The first part of the graduation thesis of traditional Chinese medicine nursing: nursing experience of fumigation therapy in traditional Chinese medicine. In recent years, fumigation therapy of traditional Chinese medicine is a further extension and development of external treatment of traditional Chinese medicine, which uses modern scientific and technological means to apply the effective components of traditional Chinese medicine to the local or whole body in the form of drug vapor ions, so as to achieve the function of relaxing meridians, promoting blood circulation, dredging collaterals and relieving pain. Clinically, it is widely used in connective tissue diseases such as rheumatism, lumbar disc herniation, osteoarthritis, scapulohumeral periarthritis, cervical spondylosis, soft tissue injury, muscle strain, deficiency-cold gastrointestinal diseases, apoplexy sequelae, diabetic peripheral neuropathy and peripheral vascular diseases, gynecological chronic pelvic inflammatory disease, dysmenorrhea, chronic prostatitis, capillary inflammation and Raynaud's disease. Since the implementation of this treatment method in our hospital in 2005, nurses have used nursing procedures to implement individualized nursing and achieved satisfactory results. The nursing experience of 2,892 patients with traditional Chinese medicine fumigation is summarized as follows:
Clinical data of 1
From June 2005 to 10 in 2005 to March 2065,438,2000, there were 2,892 patients in the Department of Integrated Traditional Chinese and Western Medicine in our hospital, the oldest being 78 years old and the youngest being 12 years old, including 352 cases of lumbar disc herniation, 263 cases of rheumatoid arthritis, 487 cases of osteoarthritis and 277 cases of scapulohumeral periarthritis. Cervical spondylosis 125 cases, stroke hemiplegia 130 cases, soft tissue injury 50 cases, deficiency-cold gastroenteritis 76 cases, chronic pelvic inflammatory disease 78 cases, chronic prostatitis 152 cases, diabetic peripheral neuropathy 272 cases, diabetic peripheral angiopathy 232 cases, diabetic peripheral neuropathy and peripheral angiopathy/kloc-0 cases.
Two methods
2. 1 preparation before fumigation treatment in traditional Chinese medicine: ① visit before treatment: after receiving the notice from the ward, the nurse in the fumigation room went to the ward 1 day before treatment to check the patient's condition, talk with the patient and make an appointment for fumigation treatment; (2) fumigation room preparation, routine disinfection, according to the agreed prescription prescribed by the doctor, prepare different fumigation liquid medicines for different patients, prepare sphygmomanometer, stethoscope, warm water, physiological saline and oral rehydration salt.
2.2 Chinese medicine fumigation procedure: add 3000ml of water to the crushed Chinese medicine formula in advance, soak it in a fumigation pot for 30min, and then heat and boil it until the temperature in the fumigation room reaches 45℃. Put the fumigation part of the patient into the fumigation room, adjust the temperature between 45℃ and 52℃ according to the patient's tolerance and illness, and leave it for 30-45 minutes. During fumigation, blood pressure and heart rate 1 were measured according to patients' self-perception.
2.3 Nursing after fumigation of traditional Chinese medicine After the fumigation time of traditional Chinese medicine reaches the set time, when the temperature of the fumigation cabin drops to 37℃, open the cabin, help the patient get out of the cabin, rinse the liquid medicine with warm water, dry the whole body skin with a dry towel, get dressed, rest in the fumigation room for 10-20 minutes, and send the patient back to the ward after the patient shows no signs of sweating all over.
3 indications and contraindications of fumigation with traditional Chinese medicine
3. 1 indications Chinese herbal fumigation is suitable for rheumatic diseases, muscle strain, degenerative joint diseases, lumbar disc herniation, deficiency-cold gastroenteropathy, chronic pelvic inflammatory disease, dysmenorrhea, chronic prostatitis, capillary inflammation, Raynaud's sign and other connective tissue diseases, diabetic peripheral neuropathy and peripheral vascular diseases.
