Analysis of clinical nursing methods in cardiovascular medicine Objective: To explore the clinical nursing methods in cardiovascular medicine. Methods: Eighty-four patients with cardiovascular diseases from June 20/kloc-0 to June 20 10 in our hospital were randomly divided into two groups, with 92 cases in each group. Patients in the control group were treated with conventional nursing methods, while patients in the observation group were treated with humanized nursing methods. The clinical nursing effects of the two groups were compared. Results: The nursing satisfaction of patients in the observation group reached 96.74%, while that of patients in the control group was 865,438 0.52%. The nursing satisfaction of patients in the observation group was significantly higher than that in the control group (P
Key words: Cardiovascular Department; Clinical nursing; Nursing methods; Humanized nursing
In order to further explore the clinical nursing methods of cardiovascular medicine, this paper selected 65,438+084 patients with cardiovascular diseases from 2065,438+00 to 2065,438+03 for analysis and research. The specific results are reported as follows.
1 data and methods
The general data of 1. 1 comes from 20 10 to 20 13/84 patients with cardiovascular diseases who were treated in the cardiovascular department of our hospital. Randomly divided into two groups, 92 cases in each group. The control group was given routine care, including 565,438+0 males and 465,438+0 females, aged from 54 to 76 years, including 26 cases of rheumatic heart disease, 42 cases of hypertension and 24 cases of coronary atherosclerotic heart disease. There were 50 males and 42 females in the observation group, aged from 55 to 77 years, including 25 cases of rheumatic heart disease, 465,438+0 cases of hypertension and 26 cases of coronary atherosclerotic heart disease. There is no obvious difference in general data such as sex, age and symptoms between the two groups (P & gt0.05), which can be statistically compared and analyzed.
1.2 Nursing methods The control group was given routine nursing methods, while the observation group was given humanized nursing methods.
1.2.65438+ ② Do necessary skin care to prevent bedsore and other complications or skin infection; (3) Carry out diet care for patients, and pay attention to control their dietary intake and nutritional intake [1]; (4) Strengthen night patrol to prevent patients from falling out of bed and having difficulty breathing at night; ⑤ Take medication care for patients according to the doctor's advice, and it is strictly forbidden to change the type and dosage of drugs at will during the treatment; ⑥ Assist long-term bedridden patients to cough and expectorate, and prevent falling pneumonia.
1.2.2 Patients in the observation group were given humanized care on the basis of routine care. ① Psychological nursing. Because patients don't know their own illness, many patients are pessimistic about the treatment and rehabilitation of their illness, resulting in bad psychology such as depression and anxiety, and even resisting treatment. Therefore, nurses should provide targeted psychological care for patients according to their psychological characteristics, combined with their academic qualifications and living habits, and explain the pathogenesis, treatment methods and matters needing attention in the treatment process to meet patients' psychological needs [2], thus increasing patients' trust in nurses and establishing good psychological relations. ② Strengthen communication with patients [3]. Nurses should often go deep into the ward to communicate with patients, grasp the problems existing in patients through communication, and take corresponding countermeasures to intervene and solve them as soon as possible to improve the treatment and nursing effect; ③ Strengthen health knowledge publicity and education [4]. After the patient is admitted to the hospital, the nursing staff should carry out necessary health education for the patient, so that the patient can understand the characteristics, pathogenesis and common causes of cardiovascular diseases, and correct the living habits of the patient, urge the patient to quit smoking and drinking, so that the patient can develop good living habits and ensure the quality of life of the patient; ④ Discharge nursing. When the patient is discharged from hospital, the nursing staff should give some discharge guidance to the patient according to the patient's recovery, inform the patient and his family about possible problems and treatment methods in the process of treatment and rehabilitation, and inform the patient to go back to the hospital for review regularly. Once you feel unwell in the process of rehabilitation, you should be admitted to the hospital for examination and treatment in time to prevent the condition from getting worse. In addition, nursing staff should also strengthen the follow-up of patients after discharge and solve the problems encountered by patients in the process of rehabilitation in time.
