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同学们好

我是

中南大学湘雅护理学院的郭佳老师

在我国新型冠状病毒肺炎疫情暴发的特殊时期

基于

前期我们对传染病共性

和防治原则的把握

一起来探讨这个新型传染病及其护理吧

首先

我们来回顾一下

人类与呼吸道传染病抗争的历史

近100年来

20世纪初

流行性感冒席卷全球

病死率约2.5%-5%

西班牙最为严重

在2009年

墨西哥爆发的

甲型H1N1流感

引起了全球流行

病死率0.6-0.7%;

2019年底

全球

再次暴发流感

疫情尚未结束

已经导致1900万人感染

美国最为严重

目前病死率约为0.1%

三次流感全球流行

病死率是在递减的

也说明

人类对流感的防控

在进步

2002年-2003年

我国是SARS非典型性肺炎重灾区

同学你应该也亲身经历了

SARS的病死率高达9.56%

十年后

在2012年

沙特暴发的中东呼吸综合征MERS

病死率更高

约35.5%

SARS和MERS的病原体

都是冠状病毒

与本次暴发于武汉的新型冠状病毒肺炎

的病原体为同一属

目前新冠肺炎的病死率为2.1%

但是在湖北省以外的地区

病死率千分之三左右

这并不意味着

湖北的医疗救治水平差

而是因为湖北省的患病人数

实在太多

这张图是《纽约时报》

在2020年1月31日总结的

几百年来人类经历严重传染病的致死率和传染性

纵坐标显示的是致死率

横坐标显示的是传染性

粉色矩形面积表示的是

新冠肺炎的致死率

和传染性估计区间

目前新冠肺炎的病死率稍高于

季节性流感

传染性比SARS和MERS强

致死率

比SARS和MERS低

下面我们回顾一下

新冠肺炎暴发的事件表

这是一个起源于武汉的故事

2019年12月8日

武汉卫健局通报了

发现

不明原因的肺炎患者

到12月31日

武汉共发现27例该肺炎患者

并且大部分病例均有

接触史

华南海鲜市场

初步判断该病毒属于冠状病毒

1月11日

到1月13日

泰国也发现了一例该肺炎患者

由此引起全球关注

1月15日

WHO确认

新型冠状病毒是“罪魁祸首”

并正式命名该新型冠状病毒为

2019新型冠状病毒

以下就是今天学习的主要内容

首先

我们来认识一下冠状病毒

冠状病毒由包膜和RNA组成

包膜上有向四周伸出的刺突蛋白

形如花冠

因而得名冠状病毒

它是单股正链RNA病毒

意味着

它比那些双链DNA病毒更容易发生变异

冠状病毒共有

α β γ和δ四个属

其中

我们熟知的SARS和MERS的病原体

都属于β属

新冠肺炎的病原体

也是β属的冠状病毒

但是它的基因特征与

导致SARS和中东呼吸综合征MERS

的冠状病毒有明显区别

与蝙蝠SARS样冠状病毒同源性达

85%以上

说明它最开始的来源可能是蝙蝠

目前发现

这个新型冠状病毒对紫外线

热和乙醚

75%乙醇

含氯消毒剂

过氧乙酸等脂溶剂敏感

56摄氏度30分钟就可将其灭活

了解这些特性

对于我们制定消杀措施

具有指导意义

新型冠状病毒是怎样

导致机体的临床症状的呢?

我们来看

首先它进入机体

通过

ACE2受体蛋白特异性结合

与眼结膜上皮细胞

呼吸道粘膜上皮细胞

消化道粘膜上皮细胞上的

导致一些局部症状

如腹泻

结膜炎

肺功能障碍等

病毒大量繁殖

进入血液循环后

出现发热

乏力等全身症状

如果炎症涉及

淋巴细胞和巨噬细胞的持续激活

和扩增

引起的细胞因子大量渗出

形成“炎症风暴”

学术上称为“细胞因子风暴综合征”

患者就会表现为全身炎症

呼吸加快

血氧饱和度下降

凝血功能障碍

多器官功能衰竭(MOF)

出现重症和危重症

致死率极高

接下来我们来看

新冠肺炎的流行病学特征

目前来看

新冠肺炎在春冬季暴发

流行周期尚不明确

全球均有病例报道

在中国湖北地区暴发

这是发病情况

截止2020年2月10日10点

新冠肺炎的传染源包括

患者及无症状感染者

以及野生动物

目前

传播途径比较明确的

是飞沫传播和接触传播

至于消化道传播

或呼吸道气溶胶近距离传播

尚未证实

对于新冠病毒 人群普遍易感

人被感染的几率

与接触病毒的量

及接触机会呈正相关

野生动物是如何感染人的呢?

