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ОСНОВНОЙ РАЗДЕЛ
UDK 6.617-089
Abduraximova Nodira Maribovna
teacher
Latipova Feruza Jamoldinovna
teacher
Ferghana 1-medical college Uzbekistan, Ferghana city
NURSING CARE IN PATIENTS WHO ARE BEING TREATED
SURGICALLY
Annotation: In this article highlights of nursing care in patients who are being treated surgically and pre-operative and after nursing care. Key words: nursing care, patients, treat, surgical procedure.
Surgical procedure - the patient's tissues and organs treatment the aim is to have a mechanical effect. Implementation term operations: scheduled (from patient admission) and prepare it carefully then one day later). Urgent (patient presentation, minimal preparation) then carried out).
Depending on the type of operation, they are: bloody and bloodless operations divided into two. In the swollen operation, tissue cutting, to stop blood flow from cuttings, tissues suture in the attachment and the nature of the operation it is understood to perform other operations. Translucency operations it does not bleed and does not bleed to do the procedures. Put the bones in place, bone this is the operation of repositioning are included. Especially in all types of operation bleeding operations, postoperative infection prevention, good anesthesia and cutaneous tissue prophylactic measures to prevent severe blood flow the complex will be implemented.
Pre-operative nursing care. Preoperative stage - when an operative procedure is called followed by a series of follow-up studies is a process.
Preoperative Thinking and Training of Patients. Recommendations from the physician on treatment methods and then add additional explanations to the patient go:
- before and after surgery a complete process of social upbringing and treatment and scheduling of other treatments;
- the appearance of pain and suffering observed in the operation level and measures to be taken;
- Postoperative intervention;
- postoperative external and functional changes, measures to be taken;
- Purpose and methods of operation.
Everyone in the hospital is a reception desk about the patient basic information (name, surname, age, patient and close relatives) residence address, referral, (or family doctor's name, surname).
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The patient is explained the hospital order, or a special procedure about a note will be provided. At the Chamber of Surgery the doctors and nurses collect a complete history and record and completely physically on the outpatient card get acquainted with the results of the inspection.
The results of the preoperative inspection of the physician evaluate and, if necessary, additional checks assigns. The nurse's task is to call the patient and the importance of its importance. Patients in written form with physician when necessary the operation is consented. The patient did not lose consciousness or if the child is inaccurate or outbid about the nature, importance, and consequences of the patient and a written consent is obtained from them. Some interference (eg: artificial backpack insertion) the patient and his relatives and the patient are temporary from being restricted from society or becoming completely disabled more detailed Patient as much as possible some of the materials used after the operation (urine, garbage collecting equipment). For example, preoperative exercise for those who have to rely on the sleeve they should try. Patients with colostomy 24 hours during walking, wearing the garbage pad, sitting and lying on the floor need. About the diagnosis of a close relative of a nurse relative information and the nature of the operation to be done should take precautions to correctly understand the consequences.
Spiritual preparation of the operation. First of all, it is the spirit and general condition of the patient Preoperative preparation. The mental state of the patient a great influence on all physiological processes in the body and operation the suspicion that the response to the injury response is there is no place. Operational Preparation is in the Operating Area Determines the recovery feature of the recovery process.
The waiting for the operation causes fear and anxiety in the patient and reduces its power. The conclusion is medical the function of the staff is the result of the operation around the patient creating a sense of trust, the patient's nervousness all negative aspects and prior to the operation stress loss. When the patient's mental emotions are evident, sedative drugs: sodium bromide, bromcamfora, valerian preparations. If it does not help powerful drugs: seductin, relanium, elenium is applied. When sleep fails, sleeping drugs are assigned. The patient has all his own problems and concerns should be encouraged.
- The patient has an understanding of the nature of the operation make sure.
- The patient's specific character, patience, perseverance, self-control, and kindness should take.
- Preparing the patient for interview with anesthesiologist.
Physical training for the operation the patient is inspected in all aspects of the system. Initially, this is the history of the patient's complaints and history data, palpation, abscess, percussion all local status of the clinical investigation and overall objective and general clinical methods of investigation.
Evaluation of the condition of the blood and circulatory system the number of pulses is the total, its tension and its rhythm is determined. Arterial pressure is detected. Blood group and rub compatibility, general blood test, blood coagulation,
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and erythrocyte the rate of drift. If necessary, blood coagulogram, platelet count the number is determined. Evaluation of heart activity for ECG. In addition to these tests, heart attacks specific to evaluate the functional state of the system functional tests are applied.
