1 psychological care: cerebral infarction mostly occurs in middle-aged and elderly people, and the onset is sudden. The patient changed from a normal person to a disabled person in a short time, unable to continue to engage in social work and favorite activities, and needed the care of others in daily life. The emotional characteristics of elderly patients are sadness, loneliness, depression, irritability, irritability, subjective impatience, self-centeredness, especially with aphasia.
More prominent. Be stricter with others. When you think that you will become a burden to others, you often feel abnormal and pessimistic. Therefore, nursing staff should have a high sense of responsibility, be sensible, be emotional, not impatient and not tired of careful nursing. Explain the truth to patients and let them work closely with doctors. Nurses should be closer to patients, ask more questions, comfort and encourage patients, organize their lives patiently and carefully, take different measures according to patients' different ideological activities, educational level, work position and severity of illness, talk with patients sincerely, answer questions, make them consciously cooperate with treatment, and enhance their confidence in overcoming diseases.
2 Nursing care of skewed corners of the mouth: Common diseases in clinic include incomplete eyelid closure, drooping corners of the mouth, inability to wrinkle forehead, closing eyes, protruding cheeks, whistling, etc. Patients often have negative emotions and lose confidence in treatment. Nurses should sympathize with and care for patients and give spiritual encouragement to gain trust and relax their emotions. Diet should be digestible and nutritious liquid or semi-liquid diet. Encourage patients to do more eye, mouth and face exercises and often massage local areas.
3. Early activity training for patients: Early activity can reduce the incidence of pulmonary infection and venous thrombosis of lower limbs, and patients with cerebral infarction can gradually increase their activity for functional exercise after a week of stable condition. Nurses can activate finger blood circulation and stimulate nerve function through massage and passive active exercise, so as to prevent or reduce disuse atrophy of musculoskeletal skin, stretch spasmodic muscles, maintain normal extension of joint ligaments and joints, and prevent joint deformity and contracture. The exercise process should be gradual to avoid overwork.
First, the passive movement of paralyzed limbs: during acute nursing, we should pay attention to putting paralyzed limbs in functional position to prevent limb contracture deformity, and mostly adopt supine position and lateral position. When the patient's condition is stable, the nursing staff can help the patient to move the affected limb first, and often carry out a full range of joint activities, which can prevent joint immobility, tendon atrophy and muscle atrophy, and can effectively prevent the occurrence of heavy feet, heavy wrists and scapulohumeral periarthritis. Instruct and assist them in functional exercise of the affected limb, starting with simple flexion and extension, requiring sufficient, reasonable and moderate activities to avoid damaging muscles and joints, 2 ~ 4 times a day, 5 ~ 30 minutes each time. Patients are required to soak their affected limbs with hot water frequently to promote their blood circulation. Not only the joints of paralyzed limbs, but also the small joints of affected limbs (finger-toe joints).
Second, help patients turn over in bed: help patients maintain good posture during bed rest. Hemiplegic patients often like to lie on the affected side, which is easy to cause limb injury. They should lie on the healthy side, or lie on the affected side or lie on their back. Prone position is a good prone position. Try to make the patient prone 15~20 minutes. When lying prone, be sure to put a soft pillow from the navel to the thigh to stretch the hip joint. And make the affected limb keep functional position, often change position every 2 hours and turn over once.
Third, exercise the affected limb in bed: encourage patients to exercise the affected limb and do various activities, such as elbow flexion and hand movement to the chest. Wipe your face with your hands and practice the flexion and extension of your fingers with a ball. Gradually, the paralyzed limbs can be lifted, and the physical exercise on these beds creates the necessary conditions for standing and walking.
Fourth, practice sit-ups, let patients exercise trunk muscles, and then let people sit up with the bed and sit up independently. After the patient sits on the bed, let him sit on the edge of the bed, make his lower limbs droop and practice his activities, and prepare to stand and walk on the ground.
5. Exercise standing and walking: At first, two people stood with their hands. Later, you can hold the patient alone or hold the bed stall or wall to let the patient stand independently. Only when the patient can stand independently and keep his posture balanced can he start striding. Be careful not to let the patient walk in a hurry, mainly to let the patient experience the feeling of stepping, keep balance, and gradually achieve the purpose of walking by himself. Old people can practice walking with crutches or crutches.
Language training for patients with language disorders: patients with language disorders are more anxious and painful. Nurses should contact patients more, understand their pain, make them happy and eliminate their nervousness. Nurses should help patients to restore their expressive ability and understanding ability as soon as possible, restore the minimum social communication, and establish patients' confidence. Strengthen oral and written pronunciation training. When talking with patients with language barriers, you should have enough time, never rush the patients, talk face to face, make it clear slowly, give patients time to react, reserve patients' needs, reduce the helplessness caused by language barriers, and encourage patients in various ways. When the patient has been named aphasia, encourage him to say the names of commonly used items from time to time to stimulate memory recovery. Nurses should understand patients' inner tension, anxiety and depression, appease patients, and help patients recover their oral English by finding and using effective communication methods.
Maintain emotional stability: most patients with cerebral infarction are related to emotional changes, and nursing staff should take acupuncture treatment.
Publicize and educate the characteristics of patients, so that they should not be too nervous emotionally, attach great importance to their thoughts, guide their emotional changes such as emotions, joys and sorrows to remain within the normal range, always maintain an optimistic mood, love life, devote themselves to life, improve their adaptability to environment and social activities, be good at controlling unpleasant emotions, be open-minded, open-minded, be willing to communicate with people, and be good at establishing good relations with people.