Weight management

The whole process of hospital nurse care?

The nurses in the hospital generally take care of the able-bodied elderly, because they can’t move, and when they just get sick, their families don’t know how to serve them. Some are all-day, some are overnight, his process is to pick up shit and urine for the elderly in the morning, and then, after washing up, feed the elderly, and prepare for injections after feeding. After injections, if you don’t give injections at noon, continue to take urine halfway through

dermatologist skin care routine

Nursing three-level round process and station?

1. Preparation before ward rounds

1. Preparation of materials:

Medical record holder, thermometer, sphygmomanometer, stethoscope, percussion hammer, flashlight, tongue depressor, watch, record sheet, pen and other related materials

2. The environment is quiet and tidy, the room temperature is suitable, the light is bright, and attention is paid to protecting patient privacy

3. The responsible nurse selects the target of ward rounds for patients with typical conditions, clear diagnosis, and special conditions. Communicate with the patient in advance and obtain the cooperation of the patient. Notify the nursing staff of the department 2-3 days in advance to preview the relevant materials

4. The nurse is neatly dressed and has a kind attitude, and understands the ward round station: the main investigator is on the right side of the patient; the person being investigated is on the left side of the patient; the intern is at the end of the bed

2. Process:

1. Before the ward round, the main inspector will introduce the subject of the ward round and explain the purpose of the ward round.

2. The responsible nurse reports the patient’s condition: including bed number, name, gender, age, chief complaint, date of admission, time, diagnosis, T, P, R, BP and main symptoms and signs, important positive and negative auxiliary examination results, surgery, basic treatment given, etc.

3. Nursing physical examination: All staff go to the ward together, and the responsible nurse conducts nursing physical examination on the patient (in order from top to bottom)

① Ask the patient’s age, etc., measure vital signs at the same time, and understand the patient’s state of consciousness. While measuring vital signs, the patient’s body shape, nutritional status, facial appearance and expression, local skin elasticity, color, temperature and humidity, whether edema, Whether there is any damage, etc. The position of the bedridden patient, the gait of the person who can get out of bed, etc.

② Facial:

a. Eyelid, conjunctiva, sclera, cornea, etc., eye movement (left-upper left-lower left-right-upper right-lower right), pupil size and light reflection

b. Whether the two ears are red and swollen, the external auditory canal, hearing conditions, etc.

c. Nose shape and tenderness

d. Lip color (ruddy and shiny), oral mucosa (smooth and pink), loose teeth, swollen tonsils, special odor in the mouth, etc.

③ Neck:

a. Whether the head can be lifted normally, and whether the neck is stiff

b. Whether the jugular vein is inflamed, and whether the carotid artery can see the pulsation in a quiet state

c. Whether the trachea is located in the middle of the front of the neck

④ Chest:

a. The thorax is oval, with or without abnormal changes

b. Breast skin, color, etc.

c. Percussion whether the lungs are voiceless, auscultation whether there are dry and wet rales, etc.

d. Observe whether the shape of the precardiac area is symmetrical with the corresponding position on the right side, and whether there is any abnormal bulge or depression; palpate whether there is lifting apical beat (left ventricular hypertrophy) and tremor (structural heart disease); percussion is voiced; auscultation There is no abnormal heart sound

⑤ Abdominal signs:

a. Visualization: The abdomen is symmetrical bilaterally, and there is no skin rash on the abdomen, no abdominal wall vein is exposed, and generally no intestinal type and peristaltic waves are seen

b. Auscultation: bowel sounds are 4-5 times per minute, and there is no vascular murmur in the abdomen, and no vibrating water sound on an empty stomach

c. Percussion: Except for the liver, spleen, enlarged bladder and uterus, and the muffled or solid sounds at the lower lumbar muscles of the abdomen on both sides, the percussion of the rest of the abdomen showed drum sounds

d. Palpation: the soft touch of the abdominal wall is easier to depression, does not cause pain when touching pressure, no rebound pain

(6) Observe whether there is edema in the perineum and lower limbs

4. Put forward the patient’s current nursing problems, the nursing and treatment measures taken; put forward the nursing problems that have not been solved at present, that is, the discussion focus of this ward round

5. Discussion:

① The main investigator pointed out the problems of the responsible nurse’s nursing physical examination

② The main investigator closely organized discussions around the patient being checked (missed nursing problems, places where the nursing measures are not implemented properly, problems existing in the patient’s nursing documents, and measures to improve the nursing effect can also be Which, discuss the unresolved nursing problems of the patient: including relevant reasons, corresponding nursing measures, the expected effect of implementing nursing measures, etc.)

6. Summary: Whether the purpose of this round has been achieved, the shortcomings existing in this round: such as preparation, reporting, physical examination, discussion, etc., and put forward the current patient care priorities.

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