3.2 Contraindications: ① Patients with severe cardiopulmonary dysfunction; ② Patients with purulent dermatosis or skin ulcer ③ Patients with acute inflammation and infectious diseases. 4 Chinese medicine fumigation care precautions
4. 1 psychological counseling should be done before fumigation. Fumigation with traditional Chinese medicine is a traditional therapy that has emerged in recent years. Many patients are anxious or afraid of this treatment. Therefore, before fumigation treatment 1 day, according to the patient's condition, it is necessary to carefully explain the function of fumigation treatment and the safety of fumigation process to patients in order to gain their trust and cooperation.
4.2 Before fumigation, the fumigation cabin should be strictly disinfected to prevent some undiscovered infectious diseases from cross-infection.
4.3 During the first fumigation 1 time, nurses should accompany and communicate with patients to understand their own feelings and prevent skin burns. Generally, the temperature during fumigation should be controlled at the lowest tolerance point of 42℃, and then gradually increase according to the patient's tolerance degree, generally not exceeding 52℃. For patients with hypertension, heart disease and chronic lung disease, the principle is that the whole body is slightly sweaty, and blood pressure and heart rate should be monitored in time to prevent sudden increase of blood pressure and heart rate.
4.4 During fumigation, 250-500ml of normal saline or warm boiled water can be taken orally frequently according to the patient's sweating amount, so as to prevent excessive sweating from causing a sudden drop in blood volume and inducing insufficient blood supply to the heart and brain or even infarction.
4.5 After fumigation, don't let the patient leave the cabin in a hurry, in case the temperature drops suddenly, causing general discomfort or even catching a cold. After leaving the cabin, you should know the patient's self-feeling, monitor blood pressure and heart rate, and compare them with those before entering the cabin to prevent the blood pressure and heart rate from being damaged to the body.
5 discussion
Traditional Chinese medicine fumigation therapy has a wide range of applications, good clinical efficacy, safety and comfort, and is a non-toxic and harmless green therapy. In recent years, this business has been widely carried out in our hospital, and the requirements for nursing process and quality have increased year by year. Through the clinical nursing observation of more than 2800 patients, targeted nursing was carried out from the above aspects. Through the evaluation before and after fumigation treatment, the nursing methods have been continuously summarized and improved for patients with different diseases and patients of different ages. Personalized nursing was given to patients with different cultural levels and psychological qualities, and satisfactory results were achieved, which made great progress in the treatment of Chinese medicine fumigation.
Graduation thesis of TCM nursing Part II: Application of TCM nursing in triage. Traditional Chinese medicine nursing is an applied subject, which is guided by the theory of traditional Chinese medicine, based on nursing procedures, using holistic concepts and traditional nursing techniques and methods to care for patients and people and protect human health [1]. It has rich content and valuable experience in daily life, emotion, diet, health care and prevention. Chinese medicine nursing has the following advantages.
Advantages of 1
The theoretical advantages of 1. 1
Traditional Chinese medicine nursing advocates conditioning patients from the aspects of human body, psychology, spirit and society. It was not until the end of last century that modern medicine changed the biomedical model into biological, psychological and social medical model, emphasizing? Holistic care? I didn't know this concept until today. People? Center. Traditional Chinese medicine nursing meets the needs of prevention, health care, treatment and rehabilitation, so it has always been loved by people. Today, when human beings are most eager to return to nature and enjoy natural life, TCM nursing will surely play an increasingly important role.
Advantages of 1.2 method
There are eight ways to treat diseases in TCM: sweating, vomiting, diarrhea, warming, clearing, eliminating and tonifying. These eight methods point out the treatment direction according to the etiology, symptoms and the location of the disease. In traditional medicine, doctors and nurses are not separated, that is? Three-point medicine, seven-point care? Compared with western medicine nursing, Chinese medicine pays more attention to the coordination of medication time and diet. In terms of non-drug treatment methods, acupuncture, moxibustion, massage, cupping, hot compress, fumigation and washing, picking and cutting, medicated pillow, washing face, foot bath, sunbathing and hot spring bath all belong to traditional Chinese medicine nursing methods. These technologies have the characteristics of simple instrument, convenient operation, wide application range, quick effect, low cost and no toxic and side effects, and are well received by the masses.
