Abstract: Hypertension is a common and frequently-occurring disease in middle-aged and elderly people. According to the report of the World Health Organization, the prevalence rate of hypertension in the elderly over 60 years old in China is as high as 39.7%. If not treated in time, it will often lead to stroke, coronary heart disease, myocardial infarction and heart failure, and it will also complicate and promote the damage of target organs such as brain and kidney, and even cause disability or sudden death. With the continuous development of society, people put forward higher requirements for the rehabilitation, diagnosis and nursing of hypertension in the elderly with high incidence. The author analyzes the reasonable nursing methods of clinical nursing for elderly patients with hypertension, and now reports as follows.
Paper Keywords: hypertension; Clinical nursing; Psychological nursing; Nursing countermeasures
1, psychological care, establish good medical ethics.
Create a good environment, strengthen patients' love for life and belief in fighting against diseases, so that patients can recover as soon as possible. Pathogenic factors: overeating, constipation, mental stress, emotional excitement, great joy and great sorrow, anxiety, depression, paranoia, loneliness, depression, etc. , will increase the release of catecholamine in the body, make blood pressure rise, heart rate accelerate, thus aggravating the condition. Patients should maintain emotional balance, give psychological counseling to patients' various ideological concerns, establish a good nurse-patient relationship, enhance trust, and eliminate their worries and paranoia, which will play a positive role in the treatment of hypertension and the occurrence and progress of complications. Explain the relationship between mental factors and disease formation to patients and their families, teach patients to master certain psychological emergency methods, learn self-psychological consultation and adjustment, improve their psychological endurance and maintain a good psychological state. If blood pressure control is not ideal, even complications or other diseases occur, patients often feel pessimistic, disappointed and afraid. Nurses should be honest with each other, have patience and in-depth understanding of patients' inner world, understand patients' pain, give them emotional help such as care and encouragement, so as to eliminate their fragile emotional state, keep their healthy, peaceful and optimistic psychology, eliminate their self-confidence, enable them to actively cooperate with treatment, improve their self-control ability and help them finally overcome the disease.
2. Health knowledge guidance
Strengthen health education, including the risk factors of hypertension, the treatment of complications, medication precautions and adverse reactions. Carry out personalized health knowledge education, demonstrate and guide patients' families, introduce the basic knowledge of hypertension prevention and treatment to patients and their families according to their cultural background, customs and habits, and help them establish a knowledge system related to hypertension, so that patients and their families can fully realize the harm of bad living habits and actively establish scientific living habits. Encourage and guide patients and their families to actively participate in learning, master the skills of self-care, self-care and self-management, achieve self-control of blood pressure, and regularly check the functions of heart, brain, kidney and other organs and fundus conditions. Adhere to long-term rational drug use according to the condition, so as to reduce and delay the occurrence and development of complications, improve patients' ability to maintain their own health and promote the improvement of their quality of life.
3, a reasonable diet, keep the stool unobstructed, prevent constipation.
Reasonable diet is the basis of hypertension treatment, which is of great significance to control the disease and prevent the occurrence and development of its complications. In principle, the diet is light, easy to digest, low in calories, fat and cholesterol, and it is advisable to eat less and eat more meals, mainly with high vitamins. Foods should be diversified, mainly cereals, and coarse grains, freshwater fish, bean products, poultry, lean meat and low-fat milk, such as celery, Chinese cabbage, tomatoes, black fungus, mushrooms, celery, hawthorn, apples, rice and other fresh vegetables and fruits with health care functions, and seafood and foods with high calcium content should be appropriately increased. Avoid overeating, drink plenty of water, quit smoking and limit alcohol, and keep your stool unobstructed.