这幅图显示的是

同样来源于自然宿主蝙蝠的

SARS MERS和新冠肺炎的三种冠状病毒

经过自然界食物链等正常活动

他们分别寄存在中间宿主

果子狸 骆驼 穿山甲等野生动物体内

人类在接触 捕杀 贩卖或者食用

这些自然宿主或中间宿主等野生动物时

将感染病毒 发病

并且人传染人

导致疫情暴发

感染新冠病毒后

一般会经历

2~14天不等的潜伏期才会发病

平均潜伏期7天

潜伏期内

人具有传染性

新冠肺炎患者有哪些临床症状呢?

包括发热 乏力 干咳等症状

逐渐出现呼吸困难

但也有不典型症状

如消化系统症状 神经系统症状

心血管系统症状 甚至结膜炎等

少数患者会发展为重症

危及生命

出现急性呼吸窘迫综合征

脓毒症休克 代谢性酸中毒

凝血功能障碍等并发症

所幸

目前新冠肺炎患者

多数为中轻症

预后良好

第五版

国家卫健委

诊疗指南

将新冠肺炎可分为

轻型 普通型 重型和危重型四类

异同如下

轻型患者发热 咳嗽等症状轻微

没有肺炎表现

肺部影像学检查

患者发热 咳嗽等症状明显

普通型

肺部影像学检查为

多发小斑片影及间质改变

以肺外带明显

但是呼吸功能正常

重症和危重症患者的发热

和呼吸道症状严重

可见多发毛玻璃影

浸润影

重症患者肺部影像学检查

危重症患者

可见肺实变

符合呼吸功能异常中的任一条

即可诊断为重症

出现呼吸衰竭或严重并发症中的任一种

即可诊断为危重型

新冠肺炎的辅助检查通常包括

肺部影像学检查和实验室检查

肺部影像学检查的异常表现

在上一张幻灯片中已经说明了

在此不赘述

实验室检查结果的异常

主要有白细胞总数正常

或降低

淋巴细胞计数减少

血常规检查

发病早期

部分患者出现转氨酶

肌酶和肌红蛋白增高

提示肝功能受损

和心肌损伤

多数患者C反应蛋白

和血沉升高

无论是哪种新型传染病

其诊断原则是确定的

主要通过流行病学史

临床表现和病原学检查来确诊

对于新冠肺炎

流行病学史中

特别强调两周内的接触史

为什么是两周呢?

因为新冠肺炎的潜伏期

一般最长是14天

本次的接触史查询

甚至包括武汉旅居史

具有诊断意义的临床症状

包括发热

有诊疗方案中描述的

肺炎影像学特征

以及白细胞总数正常或降低

或淋巴细胞计数减少等

发病早期血常规

当然

要确诊疾病

必须要有金标准

即病原学诊断

临床常用的方法是采集痰液

咽拭子 下呼吸道分泌物

血液等标本.

新冠病毒核酸

采用荧光 RT-PCR 检测

阳性即可确诊

我们在各类疫情报道中

都看到了疑似病例数

如何诊断疑似病例呢?

对于新冠肺炎

需要满足以下两点

有流行病学史中

的任何一条

符合临床表现中任意 2 条

即可诊断;

无明确流行病学史的

符合临床表现中的 3 条即可诊断

目前尚无特效抗病毒药物

关于新冠肺炎的治疗

当前的治疗原则

还是以对症和支持治疗为主,

注意加强呼吸系统功能支持

及时给予有效氧疗措施

根据氧饱和度的变化

对于抗病毒治疗

很多抗病毒药物疗效都还在临床试验阶段

例如

α-干扰素 洛匹那韦

利托那韦 利巴韦林 病毒唑等

此外

还应积极预防

和控制继发感染

避免滥用抗菌药物

对于重型 危重型病例的治疗

在对症治疗的基础上

治疗基础疾病

积极防治并发症

尤其注意

呼吸支持和循环支持

此外

采取一些其他措施

可根据实际情况

例如

根据患者呼吸困难程度

胸部影像学进展情况

酌情使用糖皮质激素抗炎;

有条件情况下

也可考虑从免疫治疗的角度

采用恢复期患者的血清治疗

“三分治疗 七分护理”

事无巨细的护理

对于患者的康复

抗击疫情至关重要

我们在前面课程学习中

反复强调过

消毒隔离永远是

首要措施

对于传染病患者的护理

这是原则 必须坚守

对于新冠肺炎的患者

消毒隔离要怎么做?

