发热病人的常规护理.pdf

1/4下载文档可编辑发热病人的常规护理【摘要】发热指产热增多或散热减少，导致体温的升高。发热是一种症状，以感染性发热为多见。非感染性发热常见于血液病，恶性肿瘤、理化因素等。临床上，按照体温的高低把发热发热的分类为：38以下为低热，3839为中热，39 40为高热，40以上为超高热。发热病人如果得不到及时有效的处理，任其发热下去，会给机体造成极大的危害。笔者就自己在临床的工作经验，对发热病人的常规护理作如下总结。【关键字】发热 体温 降温 护理一、降温发热病人应适时降温，同时选择合适的降温方法。常规的降温方法分为物理降温和药物降温，一般首选物理降温。最常用的物理降温方法有酒精擦浴，冰水浴，冰帽等，在行物理降温的时候，降温后30 分钟应复测体温并记录于体温单上。要注意的是，对冷敏感的病人不宜使用任何物理方法降温，因各种冷刺激都会使病人出现寒颤，横纹肌产热增加而影响降温效果。可选用温水擦浴等降温措施。同时，不论采用何种降温方法，都应同时在足心置热水袋，这样减轻脑组织充血，促进散热，增加舒适，尤其是冰敷头部更应重视，降低头部温度可增加脑组织对缺氧的耐受性，减少耗氧量，降低机体代谢率。-第 1 页，共 4 页精品p d f 资料 可编辑资料-2/4下载文档可编辑药物降温可与物理降温同时应用，临床最常用的降温药物一般都是解热镇痛的作用。传统的解热镇痛药物有阿司匹林，扑热息痛（口服）等，而常用于肌注的药物为鲁米那，氨基比林等。在使用此类药物时，应严格按照剂量使用，同时密切观察治疗效果及不良反应。二、病情观察病人发热伊始，经常会伴随寒战、烦燥不安、面色潮红、皮肤发热等症状，同时也可能会出现口渴、头痛、全身不适、胃肠失调等不是。加强病情的观察，有利于及时得到病人的准确信息，对护理工作的开展，医生的用药，病人病情的发展及转归都有极重要的意义。对于发热病人，应密切观察其病情变化。加强生命体征的监测，每 4 小时测量 T、P、R一次，直至体温恢复正常三日后可改可为每日测量二次。注意发热的类型及经过，有无伴随症状，观察发热的原因、治疗效果、饮食、饮水及尿量变化。同时护士应当密切观察其他生命体征变化，如有异常情况，应立即通知医生。三、休息与活动发热病人因体温升高，新陈代谢率增快，消耗多，进食少；体弱，因此应减少活动。特别是高热病人，应绝对卧床休息，低热者可酌情减少活动。评估病人是否穿着过多或被盖过于暖和，指导其正确穿衣或盖被，以利散热。同时病人寒颤时，宜给予保暖，预防感冒。-第 2 页，共 4 页精品p d f 资料 可编辑资料-文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H93/4下载文档可编辑病人休息时注意调节室温和环境，适宜的室温可防止不必要的能量消耗。体温上升期，由于寒颤，室温应稍高些、环境应舒适、安静、避免噪音、直射光线、污染空气与知觉的刺激。病人病情好转时，应鼓励并指导病人下床活动及锻炼，以增强体质，增加病人对疾病的提抗能力。四、营养与水分的补充发热病人由于胃肠活动减弱及消化吸收功能降低，会引起食欲的降低。同时因为分解代谢增加，营养物质的消耗将会大大增加，引起消瘦、衰弱和营养不良。因此，应鼓励病人进食，对不能进食者，必要时用鼻饲补充营养，以弥补代谢之消耗。体温升高可导致机体水分丢失速度加快，应鼓励病人多饮水，必要时，可静脉补充液体、营养物质和电解质等。发热病人的饮食宜清淡，易消化而富营养，多食蔬菜、水果；多饮清凉饮；忌油腻荤、辛辣食品。可给予病人高热量、高维生素、易消化的流质或半流质饮食；病人因消化不良，食欲不振，故应依其饮食爱好，提供美味可口的饮食，并嘱其少量多餐，以增进食欲。发热时鼓励病人每日饮水3000ml以上；对不能进食可按医嘱静脉补液，纠正水电解质紊乱；昏迷病人给予鼻饲流质饮食。病情好转，可逐渐过渡到正常饮食。五、口腔与皮肤的护理-第 3 页，共 4 页精品p d f 资料 可编辑资料-文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 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ZL3I1C10W5H94/4下载文档可编辑发热病人因发热致唾液分泌减少，口腔粘膜干燥，口内食物残渣易发酵致口腔溃疡。故应对不能自行清洁口腔的病人或昏迷病人行口腔护理日三次。口腔护理可在病人晨起、餐后、睡前进行，以保持保持口腔清洁，并减轻口唇干裂、口干、口臭及舌苔等现象。有假牙的应脱出清洁。口唇干裂时，应经常用温水湿润，或涂些油脂。对出汗较多的病人应随时擦汗、及时更换汗湿的衣物、被套、床单，防止受凉。加强皮肤护理，保持皮肤清洁、干燥，对长期卧床者，还应协助翻身，防止并发症的产生。六、心理护理发热可引起的心理反应，如恐惧、紧张、不安，或由于持续高热引起不明确诊断可引起的焦虑，或因住院经济负担过重造成的心理压力，因此要做好心理护理。（学习的目的是增长知识，提高能力，相信一分耕耘一分收获，努力就一定可以获得应有的回报）-第 4 页，共 4 页精品p d f 资料 可编辑资料-文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 HO9Y10M9S6R9 ZL3I1C10W5H9文档编码:CR5A8D4S3A2 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