Application advantages of 1.3
Easy to understand, simple, participatory and easy to popularize. The convenience and practicability of traditional Chinese medicine nursing are incomparable to other modern nursing, so it has a wider range of uses. Massage, qigong, medicated bath and other methods are easy to master and use; Chinese medicine? Four flavors and five flavors? It is easy to understand and use this theory to classify diet and guide patients to pay attention to diet. Chinese medicine has a very broad application prospect, and some diseases that cannot be effectively controlled by western medicine will have a good curative effect by using Chinese medicine.
2
2. 1 unique diagnosis and treatment technology
Looking, hearing, asking and feeling are the most basic and effective means for Chinese medicine to collect medical history, collect disease data, make diagnosis and implement treatment, and also the most effective way for us to fully understand the patient's condition, accurately reflect the condition and correctly pre-check and triage.
2. 1. 1 Observe the patient's spirit, color, shape, posture, head, facial features and skin. If there are signs of hyperthyroidism, the patient should be referred to the endocrinology department.
2. 1.2 We can judge the depth, deficiency, cold and heat of the affected area according to the patient's voice, the change of breathing sound, cough, vomiting and hiccup, so as to take appropriate nursing methods, give corresponding medication guidance and relieve the pain of patients. For example, hoarseness is referred to the otolaryngology department.
2. 1.3 Ask patients and their families to know their general situation, life, eating habits, family history and past history. According to these data, timely and accurate triage should be carried out, and patients should not be asked or hinted subjectively, so as to avoid inaccurate triage. For example, headache is just a symptom, and many reasons may lead to headache. Therefore, when asking about the medical history, we should understand the cause, nature and law of headache. If it is a persistent headache with progressive aggravation, you should consider arranging neurology for medical treatment. If it is a headache caused by trauma, it may be the sequela of brain injury, which is caused by nerves.
The exam is more suitable. If you have high fever, headache and purulent discharge in your ears, it should be caused by otitis media, and you should be referred to the otolaryngology department for medical treatment.
2. 1.4 When outpatients report palpitation and fatigue, they should feel the pulse to determine whether it is an emergency.
3 diet health care?
Traditional Chinese medicine dietotherapy: refers to the treatment, care and prevention of diseases through diet, including medicated diet, medicated wine, medicated tea, medicated porridge, medicated drink and so on. Dietotherapy is not only beneficial to the treatment and nursing of diseases, but also beneficial to the growth and development of children and the beauty of women. Longevity and anti-aging of middle-aged and elderly people [2]. For example, in Danggui mutton ginger soup, mutton gets ginger, which plays a synergistic role in warming and tonifying, and can treat abdominal pain due to deficiency cold. For example, some patients with hypertension and hyperlipidemia like big fish and big meat. At this time, they should patiently explain the dangers, change their eating habits and enter a light diet. Obese patients should eat light and expectorant foods: thin people should eat more foods that nourish yin, promote fluid production and replenish blood, the elderly and patients with chronic diseases should eat light, nutritious and digestible foods, and pregnant women and lactation period should eat light, nutritious and digestible foods; During the growth and development of children, it is advisable to eat nutritious foods such as cereals, fruits and vegetables; Asthmatics and people with allergies should not eat seafood such as fish and shrimp, as well as some sweet and dry products.
4 basic nursing operation application?
For example, patients with rheumatoid arthritis, dyspepsia and dysmenorrhea can be treated with warm moxibustion according to the doctor's advice, and patients with weak constitution can be taught to massage Zusanli point frequently to play a health care role. Patients with hiccups can stop hiccups by pressing Hegu point.
5 conclusion?
To cultivate the nursing quality of TCM for triage nurses requires caring for patients everywhere, serving patients wholeheartedly, treating triage work carefully, always caring about patients' condition, strengthening the study of TCM theory, implementing the holistic view of harmony between man and nature and the TCM nursing concept of dialectical nursing, so that the theoretical knowledge of Chinese and Western medicine can complement each other and be applied to clinic to benefit patients. ?
Take the exam and contribute.
Li Yuxia, Li Liping. Analysis and discussion on the teaching status of nursing course of traditional Chinese medicine. Qilu Nursing Journal, 2009, 17: 90-9 1.
[2] Ren Juan, Zeng Yuan. Application of traditional Chinese medicine nursing in community hospitals. Xinjiang traditional Chinese medicine, 2009, 5: 5 1-52.
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