1.3 observation index was used to observe the patients' satisfaction with nursing in the two groups, and the nursing satisfaction scale developed by our hospital was divided into: satisfaction (above 90 points); Basically satisfied (80 ~ 90 points); Not satisfied (below 80 points). Nursing satisfaction = basic satisfaction rate+satisfaction rate.
1.4 statistical methods SPSS 18.0 software was used for statistical analysis, and the counting data was used? 2 test, p
Two results
The satisfaction of nursing care between the two groups was compared. The satisfaction rate of patients in the observation group was 96.74%, and that of patients in the control group was 865,438 0.52%. The comparison between the two groups was statistically significant (P
3 discussion
Cardiovascular disease seriously threatens the health of elderly patients, and its incidence ranks first in China. Besides medical and surgical treatment of cardiovascular diseases, effective nursing intervention can also play an important role in the prognosis and treatment of patients.
Humanized nursing mode is patient-centered, starting from the needs of patients, caring for patients in psychological, physiological and social needs [5]. Through comprehensive and personalized nursing mode, the clinical treatment effect of patients is improved, the pain of patients is alleviated and the quality of life of patients is improved. In addition, the use of humanized nursing can effectively improve patients' satisfaction with nursing, ease the tense nurse-patient relationship, and thus establish a good hospital nursing environment.
Because the treatment and nursing of cardiovascular diseases are complicated, patients need long-term treatment and nursing during hospitalization. Therefore, it is very important to master the necessary nursing methods and adopt effective nursing methods in the nursing process, which can not only get rid of patients' bad mentality and emotions, but also make the nursing work more smooth. In this study, the patients in the observation group adopted humanized nursing, and the patients' satisfaction with nursing reached 96.74%, which fully demonstrated that adopting humanized nursing for patients with cardiovascular diseases can effectively improve the nursing effect, ease the relationship between nurses and patients, and improve the patients' satisfaction with nursing, which is worthy of clinical application.
References:
Ruan, Zhong Hua, Deng Jianfei. Risk Analysis and Countermeasures of Clinical Nursing in Cardiovascular Department [J]. Journal of Clinical Rational Drug Use, 20 1 1, 4 (15): 66-67.
[2] Chen Youchang. Risk Analysis and Countermeasures of Clinical Nursing in Cardiovascular Department [J]. Practical Preventive Medicine, 20 12, 19 (4): 62 1-622.
Ye Xiaohong, Chen Weiqiong, Huang Huixiang. Risk Analysis and Countermeasures of Clinical Nursing in Cardiovascular Department [J]. Clinical Medical Engineering, 2013,20 (6): 733-734.
[4] Cao Yun. Application of quality service in clinical nursing of cardiovascular medicine [J]. China Practical Medicine, 2013,8 (25): 274.
[5] Lv Zongxia, Xu. Risk Analysis and Countermeasures of Clinical Nursing in Cardiovascular Department [J]. China Health Nutrition, 2013,4 (8):1856.
Model II of Cardiovascular Medicine: Observation of Safe Medication for Patients in Cardiovascular Medicine Abstract Objective: To explore and analyze the value of safe medication and clinical nursing according to the clinical characteristics and medication treatment characteristics of patients in Cardiovascular Medicine. Methods: 87 patients with cardiovascular diseases in our hospital were selected as the observation objects. Take targeted measures to nurse the patients' drug reactions, observe and record the adverse drug reactions, sum up the experience of safe medication, and put forward effective measures to deal with the potential safety hazards in nursing medication. Results: Through the observation of drug use in 87 patients, targeted nursing was implemented. Except for 1 patient with hypoglycemia symptoms caused by excessive use of hypoglycemic agents, the other patients did not have obvious adverse reactions during the medication. Conclusion: According to the clinical characteristics of cardiovascular patients, taking targeted medication nursing measures can not only effectively avoid adverse drug reactions, but also improve the service quality of medication nurses, strengthen their concept of safe medication and reduce the occurrence of medical disputes.
Keywords cardiovascular; Safe medication; Drug nursing
China Library Classification Number R473 Document Identification Number A1004-7484 (2013) 09-0474-01
Cardiovascular disease is the most common medical disease in clinic, and there are more and more drugs to treat cardiovascular disease in clinic. However, there may be some incompatibility in the process of combined treatment of different types of drugs. Therefore, doing a good job in clinical medication observation and patient safety nursing during medication can not only ensure medication safety, but also ensure therapeutic effect. By observing the medication safety of 87 patients with cardiovascular diseases, our hospital has taken certain nursing measures and achieved satisfactory results. Drug safety observation and nursing experience are summarized as follows.
