常见症状发绀课件

常见症状发绀ppt课件汇报人：文小库2024-03-15CONTENTS发绀基本概念与定义发绀诊断方法与技巧常见类型发绀及其特点鉴别诊断与误区提示治疗原则与方法探讨预防措施与生活习惯调整建议发绀基本概念与定义010102发绀定义及特点特点为在皮肤较薄、色素较少及毛细血管丰富的部位（如唇、指、甲床等）表现更为明显。发绀是指血液中去氧血红蛋白增多导致皮肤和黏膜出现青紫色改变。导致血氧含量降低，如先天性心脏病、慢性阻塞性肺病等。血红蛋白异常或血液循环障碍，如高铁血红蛋白血症、硫化血红蛋白血症等。如雷诺现象、血栓闭塞性脉管炎等导致ju部血液循环障碍。心肺疾病血液疾病ju部因素发病原因及机制以下附赠各项管理制度英文版（不需要可删）急救药品、器材管理制度:1.Rescuedrugsandequipmentshouldbe"fivefixed"(fixedquantityandvariety,designatedplacement,designatedpersonstorage,regulardisinfectionandsterilization,regularinspectionandmaintenance)and"twotimely"(timelyinspectionandmaintenance,timelyreceiptandsupplementation).Theitemisclearlymarkedandcannotbeusedarbitrarily.2.Thenecessaryrescueequipmentiscomplete,ingoodperformance,andinstandbycondition.3.Therescuedrugsarecomplete,withcleardruglabelsandnodiscoloration,deterioration,expiration,ordamage.Theyshouldbeplacedandusedintheorderofdrugexpirationdates(fromrighttoleft).4.Emergencydrugsanditemsforeachdepartment'srescuevehicleshallbeuniformlyequippedaccordingtorequirements.Specializedemergencydrugsanditemsmustbereviewedandapprovedbythedepartmentdirectortodeterminethetype,quantity,specifications,anddosagetobeequipped.Rescuevehiclesmustbeplacedindesignatedlocationsandmanagedbydesignatedpersonneltoensuresafetyandeaseofuse.5.Afterusingrescuedrugsandequipment,theyshouldbefullyreplenishedwithin24hours.Iftheycannotbereplenishedduetospecialreasons,theyshouldbenotedonthehandoverregistrationformandreportedtotheheadnurseforcoordinationandresolutiontoensuretimelyuseduringpatientrescue.6.Thereisaregistrationbookfortheprovisionofdrugsandequipment.Ensureconsistencybetweenaccountsandmaterials,andhandoverbetweenshifts.7.Managementofsealedrescuevehicles:Beforesealing,theheadnurse(ornurseincharge)andanothernurseshallcountthedrugsandequipmentaccordingtotheregistrationbookofdrugandequipmentequipment,verifytheiraccuracy,andsealthemwithaseal.Twopeopleshallsignandfillinthesealingtime.Nurseschecktheconditionofthesealsoncepershiftandcompletethehandover.Theresponsiblenursescheckonceaweek,andtheheadnurseandresponsiblenursesopenthesealsandinspectthedrugsandequipmentintheambulanceonceamonth,withrecordskept.8.Nonsealedrescuevehiclemanagement:Eachshiftshallcountthedrugsandequipmentaccordingtotheregistrationbookandcompletethehandover.Theresponsiblenurseshallinspectonceaweek,andtheheadnurseshallinspectonceeverytwoweeksandkeeprecords,ensuringthattheaccountsmatchthematerials.护理文书书写制度:

1.Nursingstaffstrictlyfollowthelatestrequirementswhenwritingnursingmedicalrecords.2.Thecontentofnursingrecordsshouldbeobjective,truthful,accurate,timely,complete,andstandardized.3.Allnursingdocumentsshouldbewrittenwithablueblackorcarboninkpen.4.AllnursingdocumentsshouldbewritteninArabicnumeralsfordateandtime,withdatesinyears,months,anddays,usinga24-hoursystem,specifictominutes.5.WritingshoulduseChinese,medicalterminology,andcommonlyusedforeignlanguageabbreviations;Completerecorditems;Thetextisneat,thehandwritingisclear,andthelayoutisclean;Accurateexpression,fluentsentences,simpleandconcise:correctformatandpunctuation,notypos.6.Whenerrorsoccurduringthewritingprocess,doublelinethemonthewrongwords,keeptheoriginalrecordclearanddistinguishable,signthemodifier,indicatethemodificationtime,continuetowritethecorrectcontent,anddonotusescraping,sticking,paintingorothermethodstocoveruporremovetheoriginalhandwriting.Eachpageshouldbemodifiednomorethantwotimes,otherwisetheoriginalrecorderwillpromptlycopyagain(exceptformodificationsmadebysuperiors).7.Nursingrecordswrittenbyinternnurses,probationarynurses,orunregisterednursesshouldbereviewedandsignedbynurseswithlegalprofessionalqualificationsinthismedicalinstitution.8.Furthertrainingnursescanonlywritenursingdocumentsafterbeingrecognizedbythemedicalinstitutionreceivingthetrainingfortheirworkability.9.Superiornursingstaffhavetheresponsibilitytoreviewandmodifythewrittenrecordsofsubordinatenursingstaff.Whenmakingmodifications,reddoublelinesshouldbeusedtomarkerrors,writethemodifiedcontent,signandindicatethemodificationtime.10.Temperaturerecords,medicalorders,patientcarerecords,andsurgicalinventoryrecordsshouldbearchivedontime.中心性发绀周围性发绀混合性发绀特殊类型发绀临床表现与分类全身性发绀，除四肢及颜面外，亦见于黏膜和躯干，皮肤温暖。中心性与周围性发绀同时并存，常见于全心衰竭。常出现于肢体末端与下垂部位，ju部皮肤发凉。如高铁血红蛋白血症引起的发绀，呈棕褐色，经硫黄粉末或维生素C揉搓可消退。发绀诊断方法与技巧02病史采集与体格检查病史采集详细询问患者发绀出现的时间、部位、伴随症状等，了解有无相关疾病史，如心肺疾病、血液系统疾病等。体格检查观察发绀的部位、范围、程度等，检查心肺功能，听诊心脏杂音、肺部呼吸音等，评估患者的整体状况。检查血红蛋白含量、红细胞计数等，了解贫血程度及类型。测定动脉血氧分压、二氧化碳分压等，判断机体缺氧及酸碱平衡状况。检查肝肾功能、电解质等，了解机体代谢状况及内环境稳定性。血常规血气分析血液生化实验室检查项目选择观察肺部病变、心脏大小及形态等，评估心肺功能状况。检查心脏电生理活动，了解心律失常、心肌缺血等异常情况。观察心脏结构及功能，评估心脏瓣膜状况、心肌运动等。如CT、MRI等，可根据具体病情选择，进一步明确诊断。胸部X线片心电图超声心动图其他影像学检查影像学检查在诊断中应用常见类型发绀及其特点03中心性发绀是由于心、肺疾病导致动脉血氧饱和度降低而引起的。其特点为全身性发绀，除四肢与面颊外，亦见于黏膜（包括舌及口腔黏膜）与躯干的皮肤，但皮肤温暖。特点中心性发绀常见于急、慢性呼吸系统疾病、心脏疾病等，如重症肺炎、肺水肿、肺栓塞、慢性阻塞性肺疾病、先天性心脏病、心力衰竭等。常见疾病中心性发绀特点周围性发绀是由于周围循环血流障碍所致。其特点为发绀常出现于肢体的末端与下垂部位，如肢端、耳垂与鼻尖，且这些部位的皮肤温度低、发凉，若按摩或加温耳垂与肢体末端，可使发绀消退。常见疾病周围性发绀常见于休克、严重寒冷、雷诺现象等。周围性发绀特点混合性发绀是指中心性发绀与周围性发绀同时存在，常见于全心衰竭。其特点为发绀范围广，程度重，既可见于肢体的末端与下垂部位，又可见于黏膜和躯干皮肤，且皮肤温度低。常见疾病混合性发绀常见于全心衰竭、严重感染、严重贫血等疾病。这些疾病可导致心、肺等多个器官功能障碍，引起动脉血氧饱和度降低和周围循环障碍，从而出现混合性发绀。混合性发绀鉴别诊断与误区提示04发绀时皮肤和粘膜呈现青紫色，而苍白则是皮肤和粘膜失去血色，呈现苍白色。两者在颜色上有着明显的区别。发绀与苍白发绀是由于血液中去氧血红蛋白增多引起的，而黄疸则是由于血液中胆红素升高引起的。黄疸时皮肤、巩膜等呈现黄色，与发绀的青紫色有所不同。发绀与黄疸类似症状区分要点对发绀认识不足部分医生对发绀的认识不足，可能将其与其他类似症状混淆，导致误诊。忽视病史和体格检查在诊断过程中，如果医生忽视患者的病史和体格检查，也可能导致误诊。例如，未询问患者是否有心肺疾病史，未对患者进行详细的体格检查等。误诊原因分析医生应加强对发绀相关知识的培训，提高对发绀的认识和诊断能力。在诊断过程中，医生应重视患者的病史和体格检查，结合患者的临床表现进行综合判断。在必要时，医生可借助血液检查、心电图、胸部X线等辅助检查手段，进一步明确发绀的原因和诊断。加强发绀相关知识培训重视病史和体格检查借助辅助检查手段提高诊断准确率策略治疗原则与方法探讨0503周围循环障碍引起的发绀改善ju部血液循环，如保暖、按摩等，促进血液流通，缓解发绀症状。01心脏疾病导致的发绀治疗心脏疾病，如先天性心脏病、心力衰竭等，改善心脏功能，提高血氧饱和度。02呼吸系统疾病引起的发