开展医疗活动

严格遵循

标准预防原则

做好个人防护

手卫生 病室管理

环境消毒和废弃物管理

根据环境

和护理情况的不同

采取不同的消毒

隔离措施

同时要避免发生针刺伤

严格执行探视制度

对隔离收治的患者

如确需探视

指导探视人员

进行个人防护

应按有关规定

在做好消毒隔离的前提下

护理新冠肺炎的住院患者还应做好

一般的常规护理

注意为患者

提供心理支持

加强病情观察

和监测

同时做好用药护理

尤其是使用洛匹那韦/ 利托那韦时

患者可能出现腹泻

等不良反应

应密切关注并及时处理

对于不同症状

和不同支持治疗的患者

要采取对症护理

大多数新冠肺炎患者

有高热症状

因此要做好高热护理

而对于使用

无创呼吸机辅助通气患者

和行气管插管

或气管切开需建立人工气道的患者

护理人员需采取不同护理措施

根据情况

要做好健康指导

出院患者

让其做到公共场合佩戴口罩

勤洗手

增强免疫力

做好个人防护

避免再次感染

同时

护理人员应配合各部门

做好死亡患者的处理

按规定

避免造成其他人员的感染

对于疑似病例或有接触史等患者

需要采取居家隔离

在居家隔离期间

要做好以下几点:

最好安排患者

住单人房间

减少其活动 拒绝探视

并保证房间通风

最好安排

一位身体健康状况良好

无慢性疾病的固定家庭成员

照顾患者

当其他家庭成员

需要与患者在同一房间活动时

一定要佩戴与面部严密贴合

的医用外科口罩

随时保持手卫生

避免直接接触患者身体分泌物

不和患者共用物品

一定要做好

隔离患者的污染物的处理

对于使用过的手套 纸巾

口罩以及其他废物

都应该放在患者房间专用的垃圾袋里面

标记为污染物再丢弃

如果患者

在居家隔离期间出现以下情况

需要及时就医:

第一

出现呼吸困难

第二

出现意识障碍

第三

高烧超过39℃

另外

如果其他家庭成员

出现新冠病毒感染的可疑症状

也要立即就医

接下来

我们看看如何预防新冠肺炎

你还记得

传染病的预防原则吗?

控制传染源

切断传播途径

保护易感人群

这个也是适用于

所有传染病预防的“真理”

目前

国家实施的各类抗击疫情的措施

也是遵循这些原则来实施的

全国地毯式排查体温

追踪武汉旅居史

关停野生动物贩卖市场

派遣大量医务人员

和医疗物资

支援疫区

研发药物和机制

就是在极力控制传染源;

号召全国人民

“少出门 不聚会

出门戴口罩

勤洗手”

甚至封城

都是在为

切断传播途径而努力;

目前

在保护易感人群方面

没有明确证据显示

具有预防作用的药物

疫苗也正在研发中

但是人群普遍易感

因此呼吁民众

保护并远离野生动物

戴口罩 勤洗手

避接触

养成卫生和生活好习惯

新冠肺炎疫情引起了社会恐慌

但是对于医学生来说

我们要理性

近一百年来

人类与各类传染病

进行了无数抗争

已经充分掌握了传染病流行的规律

以及应对原则

在这个特殊时期

医务人员责无旁贷

是勇士 是英雄

我们能运用专业知识

临床经验 仁爱精神

在前线抗击疫情

要为自己的专业感到骄傲

更要明白

只要万众一心

无论什么新型的

烈性的传染病

都可以掌控

春暖花开之时终将到来

谢谢

Medical Nursing课程列表:

Unit 1 Care of Patients with Respiratory System Diseases (Part One)

-Introduction to Medical Nursing

--Introduction to Medical Nursing

--Introduction to Medical Nursing

-Chapter 1 Overview of Respiratory System Diseases

--Overview of Respiratory System Diseases

--Overview of Respiratory System Diseases

--Overview of Respiratory System Diseases

-Chapter 2 Care of Patients with Pneumonia

--Overview of pneumonia

--Overview of pneumonia

--Streptococcal Pneumonia

--Streptococcal Pneumonia

--Other types of pneumonia

--Other types of pneumonia

--The quality and color of sputum

--Care of Patients with Pneumonia

-Chapter 3 Care of Patients with Lung Abscess

--Introduction of lung abscess

--Introduction of lung abscess

--Treatment and nursing of lung abscess

--Treatment and care of nursing abscess

--Care of Patients with Lung Abscess

-Chapter 4 Care of Patients with Pulmonary Tuberculosis

--Etiology and pathogenesis of pulmonary tuberculosis

--Etiology and pathogenesis of pulmonary tuberculosis

--Clinical manifestation of pulmonary tuberculosis (I)