4. Exercise and rest care
Actively and appropriately participate in aerobic exercise, combine the changes of blood pressure and consciousness symptoms, choose the appropriate exercise mode and intensity, and do what you can. Walking, jogging, playing Tai Ji Chuan, relaxation therapy and other exercise methods can promote blood circulation and enhance the body's disease resistance. According to the patient's own situation and feelings during and after exercise, exercise moderately. For example, obese people can appropriately increase the intensity of exercise. Avoid the abnormal excitement of sympathetic nerve after strenuous exercise, which will lead to a sharp increase in blood pressure and cause cardiovascular and cerebrovascular accidents. In the process of exercise, in addition to strengthening safety awareness, it is best to stay with others to prevent accidents such as bumps and falls. Sympathetic nerve is excited in the morning, and blood pressure fluctuates easily. Therefore, patients should wake up slowly, wake up for a while, and then get up gradually to prevent the sudden drop of blood supply to the brain from causing fainting and falling. First of all, patients can be allowed to do moderate housework and encouraged to participate in social activities, such as cultivating personal hobbies according to their own tastes, such as calligraphy, planting flowers and raising birds. Guide them to make a personalized schedule, have enough sleep time, and keep the balance between exercise and rest.
5, drug care
The principle of medication is: control the dose, slowly lower the blood pressure, and insist on long-term medication, that is, start with a small dose and gradually increase. Because the elderly often suffer from arteriosclerosis of heart, brain, kidney and other organs, the overall circulation regulation function of the body is poor, the overall fluid volume of the body is reduced, and excessive hypotension is prone to occur during treatment, so it is necessary to balance the internal environment of the machine. Therefore, for the elderly patients with hypertension, the drug dosage should start from 1/3 ~ 1/2 of the young and middle-aged patients, and gradually increase the dosage by observing its response, and satisfactory results can be obtained after 2 ~ 3 months. According to the dynamic changes of blood pressure circadian rhythm in elderly patients with hypertension, the best medication time is 6: 00, 14: 00 and 22: 00; At the same time, the mechanism of different antihypertensive drugs was considered. In addition, patients and their families should be informed of the precautions and adverse reactions of drugs taken so as to take corresponding preventive measures. In addition, patients are encouraged to develop their potential, minimize physical pain and psychological pressure, and promote physical and mental health. Even if the blood pressure drops to the normal range, you can't stop taking drugs without authorization. You should get in touch with the doctor in time and ask him to adjust the medication and dosage to prevent the sudden increase of blood pressure after stopping the drug, which will lead to repeated illness. If the blood pressure suddenly changes greatly, it will easily lead to the damage of target organs such as heart, brain and kidney. Patients should be instructed to take medicine according to the doctor's advice.
Step 6 discuss
Hypertension is divided into primary and secondary. WTO standard of hypertension in the elderly: the resting systolic blood pressure ≥140mmhg (1mmhg = 0.133kpa) and/or the diastolic blood pressure ≥90 mmHg in people over 60 years old. Elderly patients with hypertension are important risk factors for common metabolic disorder atherosclerotic cardiovascular and cerebrovascular diseases, and active prevention and treatment of hypertension is an important link in the prevention and treatment of cardiovascular and cerebrovascular diseases. Effective nursing guidance should be given to patients, the inducing factors of hypertension should be avoided as far as possible, and the blood pressure should be better stabilized with clinical treatment to prevent the deterioration of the disease, so as to finally achieve the purpose of health care.
Hypertension is a global chronic disease, and rehabilitation nursing of elderly patients with hypertension is a long-term work. It requires nurses not only to have relevant theoretical knowledge and corresponding clinical experience, but also to play the role of educators, strengthen nurse-patient communication, carry out health education, and promote the early recovery of elderly patients with hypertension. In addition, while taking medicine reasonably, we should also actively treat the primary disease and pay attention to genetic tendency; In addition, guide patients to do daily health care to achieve the best effect. The development of medicine has proved that hypertension is closely related to psychosocial factors besides biological genetic factors. With the improvement of people's living standards, the incidence of hypertension in the elderly is increasing day by day, and China will enter an aging society. Therefore, nursing work should be carried out from patients' physiological, social and psychological aspects, so as to improve patients' self-care awareness, advocate scientific and healthy lifestyle and eating habits, improve diet structure, prevent obesity, advocate abstinence from drinking and smoking, and prevent hypertension from childhood. To control hypertension, we should renew our ideas, change our strategies, establish the concept of putting prevention first and strengthening psychological care, shift the focus of our work from medical care to preventive care and strengthening psychological care, and generally improve people's health knowledge and awareness, so as to achieve the goal of physical and mental health.
The above is the model essay of the opening report of nursing thesis compiled by me, hoping to help everyone.
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