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鼻饲及其护理ppt课件

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鼻饲 及其 护理 ppt 课件
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As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲病人的护 理 九八医院脑外一科 张红伟 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 学习内容 鼻饲的相关知识 鼻饲管置管的操作方法 注意事项 并发症的预防及护理 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲概念 鼻饲法 nasogastric gavege 是将胃管经鼻腔插入胃内 从胃管灌注流质食物 药 物及水分的方法 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 适应症 不能由口进食者 如昏迷患者 口腔疾患 口腔手术后的患者 上消 化道肿瘤引起吞咽困难的患者 不能张口的患者 如破伤风患者 早产儿 病情危重的患者 拒绝进食的患者 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲常用饮食 医用肠内营养液 瑞代 肠内营养混悬液 TPF 能全力 百普力 自制肠内营养液 米汤 牛奶 藕粉等 药品等 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲方法 两种 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲管置管的操作方法 插管前 核对 查对患者姓名 解释 说 明插管时的配合方法 请病人配 合 摆体位 清醒患者协助其取半 坐位或坐位 颌下铺治疗巾 无 法坐起者取右侧卧位 昏迷患者 取平卧位 头向后仰 鼻腔准备 选择鼻腔通畅一侧 清洁鼻腔 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 插管时 1 检查胃管是否通畅 2 摸剑突作标记 量长度 做标记 前发际至剑突 或耳垂至鼻尖在至剑突 约45 55cm 3 润滑胃管前端 10 20cm 4 插管 左手持纱块托住胃管 右手持镊子夹胃管 前端沿一侧鼻孔缓缓插入至会厌部 约14 16cm 嘱病人吞咽 随吞咽送管至所测的长度 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 插管后 抽 回抽胃液 1 判断胃管位置 看 将胃管末端置入水中 看 有无水泡冒出 听 用注射器从胃管末端注入 10ml空气 同时置听诊器 于剑突下 听有无气过水声 2 固定胃管 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 注意事项 每次灌注前必须证实胃管在胃内 方可灌注食物 患者对鼻饲有一适应过程 开始时膳食宜少量 清淡 中午食量稍高于早 晚 每日 次 每次灌食量不超过200ml 间隔时间大于2h 鼻饲 后根据病情给予半卧 低坡卧位或右侧卧位半小 时左右 每次鼻饲前后都要用10 20ml的温水冲洗鼻饲管腔 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 注意事项 长期鼻饲者 应每日进行口腔护理2次 根据胃管种类不同适 时更换胃管 普通胃管每周更换一次 硅胶胃管每月更换一 次 通过鼻饲管给药时 应将药片研碎 溶解后再灌入 灌注的食物过冷 过热 均可引起腹泻或其他的胃肠疾病 因此灌注前应进行测试 在灌注前注意食物 餐具和灌注时的卫生 膳食应新鲜配置 给躁动患者进行保护性约束 防止将胃管拔出 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲中并发症的预防与护理 呕吐 返流 误吸 胃管脱出 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲中并发症的预防与护理 u呕吐 1 喂养前 翻身 拍背 吸痰 清理呼吸道 2 喂养中 如果出现呕吐应立即将患者头偏向一侧 停止鼻饲 进 行气道清理 防止误吸的发生 3 喂养后 根据病情给予合适体位 低坡卧位或侧卧 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲中并发症的预防与护理 u返流 误吸 1 鼻饲前 回抽胃内容物确定胃管在胃内及检查胃内残留物 有多少 2 鼻饲时 抬高床头30 45度角 3 鼻饲后 保持半卧位0 5 1小时或斜坡右侧卧位 4 鼻饲中及鼻饲后30分钟内尽量不吸痰 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 鼻饲中并发症的预防与护理 u胃管脱出 1 告知患者及家属胃管的重 要性 增加医从性 2 固定安全 有效 3 定时巡视检查 4 讲解防止胃管脱出的相关 知识 5 对躁动的患者适当约束 6 移动患者前 后固定好鼻 饲管 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year 远期并发症 腹泻 便秘 腹胀 鼻咽部粘膜溃烂 坏死 食管炎或食管狭窄 吸入性肺炎 最严重 As the only big agricultural village in Tianding Township some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year
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