--Clinical manifestation of pulmonary tuberculosis (I)

--Clinical manifestation of pulmonary tuberculosis (II)

--Clinical manifestation of pulmonary tuberculosis (II)

--Treatment and nursing of pulmonary tuberculosis

--Treatment and nursing of pulmonary tuberculosis

--Care of Patients with Pulmonary Tuberculosis

Unit 2 Care of Patients with Respiratory System Diseases (Part Two)

-Chapter 5 Care of Patients with Chronic Obstructive Pulmonary Disease

--Care of patients with chronic bronchitis

--Care of patients with chronic bronchitis

--Care of patients with chronic bronchitis

--Introduction of chronic obstructive pulmonary disease

--Introduction of chronic obstructive pulmonary disease

--Care of chronic obstructive pulmonary disease

--Care of chronic obstructive pulmonary disease

--Oxygen

--Care of Patients with Chronic Obstructive Pulmonary Disease

-Chapter 6 Care of Patients with Bronchial Asthma

--Etiology and pathogenesis of bronchial asthma

--Etiology and pathogenesis of bronchial asthma

--Clinical manifestation of bronchial asthma

--Clinical manifestation of bronchial asthma

--Treatment and nursing of bronchial asthma

--Treatment and nursing of bronchial asthma

--Care of Patients with Bronchial Asthma

-Chapter 7 Care of Patients with Chronic Pulmonary Heart Disease

--Etiology and pathogenesis of chronic pulmonary heart disease

--Etiology and pathogenesis of chronic pulmonary heart disease

--Treatment and nursing of chronic pulmonary heart disease

--Treatment and nursing of chronic pulmonary heart disease

--Care of Patients with Chronic Pulmonary Heart Disease

Unit 3 Care of Patients with Respiratory System Diseases (Part Three)

-Chapter 8 Care of Patients with Primary Bronchogenic Carcinoma

--Etiology and pathogenesis of primary bronchogenic carcinoma

--Etiology and pathogenesis of primary bronchogenic carcinoma

--Clinical manifestation and auxiliary examination

--Clinical manifestation and auxiliary examination

--Treatment and nursing of primary bronchogenic carcinoma

--Treatment and nursing of primary bronchogenic carcinoma

--Care of Patients with Primary Bronchogenic Carcinoma

-Chapter 9 Care of Patients with Pleural Effusion

--Etiology, pathogenesis and clinical manifestations

--Etiology, pathogenesis and clinical manifestations

--Treatment and nursing of pleural effusion

--Treatment and nursing of pleural effusion

--Determination of the nature of pleural effusion

--Care of Patients with Pleural Effusion

-Chapter 10 Care of Patients with Respiratory Failure and Acute Respiratory Distress Syndrome

--Etiology and pathogenesis of respiratory failure

--Etiology and pathogenesis of respiratory failure

--Treatment and nursing of respiratory failure patients

--Treatment and nursing of respiratory failure patients

--Care of Patients with Respiratory Failure

--Introduction of acute respiratory distress syndrome

--Introduction of acute respiratory distress syndrome

--Treatment and nursing of acute respiratory distress syndrome

--Treatment and nursing of acute respiratory distress syndrome

--Care of Patients with Respiratory Failure

--Care of Patients with Acute Respiratory Distress Syndrome

-Unit Test: Respiratory System

-Unit Assignment: Respiratory System

Unit 4 Care of Patients with Cardiovascular System Diseases (Part One)

-Chapter 1 Care of Patients with Cardiovascular System Diseases

--Overview of Cardiovascular System

--Overview of Cardiovascular System

--Overview of Cardiovascular System

-Chapter 2 Care of Patients with Heart Failure

--Overview of heart failure

--Overview of heart failure

--Chronic heart failure (1)

--Chronic heart failure (1)

--Chronic heart failure (2)

--Chronic heart failure (2)