Clinical data of 1
Eighty-seven patients with cardiovascular diseases in our hospital from 2011to 20 12 and 12 were selected as the observation objects. Among these 87 patients, there are 54 male patients and 33 female patients, ranging in age from 27 to 69. 5.9 years old. Among the 87 patients, there were 22 cases of hypertension, 65,438+07 cases of coronary heart disease, 65,438+05 cases of type 2 diabetes complicated with hypertension, 65,438+02 cases of chronic rheumatic valvular disease, 65,438+00 cases of cor pulmonale, 7 cases of dilated cardiomyopathy, and the remaining 4 cases were other cardiovascular diseases. During hospitalization, according to the symptoms and clinical manifestations of the above patients, corresponding clinical medication was given. For patients with hypertension, ACE inhibitors combined with long-acting calcium channel blockers are mainly given, and other patients are given diuretics and other drugs according to their condition. When patients with coronary heart disease attack, if angina pectoris symptoms are serious, isosorbide dinitrate and nitroglycerin should be given in time to relieve the pain of patients [1-2]. For patients whose heart rate is 120 beats/min, a certain dose should be given according to the clinical manifestations and the severity of the disease? -Treatment with drugs such as receptor blockers. In the treatment of diabetic patients, sulfonylurea drugs are given to reduce the blood sugar concentration of such patients. In the process of drug administration and treatment for the above patients, the corresponding nursing staff were arranged to care for the above patients, and whether there were any adverse reactions after drug administration was observed. Through the observation and targeted nursing of 87 patients, except for 1 patient who caused hypoglycemia symptoms by increasing the dosage of hypoglycemic agents, the other patients did not have obvious adverse reactions during the medication.
2 medication observation and nursing experience
2. 1 Pre-medication evaluation
Before giving medication guidance to patients, nurses should first prepare for medication according to the actual situation of patients, evaluate the condition according to the doctor's advice, understand the purpose and dosage of treatment, provide special nursing services to high-risk patients, and at the same time understand the use of drugs and check whether there are any drug taboos [3]. For patients with medication disorders, they should communicate with their families in time to help them use drugs reasonably, timely and on the basis, and inform patients and their families not to increase or decrease the dose without authorization.
2.2 Observation and nursing of digitalis drugs
In the process of using digitalis to treat patients with cardiovascular diseases, one of the most commonly used drugs is digoxin, and the clinical dosage of this drug is about 60% of the toxic dose. Therefore, when using this drug to treat patients, nurses must pay attention to controlling the treatment dose to avoid poisoning. At the same time, because the organ function of elderly patients with cardiovascular diseases is worse than that of young or middle-aged patients, factors such as decreased drug tolerance must be considered when nursing such patients, and the dose should be strictly guaranteed to be outside the poisoning range. At the same time, elderly patients should be taught to understand the side effects caused by using such drugs, so as to increase the self-observation ability of elderly patients to adverse reactions and ensure drug safety.
2.3 observation and nursing of safe use of diuretics
Long-term use of diuretics to treat patients with cardiovascular diseases is likely to lead to imbalance of water and electrolyte and acid-base metabolism in patients. Therefore, when nursing staff use this medicine to treat patients according to the doctor's advice, they must closely observe the changes of patients' physical signs after taking it, so as to prevent other complications caused by acid-base imbalance, water-electrolyte metabolism imbalance and so on, further aggravating the patients' condition, which is not conducive to improving the treatment effect. At the same time, the nerve sensitivity of elderly cardiovascular patients will be reduced, so the adverse drug reactions will be delayed to a certain extent. Strengthening the dosage of such drugs without authorization will seriously affect the treatment effect and increase the incidence of adverse reactions. Therefore, nurses should educate patients, explain the side effects of such drugs in detail, enhance patients' awareness of safe drug use, record and understand the occurrence of patients' related adverse symptoms in time, measure patients' urine volume and weight, and make records.
