二十七页，共52页NonsurgicalTherapy-BariumEnemacomplicationchemical

peritonitisNonsurgicalTherapy---

BariumEnema第二十八页，共52页Intussusceptionpresenting<48hours.Goodgeneralappearance.Withoutabdominaldistention,hightemperatureandtoxicosis.ETIOLOGYNonsurgicalTherapy-AirEnema1.IndicationsNonsurgicalTherapy---

AirEnema第二十九页，共52页

2.Procedure

Restrainedthepatient,insertedtheFoleycatheterintorectum,inflatedtheballoon.NonsurgicalTherapy---

AirEnema第三十页，共52页2.headofintussusceptum

locatedinthehepatic

flexureofthecolon1.beforeairclysis3.reductionoccur4.reductiongoon5.thefillingofnumerousloopsofintestine第三十一页，共52页3.

SignsofCompleteReductionFreeflowofairintoseveralloopsofsmallbowelwithsimultaneousexpulsionoffeces.Stopcrying,bequiet.Disappearoftheabdominalmass.

NonsurgicalTherapy---

AirEnema第三十二页，共52页4.

NursingCareofPost-airenemaCarbontest:take0.5-1gactivatedcarbonorally,appearinginstool6-8hourslater.Basictherapy.Dietaryguidance.Clinicalobservationclosely.

NonsurgicalTherapy---

AirEnema第三十三页，共52页SurgicalTherapy

第三十四页，共52页

PuremanualreductionIntestinalanastomosisEterostomySurgicalTherapy

第三十五页，共52页1.SurgicalIndicationEnemafailure.Intussusceptionoccuringmorethan48-72hours.Intestinalnecrosis.Intestinalperforation.SurgicalTherapy

第三十六页，共52页

2.NursingDiagnosisPainAnxietyHight

riskforfluidvolumedeficitPotencialcomplicaion:shockSurgicalTherapy

第三十七页，共52页3.Postoperative

NursingInterventionMonitoringthevitalsignsandconsciousnessstate.Oralfeedingonagradualschedule----obeyingthedoctor’sinstruction.SurgicalTherapy

第三十八页，共52页Intensivecarefornasogastrictube.Preventionofcomplications:preventionof

intestinal

adhesion,fluidinfusiontopreventbleeding,infection,etc.3.Postoperative

NursingInterventionSurgicalTherapy

第三十九页，共52页

Activity:Passiveactivity3.Postoperative

NursingInterventionSurgicalTherapy

第四十页，共52页Health

Guidance

fordischargedpatientsAnimportantwaytopreventintussusceptionandfinddiseasesintime.第四十一页，共52页*Livingguide*Diseaseobservation*Dietguide*Specialcareguide第四十二页，共52页LivingGuide*Lettheparentsrealizethe

importanceofkeepmoving.*Enoughphysicalactivities.*Preventionofintestinal

adhesion.EXERCISE第四十三页，共52页INFECTIONPREVENTIONAdenovirusinfectionIntestinallymophfollicleshyperplasiaExcessiveintestinalStimulatetheautonomicnervoussystemperistalsisIntussusceptionSo*Preventcolds*SafetyfoodLivingGuide第四十四页，共52页DiseaseObservationWOUNDNURSING*Takeashowerinsteadofbath.*Getridoftheriskfactorsof

damagingthewound.*Ifthewoundisredor

cracks,pleasegotohospital.第四十五页，共52页DiseaseObservationPainnursingAttentions!Ifthechildcrieswithanyparoxysmal,youhadbetterdoatimelymannerBtoexceedcheek,againsttoruleoutthepossibilityofintussucception.pain3-10monthshealthyfatinfant*colickyabdominalpain

*abdominal

swelling

or