--Acute heart failure

--Acute heart failure

--Heart Failure

-Chapter 3 Care of Patients with Arrhythmia

--Overview of arrhythmia

--Overview of arrhythmia

--Sick sinus syndrome

--Sick sinus syndrome

--Supraventricular tachycardia

--Supraventricular tachycardia

--Atrial fibrillation

--Atrial fibrillation

--Ventricular tachycardia

--Ventricular tachycardia

--Atrioventricular block

--Atrioventricular block

--Nursing care of patients with arrhythmia

--Nursing care of patients with arrhythmia

--Cardiac arrhythmia

Unit 5 Care of Patients with Cardiovascular System Diseases (Part Two)

-Chapter 4 Care of Patients with Coronary Artery Disease

--Overview of coronary heart disease

--Overview of coronary heart disease

--Stable angina pectoris

--Stable angina pectoris

--Unstable angina pectoris

--Unstable angina pectoris

--Acute myocardial infarction (1)

--Acute myocardial infarction (1)

--Acute myocardial infarction (2)

--Acute myocardial infarction (2)

--Acute myocardial infarction (3)

--Acute myocardial infarction (3)

--Coronary Artery Disease

--Difference between angina pectoris and myocardial infarction

-Chapter 5 Care of Patients with Hypertension

--Primary hypertension (1)

--Primary hypertension (1)

--Primary hypertension (2)

--Primary hypertension (2)

--Primary hypertension

--Safe nursing for patients with hypertension

-Chapter 6 Care of Patients with Myocardial Diseases

--Myocardial Diseases (1)

--Myocardial Diseases (1)

--Myocardial Diseases (2)

--Myocardial Diseases (2)

--Myocardial Diseases (3)

--Myocardial Diseases (3)

--Myocardial Diseases

-Unit Assignment: Cardiovascular System

Unit 6 Care of Patients with Digestive System Diseases

-Chapter 1 Overview of Digestive System

--Overview of digestive system(I)

--Overview of digestive system(I)

--Overview of digestive system(II)

--Overview of digestive system(II)

--Overview of Digestive System

-Chapter 2 Care of Patients with Peptic Ulcer

--Etiology and clinical manifestation of peptic ulcer

--Etiology and clinical manifestation of peptic ulce

--Treatment and nursing of peptic ulcer

--Treatment and nursing of peptic ulcer

--Recurrence of peptic ulcer

--Care of Patients with Peptic Ulcer

-Chapter 3 Care of Patients with Hepatic Cirrhosis

--Etiology and clinical manifestation of hepatic cirrhosis

--Etiology and clinical manifestation of hepatic cir

--Treatment and nursing of hepatic cirrhosis

--Treatment and nursing of hepatic cirrhosis

--Cirrhosis

--Care of Patients with Hepatic Cirrhosis

-Chapter 4 Care of Patients with Hepatic Encephalopathy

--Etiology and pathogenesis of hepatic encephalopathy

--Etiology and pathogenesis of hepatic encephalopath

--Clinical manifestation,treatment and nursing of hepatic encephalopathy

--Clinical manifestation,treatment and nursing of he

-- Care of Patients with Hepatic Encephalopathy

-Chapter 5 Care of Patients with Upper Gastrointestinal Hemorrhage

--Upper gastrointestinal hemorrhage(I)

--Upper gastrointestinal hemorrhage(I)

--Upper gastrointestinal hemorrhage(II)

--Upper gastrointestinal hemorrhage(II)

--Upper gastrointestinal hemorrhage(Ⅲ)

--Upper gastrointestinal hemorrhage(Ⅲ)

