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Wysłany: Wto 0:02, 08 Mar 2011
Temat postu: Anti-TB drugs in patients with drug fever caused b
Drug fever caused by anti-TB drugs in the care of patients
28,53.6%), thermal-type mostly remittent fever (23/28,
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, 82.1%). In addition to fever or allergy symptoms, patients are generally in good condition, no obvious symptoms of poisoning, do not support the experimental examination of the infection, tuberculosis, symptoms of poisoning and other febrile illness. The first is caused by thermal drugs streptomycin (10/28, 35.7%), the second amino acid to sodium (2 / 28, 25.O%), the third to rifampin (6 / 28,21.4%). High fever after the original heat treatment in 6 cases, the original heating temperature is normal after anti-TB drugs after the heat treatment in 9 cases, no heat treatment after the original fever in 13 cases. 1 month after treatment were more heat. A heavier burden on the patient thought, and affects the heat treatment of the disease, so patients with more fear. 2 care 2. I strengthen the psychological counseling, master of psychological dynamics, to establish adequate treatment confidence, changes in body temperature to give a reasonable explanation. Tell the patient a lot of anti-TB drugs, and can substitute for each other, do not have minds of too many primary diseases, affect the treatment. 2.2 strengthen the dietary guidance given to high-protein, high vitamins, high-calorie, digestible liquid diet, because patients with low resistance, symptoms weight, high nutritional needs, but also should pay attention to nutrition, and absolute bed rest. The patient's breath and high fever, skin sweat more, causing significant loss of water, more water should be encouraged, for those who can not eat water, intravenous fluids to be directed by your doctor or nasal feeding. 2.3 The close observation of changes in body temperature, measured every 4h and record 1. Hyperthermia were given cooling. Cool as possible using physical methods,
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, the skin allergy symptoms do not advocate alcohol sponge bath. 2.4 strengthen the oral care and oral hygiene health guidance, guide patients with normal oral hygiene, elimination of teeth within the residue. 2.5 to enhance skin care, timely dry sweat, the timely replacement of bedding,
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, then lower the patient skin resistance, easily lead to infection. Itching of the skin, distraction, to avoid scratching grasp cause infection. Received :2004-10-03 liver cirrhosis patients with upper gastrointestinal bleeding Nursing care Dong Yuhua, Shi Luo, Hong Jing, Wei Jinlan (Yidu Central Hospital, Weifang City, Shandong Qingzhou 262500) complications of upper gastrointestinal bleeding in cirrhosis, high mortality rate, our department since June 2000 ~ December 2003 on the treatment of liver cirrhosis patients with 76 cases of gastrointestinal bleeding, and achieved satisfactory results, will now report as follows Nursing rescue. 1 clinical data in this group 49 males and 27 females ,26-72 years, mean 52 years. The active bleeding, liver, lower portal pressure and other treatment, 58 cases improved, 18 cases of death, length of stay 1-39d. 2 rescue and medical care and 2.1 immediately do blood typing and blood tests and blood cross, rescue ready goods, air cylinder, suction, hemostatic, boost medicine. 2,
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,2 rapid establishment of intravenous access, maintain smooth infusion, infusion needle puncture with a 9, and make blood transfusion preparations. The orders to the 10% glucose injection solution 20ml 938 plus vasopressin 1O observed changes in blood pressure, blood pressure maintained at 9O a 100/60-80mmHg, such as high blood pressure can slow down the drip rate. 2.3 to maintain airway patency, a lot of vomiting in patients with head to one side to prevent choking or vomiting caused by hypostatic pneumonia, timely use of suction clear respiratory secretions, and wipe the blood. 2.4 oxygen 3-5L/min, increase blood oxygen content, close observation of respiratory rhythm, frequency, and oxygen level. 2.5 repeated a large number of bleeding is difficult to stop the bleeding, surgical operations, should actively carry out preoperative preparation. 2.6 hand care, close observation and changes in vital signs, each measuring 15min pulse, respiration, blood pressure again, and note the change of consciousness and urine. If the patient was pale, cold sweats, irritability,
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, thin pulse, blood pressure, suggesting disease progression, immediately notify the physician, ready to rescue, accurate records of intake and output, provide the basis for the development of treatment programs. 2.7 reasonable adjustment diet, bleeding during the temporary fasting, the bleeding stopped after 24-48h, giving a small amount of liquid diet ,48-72h later, into the semi-liquid diet, after the soft food is better. 2.8 were due to liver dysfunction, blood in the gut produce large amounts of ammonia decomposition hepatic coma produced at any time possible. can 1O% vinegar plus high saline enema acidified gut, preventing the absorption of ammonia, and clear the accumulated feces and blood. 2.9 decreased body resistance in patients with hemorrhage, immune dysfunction Easy secondary infection, the patient required placement in a quiet, clean wards, Zhu Huanzhe bed rest
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