Mozzar's test: The patient's arterial pressure is then measured. For 25 seconds breathing is recommended and more arterial pressure is measured. The obvious change in the norm will not be. If there is a cardiovascular insufficiency, arterial pressure decreases from the initial value.
Quince Tests: During the day about cardiac activity, urine extracted in comparison with daytime and nighttime diuresis the results are summarized according to the Daytime in a healthy heart the amount of urine is higher than that of the diarrhea, on the contrary. Spirometry for evaluation of respiratory system and the Stange test. Spirometry special apparat - spirometer.
Strange Test: After the patient breathes deeply it breathes in. Hold for 40 seconds the capability of the respiratory tract to get anesthesia is considerable the availability of spare reserves. If you breathe If the holding time is 20 seconds or less, this is the breath lack of system and general anesthesia it is not possible. Surgery and anesthetics during and after the first postoperative period such patients to prevent complications treatment and the need for preventive measures. If necessary, perform a X-ray examination.
Check-in is simple or computer-friendly tomography and UTT. These methods are operated. First, it is possible to get full information about the respiratory organs it provides an initially, oral cavity in the digestion system will be reviewed. Caries teeth, gingivitis and stomatitis when fully detected and treated. Meat and patients with suspected colonic duodenal ulcer it is possible to evaluate the gastric juice properties. The duodenal probe can not only contain the entire duodenum, but the herniation of the herbal fluid, its microscopy allowing you to evaluate. Here are common grass trails, grass bladder and chest pain in the liver. Required X-rays in esophageal, gastric, duodenal ulcer cases endoscopic examination is performed.
These methods allow to determine the location of the pathological furnace with the adjacent organs. Endoscopic examination for histological examination biopsy. Definition of liver function for biochemical testing. Here is the grass in the blood pigments are determined. Determination of bilirubin levels as well as transaminase, alkaline phosphatase, total protein content, prothrombin index, and sugar content the number of other components is determined. When needed X-ray scans are examined. In this case intravenous contrast media and radiographs taken. Cholangiography is the grass inside and outside the liver conjunctions, tumors, scarf structures to help you identify. Verification process with UTT filled up. Laparoscope for instructions.
Laparoscopic examination is performed in the operating room. Local under the anesthesia, the abdominal wall is pierced and then gas is transmitted special equipment - members of the abdominal cavity using laparoscope will be reviewed.
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Bowel Preparation: Before and after Operation 3 hours prior to the surgery will be cleaned. Operation area is cleared from the morning operation area.
The patient took a shower with underarms and bed linen exchange is offered. Operation area is clinically accepted disinfected by the method.
Skin cleansing. Leather skin in the operated area - it is cleaned and is being washed away the objects are removed, the area of operation is poorly dehydrated:
- Washing with soap and toilet and cleaning the skin will be provided.
- Hair removal from the body is removed.
When using the glaze, keep in mind the condition of lower injury and infection so it is very easy to use recommended. Many bacteria in the bone field -and accumulate infectious environment. That's why olive oil contamination and infection need to be eliminated.
Preparing Paths. Purpose of cleaning bowels, aspiration during anesthesia, operation area contamination and postoperative complications (suture open, open, relax). Food and Liquor to give advice about the need to avoid eating need. Accepting intestinal diluent before surgery and the date of the day of sanctions the concept will be given.
Premedication. Succeed in keeping and keeping anesthesia sedatives, tranquilizers, anesthetics, with the help of analgesics and parasympatolytic drugs premedication. Sometimes medicines use breathing, pulse acceleration, fall of the EU and so on vital indicators before and after delivery measuring and monitoring the general condition of the body must be. It is necessary to ensure that the patient is in bed due to orthostatic pressure drop after premedication balance may be corrupted.
Reference:
1. Барыкина Н.В., Зарянская В.Г. Сестринское дело в хирургии. - Ростов-на-Дону: «Феникс», 2010.
2. Yunusjonova Z.S., Mirzayeva S.A., Basitkhanova E.I. Psychological care "National Society of Philosophers of Uzbekistan" - T., 2010.
3. Hamrayev A.J., Khamedova M.A. Surgery. - T: "Teacher", 2009.
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