--Upper gastrointestinal hemorrhage

--Care of Patients with Upper Gastrointestinal Hemorrhage

-Unit Test: Digestive System

-Unit Assignment: Digestive System

Unit 7 Care of Patients with Urinary System Diseases

-Chapter 1 Overview of Urinary System

--Overview of Urinary System

--Overview of Urinary System

--Overview of Urinary System

-Chapter 2 Care of Patients with Glomerular Diseases

--Care of Patients with Glomerular Diseases

--Care of Patients with Glomerular Diseases

--Care of Patients with Glomerular Diseases

--Acute Glomerulonephritis

--Acute Glomerulonephritis

-- Acute Glomerulonephritis

-- Rapidly Progressive Glomerulonephritis

--Rapidly Progressive Glomerulonephritis

--Rapidly Progressive Glomerulonephritis

--Chronic Glomerulonephritis

--Chronic Glomerulonephritis

--Chronic Glomerulonephritis

-Chapter 3 Care of Patients with Nephrotic Syndrome

--Nephrotic Syndrome

--Nephrotic Syndrome

--Nephrotic Syndrome

Unit 8 Care of Patients with Urinary System Diseases

-Chapter 4 Care of Patients with Urinary Tract Infection

--Care of Patients with Urinary Tract Infection

--Care of Patients with Urinary Tract Infection

--Care of Patients with Urinary Tract Infection

--Care of Patients with Urinary Tract Infection

--Care of Patients with Urinary Tract Infection

-Chapter 5 Care of Patients with Chronic Renal Failure

--Care of Patients with Chronic Renal Failure

--Care of Patients with Chronic Renal Failure

--Care of Patients with Chronic Renal Failure

--Care of Patients with Chronic Renal Failure

--Care of Patients with Chronic Renal Failure

--Unit Assignment: Urinary System

-Chapter 6 Care of Patients with Systemic Lupus Erythematosus

--Care of Patients with Systemic Lupus Erythematosus

--Care of Patients with Systemic Lupus Erythematosus

--Care of Patients with Systemic Lupus Erythematosus

--Care of Patients with Systemic Lupus Erythematosus

--Care of Patients with Systemic Lupus Erythematosus

--Care of Patients with Systemic Lupus Erythematosus

--Care of Patients with Systemic Lupus Erythematosus

Unit 9 Care of Patients with Hematologic and Hemopoietic System Diseases (Part One)

-Chapter 1 Overview of Hematologic System

--Overview of hemopoietic system diseases (I)

--Overview of hemopoietic system diseases (I)

--Overview of hemopoietic system diseases (II)

--Overview of hemopoietic system diseases (II)

--Overview of hemopoietic system diseases (I)

--Overview of hemopoietic system diseases (II)

-Chapter 2 Overview of Anemia

--Overview of Anemia

--Overview of Anemia

--Overview of Anemia

-Chapter 3 Care of Patients with Iron Deficiency Anemia

--Overview,etiology and pathogenesis,clinical manifestation,auxiliary examination and diagnosis of iron deficiency anemia

--Overview,etiology and pathogenesis,clinical manifestation,auxiliary examination and diagnosis of iron deficiency anemia

--Treatment and nursing of iron deficiency anemia

--Treatment and nursing of iron deficiency anemia

--Nutrition and Anemia

--Iron Deficiency Anemia (I)

--Iron Deficiency Anemia(II)

-Chapter 4 Care of Patients with Aplastic Anemia

--Definition, etiology,clinical manifestation,auxiliary examination and diagnosis of aplastic anemia

--Definition, etiology,clinical manifestation,auxiliary examination and diagnosis of aplastic anemia

--Treatment and nursing of aplastic anemia

--Treatment and nursing of aplastic anemia

--Pancytopenia

--Care of Patients with Aplastic Anemia

-Chapter 5 Care of Patients with Hemolytic Anemia

--Nursing of patients with hemolytic anemia

--Nursing of patients with hemolytic anemia

--Care of Patients with Hemolytic Anemia

Unit 10 Care of Patients with Hematologic and Hemopoietic System Diseases (Part Two)

-Chapter 6 Care of Patients with Hemorrhagic Diseases

--Overview of hemorrhagic diseases

--Overview of hemorrhagic diseases

--Nursing of patients with idiopathic thrombocytopenic purpura

--Nursing of patients with idiopathic thrombocytopenic purpura

--Nursing of patients with anaphylactoid purpura

--Nursing of patients with anaphylactoid purpura

--Overview of hemorrhagic diseases

--Nursing of patients with idiopathic thrombocytopenic purpura

--Nursing of patients with anaphylactoid purpura

-Chapter 7 Care of Patients with Leukemia

--Definition, etiology and classification of leukemia

--Definition, etiology and classification of leukemia

--Definition and clinical manifestation of acute leukemia

--Definition and clinical manifestation of acute leukemia

--Auxiliary examination of acute leukemia

--Auxiliary examination of acute leukemia

--Nursing of acute leukemia(I)

--Nursing of acute leukemia(II)

--Nursing of acute leukemia

--Definition ,clinical manifestation and auxiliary examination of chronic myeloid leukemia

--Definition ,clinical manifestation and auxiliary examination of chronic myeloid leukemia

--Treatment and nursing ofchronic myeloid leukemia

--Treatment and nursing ofchronic myeloid leukemia

--Bone Pain

--Care of Patients with Leukemia

-Chapter 8 Care of Patients with Lymphoma

--Definition ,clinical manifestation, auxiliary examination,treatment and nursing of lymphoma

--Definition ,clinical manifestation, auxiliary examination,treatment and nursing of lymphoma