2.4 observation and nursing of safe use of antihypertensive drugs
In the treatment of patients with hypertension, antihypertensive drugs are usually used to avoid hypertension. In the process of using antihypertensive drugs, nursing staff must strictly follow the doctor's advice and can't increase or decrease the dose at will, otherwise it will cause serious adverse reactions and have a relatively adverse impact on the treatment effect. After taking this kind of drugs, nursing staff should closely observe the patient's vital signs, monitor the patient's blood pressure, observe whether the patient has symptoms such as pallor, palpitation and arrhythmia, and inform the patient of precautions and adverse drug reactions. If there are adverse reactions, you should report them to the doctor in time and receive treatment.
2.5 safety observation and nursing care of nitrate drugs
When patients with coronary heart disease have angina pectoris symptoms, it will have a serious adverse impact on their quality of life and physical health. Therefore, nitroglycerin and indomethacin can be given appropriately according to the needs of patients and the degree of illness, and are often treated by sublingual administration or intravenous injection in clinic. However, long-term use of nitrate drugs will produce a certain degree of drug resistance, further reducing the therapeutic effect; Therefore, nurses should pay attention to the interval of medication when giving this kind of drug treatment, and reduce the dose after stopping the drug until it is completely stopped, so as to avoid rebound. At the same time, tell patients not to stop taking drugs without authorization, and should use drugs in strict accordance with the doctor's advice to ensure drug safety.
2.6 Observation and nursing of intravenous infusion.
Patients with cardiovascular diseases will have certain symptoms of liver failure to some extent. So the reserve capacity of the heart is worse than that of other patients. In the process of intravenous infusion, the infusion speed should not be too fast or too much. Patients should be told not to adjust the infusion speed without authorization, and strengthen inspection to prevent adverse reactions caused by too fast infusion.
3 discussion
The main clinical treatment is medication. The safety and accuracy of clinical medication are not only related to the therapeutic effect of patients' diseases, but also related to the safety of patients' lives. Therefore, taking effective measures to avoid medication errors in advance, giving targeted medication care to patients and improving nurses' concept of safe medication can not only effectively reduce the rate of medication errors, but also be one of the effective ways to reduce the incidence of medical disputes.
In the process of medication for patients with cardiovascular diseases, we should give full play to the role of nursing staff in medication to ensure the safety of clinical medication, and take corresponding care according to the types of drugs used by patients, strengthen patrol observation and strengthen the safety of medication for cardiovascular diseases, which can not only ensure the therapeutic effect, but also reduce the occurrence of medical disputes.
To sum up, strengthening the observation of medication safety of patients with cardiovascular diseases and summarizing effective medication nursing measures can not only ensure the treatment effect, but also effectively avoid the phenomenon of medical disputes caused by medication accidents, strengthen nurses' awareness of safe medication and improve the quality of nursing services.
References:
[1] Tu Juanhua, Zhou Juanhua, Cheng Xiaotao. Medication safety and nursing quality management of patients with cardiovascular diseases [J]. Hospital Management Forum, 20 12 (6): 47-48
[2] Chen. Safety management and nursing quality management of cardiovascular internal medicine [J]. Jilin Medicine, 20 10 (30): 5456
[3] Jiang Qian, Luo Yue. Analysis of the problems in the treatment of cardiovascular diseases with combined drugs [J]. China Health Nutrition (next issue): 2012 (7):1752-1752.
Study on Clinical Nursing of Cardiovascular Medicine
Objective: To analyze the nursing of cardiovascular diseases. Methods: 50 patients with cardiovascular diseases were selected as the research object. While treating patients, we should give them humanized care and pay attention to health education, including education on disease awareness, eating habits and rational drug use. Results: According to the two major factors in nursing, the improvement measures were put forward. Conclusion: The characteristics of common cardiovascular diseases were analyzed, and the nursing points were briefly described.
