当前课程知识点:Medical Nursing > Unit 1 Care of Patients with Respiratory System Diseases (Part One) > Chapter 3 Care of Patients with Lung Abscess > Treatment and nursing of lung abscess
同学们好
上节课我们和大家一起学习了肺脓肿的定义
分类 临床表现和诊断方法
大家还记得吗
让我们来回顾一下上堂课的案例
李某 女 42岁 慢性咳嗽
咳浓痰2个月
伴咳血半日入院
上堂课我们已经带着大家解决了第一个问题
这个患者我们首先考虑是何种疾病
怎么进行进一步确诊
那么就在今天的课堂上找第二个问题答案吧
该患者目前存在的主要护理问题有哪些
如何护理
对于肺脓肿的治疗原则是
积极抗感染
加强脓液引流
对于吸入性肺脓肿一般选用青霉素
疗效不佳时可用林可霉素、克林霉素、甲硝唑等
根据病情严重程度决定青霉素剂量
除了抗菌素以外 引流脓液也是十分重要的
引流脓液有利于提高疗效
身体状况较好者可采取体位引流排痰
经纤支镜冲洗和吸引也是有效的方法
对于内科积极治疗3个月以上
脓腔不缩小
疗效不佳时或出现并发症时
可考虑手术治疗
常见的护理问题包括
体温过高 清理呼吸道无效
气体交换受损
营养失调:低于机体需要量
疼痛:胸痛
针对这些护理问题
护士可以采取的护理措施主要分为以下几个方面
首先是一般护理
比如病房的环境清洁
温湿度适宜
保持病室内空气流通
同时注意保暖 注意卧床休息
给予高蛋白 高热量 高维生素饮食
加强营养 提高免疫力
其次是注意观察病情及对症护理
特别是观察
痰液的色 性质 量 气味
正确留取痰标本
并及时做细菌培养
出现血痰时立即报告医生
并密切关注咯血量及有无窒息
对症护理方面 如高热者做好降温处理,
鼓励有效咳嗽 多饮水
咯血者做好咯血护理
保持呼吸道通畅
预防窒息 做好口腔护理 做好体位引流
我们来重点了解一下什么是体位引流 如果进行需要注意些什么
引流前准备
向患者解释体位引流的目的、过程和注意事项
监测生命体征和肺部听诊
以明确病变部位
引流体位
根据病变部位 患者经验
自觉有利于咳痰的体位
采取适当体位
引流体位不宜刻板地执行
必须采用患者能够接受
又利于排痰的体位
原则上
是抬高患者病变肺部位置
引流支气管开口向下
有利于潴留的分泌物
随重力作用流入大支气管和气管排出
引流时间和观察
根据病变部位
病情和患者体力
每天1到3次,每次15到20分钟
一般在餐前引流
引流过程中
应有护士或家人协助
密切观察患者病情变化
如有发现
脸色苍白 发绀 心悸 呼吸困难等异常
应立即停止体位引流
有高血压 心力衰竭严重者 高龄者
禁止体位引流
促进痰液引流的措施
对痰液黏稠者
引流前15分钟先遵医嘱
给予雾化吸入
引流时
以胸部叩击等措施
指导其进行有效咳嗽
以提高引流效果
引流后护理
注意休息 给予清水漱口
去除痰液气味 保持口腔清洁
减少呼吸道感染
观察痰液情况
记录排痰量及性质
必要时送检
复查生命体征和肺部呼吸音及啰音变化
观察引流效果
心理护理方面 对于情绪低落者予以心理指导
鼓励其树立战胜疾病的信心
用药护理方面
遵医嘱给予抗生素 祛痰药
支气管舒张药 给予雾化吸入
最后还应向患者及家属进行多方位全面指导
首先是疾病知识的指导
介绍肺脓肿相关知识
简要给患者和家属介绍本病的发生发展
主要症状特点
临床治疗及护理过程
其次是护理知识指导
叮嘱患者戒烟
避免尘埃与烟雾刺激
不酗酒
保证营养充足
多饮水 预防口腔炎
合理安排休息 避免劳累
维持适宜温湿度
注意保暖 避免受凉
告知患者积极治疗口腔 上呼吸道感染病灶
防止病灶分泌物
吸入下呼吸道
另外就是关于药物治疗方面的宣教
告知患者及家属
本病抗生素治疗耗时较长
8~12周才能治愈
向其讲解抗生素用药的疗程 方法 不良反应
及坚持疗程的重要性
还有一点需要注意的是关于排痰的指导
告知患者清除痰液
对减轻症状预防感染的重要意义
嘱其多饮水
指导其练习深呼吸 采取有效咳嗽咳痰
进行正确的体位引流
通过本节知识点的学习
希望大家能学会肺脓肿患者主要的治疗方式
常见的护理问题以及
护理要点
特别要掌握如何科学进行体位引流
促进患者有效排痰
本次课程到此结束 我们下一节课再见
-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
--Streptococcal 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
-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
-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
-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
--Chronic heart failure (1)
--Chronic heart failure (2)
--Acute heart failure
-Chapter 3 Care of Patients with Arrhythmia
--Overview of arrhythmia
--Sick sinus syndrome
--Supraventricular tachycardia
--Supraventricular tachycardia
--Atrial fibrillation
--Ventricular tachycardia
--Atrioventricular block
--Nursing care of patients with arrhythmia
--Nursing care of patients with arrhythmia
-Chapter 4 Care of Patients with Coronary Artery Disease
--Overview of coronary heart disease
--Overview of coronary heart disease
--Stable 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)
--Difference between angina pectoris and myocardial infarction
-Chapter 5 Care of Patients with Hypertension
--Primary hypertension (1)
--Primary hypertension (2)
--Safe nursing for patients with hypertension
-Chapter 6 Care of Patients with Myocardial Diseases
--Myocardial Diseases (1)
--Myocardial Diseases (2)
--Myocardial Diseases (3)
-Unit Assignment: Cardiovascular System
-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
--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
--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
-Chapter 1 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
-- Rapidly Progressive Glomerulonephritis
--Rapidly Progressive Glomerulonephritis
--Rapidly Progressive Glomerulonephritis
--Chronic Glomerulonephritis
-Chapter 3 Care of Patients with Nephrotic Syndrome
--Nephrotic Syndrome
-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
-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
-Chapter 3 Care of Patients with 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
-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
--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
-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
--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
--Care of Patients with Lymphoma
-Unit Test: Hematologic System
-Unit Assignment: Hematologic System
-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
-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
-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
-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(II)
--Intracerebral Hemorrhage(II)
--Intracerebral Hemorrhage(II)
-Chapter 4 Care of Patients with Cerebrovascular Diseases (Episode 2)
--Subarachnoid Hemorrhage
--Transient Ischemic Attack
--Cerebral Thrombosis(I)
--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