当前课程知识点:Medical Nursing > Unit 6 Care of Patients with Digestive System Diseases > Chapter 3 Care of Patients with Hepatic Cirrhosis > Treatment and nursing of hepatic cirrhosis
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上节课我们学习了
肝硬化的病因 病理类型
及发病机制
还有肝功能减退和
门静脉高压症的典型表现
如果疾病没有得到有效控制
可能发生一系列严重的并发症
那么大家知道
可能发生哪些并发症吗
首先是上消化道出血
它由食管下段或胃底静脉曲张
破裂出血所致
是肝硬化最常见的并发症
常常在恶心 呕吐 咳嗽 负重等
使腹内压突然升高
或因粗糙食物导致机械损伤的情况下
引起突然的呕血 黑便 贫血 休克
另外 肝性脑病是晚期肝硬化
最严重的并发症
也是肝硬化患者
最常见的死亡原因
通常表现为意识障碍
神经系统表现等
感染也是一个很严重的并发症
由于患者的抵抗力低下
门腔静脉侧支循环
开放等因素
增加了病原体的入侵繁殖机会
容易合并感染并出现发热
腹痛 腹膜刺激征等表现
第四大并发症为肝肾综合征
患者肾脏无明显器质性损害
又称为功能性肾衰竭
是肝硬化终末期最常见的
严重并发症之一
主要临床表现包括
少尿 氮质血症 低钠血症
如果肝硬化患者短期内出现病情迅速恶化
肝脏进行性增大
原因不明的持续性肝区疼痛或者发热
腹水增多且为血性
应该考虑并发原发性肝癌
电解质和酸碱平衡紊乱
也不容忽视
患者出现腹水和其他并发症以后
电解质紊乱趋于明显
常见的有低钠血症 低钾血症 低氯血症等
肝肺综合征是严重肝病
伴肺血管扩张和低氧血症
通气/血流失调
门静脉血栓形成 会出现腹胀
剧烈腹痛 呕血
便血等症状
并且容易诱发肝性脑病
大家要特别注意在这么多的并发症中
最严重的是肝性脑病
最常见的是上消化道出血
辅助检查可以做哪些呢
首先 血常规检查
在代偿期大多都是正常的
失代偿期常常有
不同程度的贫血
肝功能检查
在代偿期正常
或者轻度异常
失代偿期多有异常
还有白蛋白降低
球蛋白增高 胆红素增高
凝血酶原时间延长
免疫功能检查显示
相关肝炎病毒标记物呈阳性反应
腹水检查内容包括
腹水的颜色 比重 蛋白定量 血清
和腹水清蛋白梯度 细胞分类等
影像学检查中 X线检查
显示食道静脉曲张部位呈虫蚀样
或蚯蚓状充盈缺损
纵行黏膜皱襞增宽
胃底静脉曲张部位呈菊花样充盈缺损
超声显影可以显示肝脾的大小
门静脉高压 腹水
CT和MRI检查可以显示肝
脾 肝内静脉 肝静脉
侧支血管形态改变和腹水
上消化道内镜检查
可以观察食管胃底
静脉有无曲张
及其曲张的程度和范围
B超引导下的肝穿刺活组织检查可以作为
代偿期肝硬化诊断的金标准
综上 要诊断肝硬化
除了根据病毒性肝炎
长期饮酒等相关病史
以及肝功能减退
与门静脉高压症的临床表现外 还要
结合实验室肝功能检查结果
目前对于肝硬化 还没有特效的治疗方法
应该重视早期诊断
加强病因的治疗
比如说 乙肝肝硬化的患者
应该进行抗病毒治疗
失代偿期主要是对症治疗
改善肝功能和处理并发症
有手术适应证者
慎重选择时机进行手术治疗
失代偿期肝硬化患者
应强调休息及营养
无肝性脑病等并发症的情况下
应注意加强营养
但有肝性脑病先兆时
应限制蛋白质饮食
防止血氨进一步升高
基础疾病的治疗可同时进行
比如肝炎的抗病毒治疗
血吸虫的驱虫治疗
但对于肝纤维化的治疗
目前尚无确切的治疗药物
腹水的治疗是内科治疗的重点
包括4个要点
第一 限钠限水
氯化钠日摄入量可控制在1.5g以内
如能严格限钠
不必严格限水
但是伴有严重低钠血症
也就是小于125mmol/L的时候
必需严格限水(500ml/d)
第二 利尿剂的使用是目前临床应用最广泛的治疗腹水的方法
常用组合是螺内酯和呋塞米
一开始使用螺内酯60mg/d
加呋塞米20mg/d
逐渐增加至螺内酯120mg/d
加呋塞米40mg/d
第三是提高血浆胶体渗透压
定期输注血浆 新鲜血或白蛋白
难治性腹水指经严格限钠水
及大剂量利尿剂治疗
排除其他因素对利尿剂疗效的影响
或已予纠正时
仍难以消退或很快复发的腹水
对于难治性腹水可以选择大量
放腹水加输注白蛋白
经颈静脉肝内门体分流术等方法进行治疗
万一患者发生了并发症自发性腹膜炎
后果将非常严重
容易诱发肝肾综合征
肝性脑病等严重的并发症
所以需要早期诊断 积极治疗
肝肾综合征缺乏有效的治疗方法
重点在于预防
要去除各种诱发因素
比如出血 感染 电解质和
酸碱失衡 并通过各种方法提高
有效循环血量 使肾血流量增加
可同时使用可能扩张肾血管
增加肾小球滤过率的药物
比如多巴胺
另外 治疗门静脉高压症的
方法有各种分流 断流术以及脾切除术
目的是为了降低门脉系统的压力
和消除脾功能亢进
主要用于食管胃底静脉曲张
破裂大出血
各种治疗无效的时候
或者曲张静脉破裂出血
以后预防再次出血
脾切除术也是治疗脾功能亢进的有效方法
但只能短期降低门静脉的压力
其实肝移植才是
晚期肝硬化最佳的治疗方法
肝硬化的患者
在病程中可能会遇到的护理问题有
营养失调 低于机体需要量
体液过多
潜在并发症有
上消化道出血 肝性脑病
还有皮肤完整性受损的危险 有感染的危险等等
对于主要的护理问题
我们可以进行针对性的护理
对于营养失调 低于机体需要量的问题
我们可以从以下几个方面着手
首先是做好饮食护理
以高热量
高蛋白质 高维生素 易消化饮食为原则
但需要根据病情变化及时调整
比如蛋白质
应选择以豆制品 鸡蛋 鱼为主
但血氨升高时应限制或禁食蛋白质
然后要限制水钠
腹水者低盐或无盐饮食
每天的进水量不超过1000ml
如果伴有低钠血症
应该限制在每天500ml左右
对于一些高钠的食物 比如咸肉
酱菜 酱油 罐头
含钠味精等应该尽量少吃
为了避免损伤曲张静脉
应进食菜泥
肉末 软食等
并且注意要细嚼慢咽 避免坚硬 粗糙的食物
同时也要做好营养支持
必要的时候遵医嘱给予
静脉补充营养
其次也要注意营养状况监测
经常评估患者的饮食和营养状况
对于体液过多的问题
护理重点在于休息和体位
应尽量取平卧位
以增加肝 肾血流量
大量腹水者
取半卧位
阴囊水肿者用托带托起阴囊
以利水肿消退
大量腹水时
避免使腹内压
突然剧增的因素
比如剧烈咳嗽 打喷嚏
同时应该保持大便通畅 避免用力排便
其次是做好皮肤护理
因为患者机体的抵抗力下降
门静脉侧支循环开放
而且长期营养不良 水肿 长期卧床
所以要特别注意
防止感染及压疮的产生
控制钠 水的摄入
就像是前面说到的
饮食护理那样限水限钠
观察腹水和下肢水肿的消长
特别是要注意
准确记录出入量
测量腹围 体重
并教会病人正确的测量和记录方法
遇到有进食不足 呕吐 腹泻等情况的时候
或者遵医嘱利尿
放腹水以后更应该严密观察
做好腹腔穿刺放腹水的护理
应该做好术前
术中 术后的准备
比如术后要敷紧腹带
以免腹内压骤然下降
同时要记录好抽出的腹水的量
性质和颜色
在用药护理方面 使用利尿剂的时候
应该特别注意维持水
电解质和酸碱平衡
利尿的速度也不宜过快
每天体重减轻一般是不超过0.5kg
由于肝硬化的病因 病理类型 营养状况
肝功能代偿的程度
有无并发症等情况比较复杂
所以说患者配合治疗
和护理是非常重要的
同时 肝硬化也是一个慢性的过程
作为护士应该帮助患者和
家属掌握这个疾病的有关知识
对并发症早期预防 早期发现
将治疗计划落实到日常生活当中
从而协助患者控制疾病
我们今天的课到这里结束
下次课程再见
谢谢
-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