Keywords cardiovascular; Medical diseases; nurse
With the development of society, more and more cardiovascular diseases occur. Cardiovascular diseases, also known as circulatory diseases, are a series of diseases related to the circulatory system. The circulatory system refers to the organs and tissues that transport blood in the human body, mainly including the heart and blood vessels (arteries, veins and microvessels), which can be divided into acute and chronic according to the order of onset, but most of them are related to arteriosclerosis. Common cardiovascular diseases include coronary heart disease, hypertension, angina pectoris and acute myocardial infarction. Cardiovascular disease is a high-risk specialty in hospitals, with various types, complicated causes and rapid changes in conditions. The nursing content becomes heavy and the risks increase. [1] Patients with cardiovascular diseases should be provided with health education, mental and emotional services and nursing besides necessary medical treatment and nursing. This plays an important role in promoting the rehabilitation of hospitalized patients.
1 data and methods
1. 1: 50 General data of patients admitted to the Cardiovascular Department of our hospital from 201to 20 12. There were 29 males and 2 females1person, with an average age of 48 years. There were 23 cases of hypertension, hypotension 1 1 case, and heart failure1case.
1.2 methods: 50 selected patients were investigated by questionnaire to understand the inducing factors of the disease, and corresponding treatment measures were given during clinical treatment. Systematic medical care and targeted health education (knowledge of cardiovascular diseases, rational drug use, establishment of eating habits, regular exercise, etc.) should be given to patients. ) and psychological care, so as to increase their confidence in disease treatment and improve their quality of life.
Results Through medical nursing intervention and prevention and treatment of cardiovascular diseases, patients' medical care knowledge was effectively improved, and the incidence of cardiovascular diseases was clearly understood, which reduced the recurrence rate of diseases. At the same time, patients' self-care consciousness and ability have also been greatly improved.
3 discussion
3. 1 As for the inducing factors of cardiovascular diseases, we know from the questionnaire that there are the following aspects: ① The amount of exercise suddenly increases and the mood changes. Most patients have experienced rapid exercise or mood swings before the onset, which further triggered the occurrence of cardiovascular diseases. ② Climate change. The questionnaire shows that when the climate changes greatly, the outdoor sports and blood circulation of the elderly will be affected to some extent, which will lead to an increase in the incidence of cardiovascular diseases. ③ It can be seen from the accumulation of a large number of clinical data that the increase of cholesterol is an important factor causing atherosclerosis in patients, and the increase of saturated fatty acids can increase the activity of platelets and the formation of thrombus, thus accelerating the process of atherosclerosis and eventually leading to the occurrence of cardiovascular diseases [2].
3.2 Prevention of cardiovascular diseases Cardiovascular diseases are mostly chronic diseases, and the treatment is complicated, which requires different physical conditions of patients. Once acute cardiovascular diseases such as acute myocardial infarction occur, it will often cause serious and irreversible consequences. Therefore, the best treatment for cardiovascular disease is effective prevention before the disease occurs. Yusuf's research found that lifestyle changes and appropriate medication, such as quitting smoking, healthy eating and strengthening exercise, can reduce the risk of myocardial infarction by 80% [3].
3.3 Living Habits In recent years, people's life pressure is getting higher and higher. The life of getting up early and going to bed late every day seriously affects everyone's health and cardiovascular system. In addition, many people are busy with work and have no time to do moderate aerobic exercise, which will lead to cardiovascular diseases.
3.4 Patients' own psychological adjustment Patients with cardiovascular diseases will have a variety of different psychology, and anxiety will make patients sigh every day and be skeptical about the treatment effect; Despair will make patients fear and resist their own diseases; Doubt and opposition will increase the difficulty of treatment and nursing for medical staff because of all kinds of distrust; Stress psychology will cause imbalance and low self-defense function, which will lead to aggravation of the disease [4].
3.5 Regular physical examination Middle-aged and elderly people, obese people with a family history of hyperlipidemia, entertainment people who often smoke and drink, and workers with high mental stress are all high-risk objects of cardiovascular disease, so they need to go to the hospital for regular physical examination to check cardiovascular related indicators such as blood lipid and blood pressure. The best method for early diagnosis of cardiovascular diseases is regular physical examination, which should be kept at least once a year. Once the problem is found, drug or non-drug treatment should be carried out in time to avoid further development and complications.