--Superficial Lymphadenopathy

--Care of Patients with Lymphoma

-Unit Test: Hematologic System

-Unit Assignment: Hematologic System

Unit11 Care of Patients with Endocrine System Diseases and Metabolic Disorders

-Chapter1 Overview of Endocrine ystem

--Overview of Endocrine System

--Overview of Endocrine System

--Overview of Endocrine System

-Chapter2 Care of Patients with Hypercortisolism

--Care of Patients with Hypercortisolism 1

--Care of Patients with Hypercortisolism 1

--Care of Patients with Hypercortisolism 2

--Care of Patients with Hypercortisolism2

--Care of Patients with Hypercortisolism

--Care of Patients with Hypercortisolism

-Chapter3 Care of Patients with Hyperthyroidism

--Care of Patients with Hyperthyroidism 1

--Care of Patients with Hyperthyroidism 1

--Care of Patients with Hyperthyroidism 2

--Care of Patients with Hyperthyroidism 2

--Care of Patients with Hyperthyroidism

--Care of Patients with Hyperthyroidism

-Chapter4 Care of Patients with Diabetes Mellitus

--Care of Patients with Diabetes Mellitus1

--Care of Patients with Diabetes Mellitus 1

--Care of Patients with Diabetes Mellitus2

--Care of Patients with Diabetes Mellitus 2

--Care of Patients with Diabetes Mellitus 3

--Care of Patients with Diabetes Mellitus 3

--Care of Patients with Diabetes Mellitus 4

--Care of Patients with Diabetes Mellitus 4

--Care of Patients with Diabetes Mellitus 5

--Care of Patients with Diabetes Mellitus 5

--Care of Patients with Diabetes Mellitus

--Care of Patients with Diabetes Mellitus

-Unit Review: Endocrine System

--Unit Assignment: Endocrine System

--Unit Test: Endocrine System

Unit 12 Care of Patients with Infectious Diseases (Part One)

-Chapter 1 Overview of Infectious Diseases

--Overview of Infectious Diseases 1

--Overview of Infectious Diseases 1

--Overview of Infectious Diseases 1

--Overview of Infectious Diseases 2

--Overview of Infectious Diseases 2

--Overview of Infectious Diseases 2

--Overview of Infectious Diseases

-Chapter 2 Care of Patients with Viral Hepatitis

--Care of Patients with Viral Hepatitis 1

--Care of Patients with Viral Hepatitis 1

--Care of Patients with Viral Hepatitis 1

--Care of Patients with Viral Hepatitis 2

--Care of Patients with Viral Hepatitis 2

--Care of Patients with Viral Hepatitis 2

--Care of Patients with Viral Hepatitis 3

--Care of Patients with Viral Hepatitis 3

--Care of Patients with Viral Hepatitis 3

--Care of Patients with Viral Hepatitis 4

--Care of Patients with Viral Hepatitis 4

--Care of Patients with Viral Hepatitis 4

--Care of Patients with Viral Hepatitis

-Chapter 3 Care of Patients with Hemorrhagic Fever with Renal Syndrome

--Care of Patients with Hemorrhagic Fever with Renal Syndrome 1

--Care of Patients with Hemorrhagic Fever with Renal Syndrome 1

--Care of Patients with Hemorrhagic Fever with Renal Syndrome 1

--Care of Patients with Hemorrhagic Fever with Renal Syndrome 2

--Care of Patients with Hemorrhagic Fever with Renal Syndrome 2

--Care of Patients with Hemorrhagic Fever with Renal Syndrome 2

-Chapter 4 Care of Patients with Acquired Immune Deficiency Syndrome

--Care of Patients with Acquired Immune Deficiency Syndrome 1

--Care of Patients with Acquired Immune Deficiency Syndrome 1

--Care of Patients with Acquired Immune Deficiency Syndrome 1

--Care of Patients with Acquired Immune Deficiency Syndrome 2

--Care of Patients with Acquired Immune Deficiency Syndrome 2

--Care of Patients with Acquired Immune Deficiency Syndrome 2

-Chapter 5 Care of Patients with Rabies

--Care of Patients with Rabies 1

--Care of Patients with Rabies 1

--Care of Patients with Rabies 1

--Care of Patients with Rabies 2

--Care of Patients with Rabies 2

--Care of Patients with Rabies 2

--Care of Patients with Rabies

Unit 13 Care of Patients with Infectious Diseases (Part Two)

-Chapter 6 Care of Patients with Epidemic Encephalitis B

--Care of Patients with Epidemic Encephalitis B 1

--Care of Patients with Epidemic Encephalitis B 1

--Care of Patients with Epidemic Encephalitis B 2

--Care of Patients with Epidemic Encephalitis B 2

--Care of Patients with Epidemic Encephalitis B

-Chapter 7 Care of Patients with Epidemic Cerebrospinal Meningitis

--Care of Patients with Epidemic Cerebrospinal Meningitis 1

--Care of Patients with Epidemic Cerebrospinal Meningitis 1

--Care of Patients with Epidemic Cerebrospinal Meningitis 2

--Care of Patients with Epidemic Cerebrospinal Meningitis 2

--Care of Patients with Epidemic Cerebrospinal Meningitis

-Chapter 8 Care of Patients with Cholera

--Care of Patients with Cholera

--Care of Patients with Cholera

--Care for patients with cholera

-Chapter 9 Care of Patients with Bacillary Dysentery

--Care of Patients with Bacillary Dysentery

--Care of Patients with Bacillary Dysentery

--Care of Patients with Bacillary Dysentery

-Chapter 10 Care of Patients with Schistosomiasis

--Care of Patients with Schistosomiasis 1

--Care of Patients with Schistosomiasis 1

--Care of Patients with Schistosomiasis 2

--Care of Patients with Schistosomiasis 2

--Care for patients with schistosome

-Chapter 11 Care of Patients with COVID-19

--Care of Patients with COVID-19

--Care of Patients with COVID-19

-Chapter 12 Psychological Coping Modes to the Epidemic of COVID-19

--Psychological Coping Modes to the Epidemic of COVID-19

--Psychological Coping Modes to the Epidemic of COVID-19

-Unit Test: Infectious Diseases

--Unit Test: infective disease

-Unit Assignment: Infectious Diseases

--Unit Assignment: Infectious Diseases

Unit 14 Care of Patients with Nervous System Diseases (Part One)

-Chapter 1 Overview of Nervous System Diseases

--Overview of Nervous System Diseases(I)

--Overview of Nervous System Diseases(I)

--Overview of Nervous System Diseases(I)

--Overview of Nervous System Diseases(II)

--Overview of Nervous System Diseases(II)

--Overview of Nervous System Diseases(II)

-Chapter 2 Care of Patients with Facial Neuritis

--Care of Patients with Facial Neuritis

--Care of Patients with Facial Neuritis

--Care of Patients with Facial Neuritis

-Chapter 3 Care of Patients with Cerebrovascular Diseases (Episode 1)

--Overview of Cerebral Vascular Diseases (I)

--Overview of Cerebral Vascular Diseases (I)

--Overview of Cerebral Vascular Diseases (I)

--Overview of Cerebral Vascular Diseases(II)

--Overview of Cerebral Vascular Diseases(II)

--Overview of Cerebral Vascular Diseases(II)

--Intracerebral Hemorrhage(I)

--Intracerebral Hemorrhage(I)

--Intracerebral Hemorrhage(I)

--Intracerebral Hemorrhage(II)

--Intracerebral Hemorrhage(II)

--Intracerebral Hemorrhage(II)

Unit 15 Care of Patients with Nervous System Diseases (Part Two)

-Chapter 4 Care of Patients with Cerebrovascular Diseases (Episode 2)

--Subarachnoid Hemorrhage

--Subarachnoid Hemorrhage

--Subarachnoid Hemorrhage

--Transient Ischemic Attack

--Transient Ischemic Attack

--Transient Ischemic Attack

--Cerebral Thrombosis(I)

--Cerebral Thrombosis(I)

--Cerebral Thrombosis(I)

--Cerebral Thrombosis(II)

--Cerebral Thrombosis(II)

--Cerebral Thrombosis(II)

-Chapter 5 Care of Patients with Epilepsy

--Care of Patients with Epilepsy(I)

--Care of Patients with Epilepsy(I)

--Care of Patients with Epilepsy(II)

--Care of Patients with Epilepsy(II)

--Care of Patients with Epilepsy

-Chapter 6 Care of Patients with Parkinson Disease

--Care of Patients with Parkinson Disease(I)

--Care of Patients with Parkinson Disease(I)

--Care of Patients with Parkinson Disease(II)

--Care of Patients with Parkinson Disease(II)

--Care of Patients with Parkinson Disease

-Unit Assignment: Nervous System

--Unit Assignment: Nervous System

Care of Patients with COVID-19笔记与讨论

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