Clinical care of patients with hepatocellular carcinoma

By | April 25, 2012

Clinical care of patients with hepatocellular carcinoma, (a) General Nursing
1. Warm reception of patients, hospital mission to do good work and eliminate the fear of patients, in which patients have a sense of trust, to actively cooperate with treatment.
2. Attention to rest, reduced activity levels and to reduce the load of the liver.
3. To ensure the protein intake, eating the right amount of fat and vitamins.
4. To have ascites, to restrict salt intake, the daily 3-5g; aura of a hepatic coma and hepatic coma, to temporarily stop the intake of protein, intake of sugar-based.
5. Maintain a clean and flat bed unit, timing stand, weight loss, a daily massage with safflower bony protrusion at the alcohol to prevent bed sores.
6. On hepatic coma and those who can not eat good oral care.
(B) symptomatic care
1. Liver pain, according to three levels of analgesia given analgesics, good psychological care, good pain relief hygiene education.
2. On the loss of appetite, eating patterns should be changed frequently, small meals often. Active upper gastrointestinal bleeding should be fasting.
3. Distension and ascites, should be taken half-lying position, to keep beds clean, regularly turn over to prevent bedsores.
4. Complication nursing reference section IV of this chapter.
(C) of the disease observed
1. Observe the changes in vital signs and conscious state, and found that condition changes.
2. Observe the nature of liver pain, duration, with or without radiation and so on.
3. Liver interventional therapy, patients were observed whether the dorsalis pedis artery pulse and wound bleeding, observed changes in blood pressure.
4. Radiotherapy and chemotherapy after surgery, should be closely observed the occurrence of various side effects, good symptomatic treatment.
Clinical care of patients with hepatocellular carcinoma, (d) health guidance
1. Active smoking, and alcohol. There are several cancer-causing substances in tobacco; long-term excessive drinking, increase the burden of the liver, the disease rehabilitation harmful.
2. To lift the burden of patients thought to encourage patients to actively participate in recreational activities, living a regular life. Eased in the illness, should participate in whatever work, eliminating the "incurable disease" effect, to maintain the normal function of the body. Compensatory dysfunction in the case of concurrent infection must be absolute bed rest.
3. Pay attention to personal hygiene, clothing and timely replacement of contaminated clothing, keep the environment clean and well ventilated. Trim nails regularly to prevent scratching the skin to cause infection. To avoid the collision and compression parts of the skin edema.
4. Actively prevent pressure ulcers, bedridden patients every 2 hours to replace a position. Ascites, limb edema in combination, should be properly recorded and out of control volume and abdominal circumference measurement method.
5. Food nursing, especially after surgery and chemotherapy during the rehabilitation period, must pay attention to diet nursing to facilitate rehabilitation. Into the high-calorie, high protein, high vitamin, low-fat diet, edema inedible bacon, pickles, a cirrhosis fasting hard, hot, spicy food.
6. Of chemotherapy in patients with drug toxicity should be observed, such as oral ulcer can gargle salt water or acidic water shed, partial coating gentian violet; hair loss, wigs; periodic review of white blood cells, such as white blood cells less than 4X109 / L, should be suspension of chemotherapy, because chemotherapy drugs inhibit the hematopoietic system easily complicated by infection; attention to ward air flow, indoor and disinfected regularly to limit access.
7. Liver surgery, a comprehensive investigation of preoperative liver function and coagulation, 3 days before surgery for bowel preparation, oral administration of streptomycin 1g 2 times, further cleansing enema the night before surgery, preoperative intramuscular injection of vitamin 3 days K1.

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