4 nursing care
4. 1 nursing points of patients with hypertension Among the subjects in this study, 23 patients with hypertension generally have symptoms such as dizziness, dizziness, palpitation, memory loss, irritability, numbness of hands and feet, and most of them are caused by late neurological dysfunction. In addition to hypertension, heart, brain, kidney and other organs will also be damaged in the later stage, ranging from dysfunction to failure. Therefore, it is necessary to intervene and supervise the lifestyle of patients in nursing: ① Pay attention to rest, patients should rest regularly, ensure the quality of sleep, combine work with rest and avoid overwork. 2 diet, avoid high-salt and high-fat foods. Patients consume less than 3 g of salt and 30 g of fat every day, and quit smoking and drinking. (3) Appropriate exercise: keep doing Tai Ji Chuan and jogging 1 h every day, keep your heart rate below 1, 70 times/min during exercise, or sweat slightly to avoid fatigue, and exercise for at least 5 days every week for a long time. ④ Take the medicine strictly according to the doctor's advice, and do not stop using it at will or adjust the dosage privately, and switch to other prescriptions. , and closely observe and record the changes of blood pressure. ⑤ Maintain a relaxed and stable mood, avoid excessive emotional changes, be calm, not impulsive, and be less angry.
4.2 The nursing points of patients with hypotension were 1 1 hypotension, including 5 cases of postural hypotension, 5 cases of symptomatic hypotension and 4 cases of asymptomatic hypotension. When nursing, patients are required to: choose a sleep mode with head high and feet low to increase blood circulation and release renin; Avoid lying for a long time, often change positions, and move gently and slowly; Do not overeat, eat less and eat more meals; Don't use overheated water in the bath to prevent slipping; If you have symptoms such as syncope, lie down on the spot and the medical staff will take rescue measures in time.
4.3 The nursing points of patients with heart failure belong to 16 cardiovascular diseases, and the early symptoms are fatigue, irritability and insomnia [5]. Such patients often suffer from insomnia, asthma or wake up, rapid heartbeat, polyuria and other symptoms when sleeping at night due to insufficient blood supply to the brain. When nursing this kind of patients, we should tell the patients or their families to pay attention to the following points: ① For patients with poor heart function, they should stay in bed or rest in half a bed most of the time. After the situation is stable, you can get out of bed and walk around properly to avoid physical decline, lung infection and lower limb embolism. If the condition is serious, you should stay in bed for a long time to reduce the burden on your heart. ② For patients with obvious shortness of breath, give oxygen bag to assist breathing. When sputum cannot be coughed up, lateral drainage should be adopted appropriately. ③ Strictly control the salt intake not to exceed 3 g per day. A low-salt and digestible diet can reduce the burden on the heart. (4) Smoking and drinking are prohibited, and irritating food should not be eaten. Water should be controlled to avoid edema in the body and increase the burden on the heart. ⑤ Pay close attention to the changes of patients' heart rhythm and heart rate, and measure the heart rate in time if there is atrial fibrillation. When abnormal changes are found in the condition, immediately notify the medical staff to take corresponding treatment measures.
5 discharge guidance before discharge, explain the usage and precautions of exclusive drugs to patients, guide patients to use drugs rationally, and pay attention to timely review and follow-up. Tell patients to keep good habits in diet and life [6].
refer to
[1] Liu Guiling. Analysis of unsafe factors in cardiovascular internal medicine nursing [J]. Journal of Cardiopulmonary Vascular Diseases, 2012,20 (1):152.
[2] Chen Meixian. Cause analysis of cardiovascular disease and experience of internal medicine nursing [J]. Chinese and foreign medical treatment, 20 10, 19: 127.
[3] Yusuf, Hawken, Opal, et al. Influence of potential risk factors related to myocardial infarction in 52 countries (INTERHE ART study): A case-control study [J]. The Lancet, 2004,364 (9438): 937.
[4] Liu Haiying. Prevention and nursing intervention of cardiovascular diseases [J]. Asia-Pacific Traditional Medicine, 2008, 7: 72-73.
[5] Shu-Ping Lin. Analysis of the influence of nursing intervention on the quality of internal medicine nursing [J]. China Medical Innovation, 20 12 (32): 69-70.
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Model essay of cardiovascular internal medicine 4: