CN115463149A

CN115463149A - Clinical tumor nursing and treating method

Info

Publication number: CN115463149A
Application number: CN202211083205.1A
Authority: CN
Inventors: 郑潇然
Original assignee: Individual
Current assignee: Individual
Priority date: 2022-09-06
Filing date: 2022-09-06
Publication date: 2022-12-13

Abstract

The invention provides a clinical tumor nursing treatment method, which comprises the following steps: psychological care before admission is carried out, the patient's confidence in treatment is aroused, when the patient is admitted, enthusiasm is received, relevant regulations are introduced, civilized terms are paid attention, the patient feels the care of nursing staff when stepping into a ward, the patient is informed of the illness state in stages according to the condition at the early stage of the illness, a nursing scheme which is in accordance with the characteristics of the patient is formulated, diet of the patient is very important in physiological care, a diet plan which is suitable for the patient is formulated according to different constitutions and generated symptoms of different patients, a proper diet plan is very important for body recovery of the patient, side effects of the medicine on the patient are fully considered in medicine nursing, different patients have different constitutions, the reaction to the side effects of the medicine is also different, and the nursing staff needs to fully know the condition of the patient to carry out optimal nursing on the patient.

Description

Clinical tumor nursing and treating method

Technical Field

The invention relates to the field of tumor treatment and nursing, in particular to a clinical tumor nursing and treating method.

Background

The cell number of each system of the human body is basically in dynamic balance, and when some cells are aged and dead, new cells are generated to maintain the normal operation of tissues and organs. If a group of cells in a body are over-proliferated under various tumorigenic factors, the stable state of cell regulation can be broken, different types of tumors are formed, at present, specific epidemiological data is not available for the occurrence and development of the tumors, but all tumor patients need to receive diagnosis and treatment as soon as possible to control the progress of disease conditions, and the serious damage to the body is avoided as far as possible.

Chemotherapy differs from surgical and radiation therapy in that it is integral in the treatment of the human body, acting systemically through oral and intravenous administration, while cancer, is a local manifestation of systemic disease. The greatest threat to patients is spread and metastasis, and chemotherapy, which is unique to eliminating distant metastasis or preventing recurrence of a certain cancer, is an integral part of cancer treatment methods. Chemotherapy is increasingly used in the treatment of tumors.

The chemotherapy is matched with other treatment methods, so that the treatment effect of malignant tumors is greatly improved, and the spread and the metastasis of cancer are effectively controlled. Chemotherapy is the fastest growing treatment in the treatment of tumors in recent years. However, chemotherapy drugs are usually "unclear" and "indistinct," and when killing tumor cells, also kill normal cells of the human body, and the chemotherapy may have toxic effects and adverse reactions.

Disclosure of Invention

The invention aims to design a clinical tumor nursing and treating method which is carried out by combining three aspects of psychological nursing, physiological nursing, drug nursing and the like to optimally nurse a patient.

In order to achieve the purpose of the invention, the invention adopts the technical scheme that: a clinical tumor nursing treatment method is characterized by comprising the following steps:

(1) Psychological care before admission is carried out, the patient's confidence in treatment is aroused, when the patient is admitted, the patient receives treatment in enthusiasm, and relevant regulations are introduced, civilized terms are noticed, so that the patient feels the care of nursing staff when stepping into a ward, and at the early stage of illness, the patient is informed of the illness state in stages according to the situation, and a care scheme which accords with the characteristics of the patient is formulated;

(2) Nausea and vomiting can be performed by adopting fasting or administration before sleeping, fasting is performed for several hours before treatment, used chemotherapeutics stimulate gastric mucosa, sodium bicarbonate, aluminum hydroxide gel and the like can be simultaneously administered, a patient with heavy mental burden and fear is gradually required to be nourished into a small amount of dinning and chewing habits, light and fluid diet such as apple juice, orange juice, tea and the like is selected, the patient is prevented from eating sweet, greasy, spicy and smelly food, the patient is properly scattered before and after meals, vomiting occurs when lying on the bed, the patient is required to gargle after vomiting, the amount and the nature of the vomiting are required to be recorded, a small amount of vomit is retained for laboratory examination if necessary, for the patient who frequently vomits, liquid is required to be supplemented, and intravenous infusion is required to maintain the balance of water and electrolytes if the patient has continuous vomiting or jet vomiting, a doctor is required to be informed in time;

(3) The appetite is reduced, the negative emotion is overcome, the special importance of dietary nutrition is clearly known, a strong patient can use the food to be refreshed, in order to ensure that enough nutrition is taken, the planned completion of quantification is realized, the food consumption is reduced, the food consumption is increased, the frequency is increased, the burden of the patient on taking food every time is reduced, and the food which the patient likes is selected, and the sweet food is eaten less;

(4) When abdominal pain and diarrhea occur, and the patient has digestive tract symptoms such as abdominal pain and diarrhea, the following care should be taken: observing the nature and frequency of abdominal pain and diarrhea, causing mucosal necrosis and detachment due to severe toxic reaction, so as to cause perforation, if abnormal conditions exist, defecating is difficult to check, soft food, little residue, low fiber and non-irritating food are taken, food easy to generate gas is avoided, attention is paid to diet sanitation, perineum skin is kept clean, warm water is used for washing after defecation, the perineum skin is lightly stained dry, and zinc oxide ointment can be locally coated;

(5) Constipation, constipation is accompanied by symptoms such as anorexia and abdominal distension, and the following nursing contents should be paid attention to and exercise should be properly performed: under the condition that the patient's state of an illness allows, can assist the patient to leave the bed and move, go to the lavatory regularly: according to the past defecation habits, even if the defecation is not satisfactory, the people should go to the toilet on time to induce defecation, eat more fresh vegetables,

Fruits and coarse food grains encourage more drinking water, if defecation does not occur in 3 days, laxatives can be used, the liquid paraffin can be taken orally by 30 milliliters for 3 times in 1 day, enema can also be used, and when the defecation is dry, oil can be used for retention enema to soften the defecation and promote the defecation, or a nurse or a family nursing at the side can wear gloves to manually defecate;

(6) The prevention measures of the dental ulcer, before chemotherapy begins, broken teeth and residual roots in the oral cavity are removed, non-irritating diet is eaten, too hard, too coarse, too cold, too hot and spicy food is prevented from being eaten during chemotherapy, oral mucosa is prevented from being damaged, oral hygiene is paid attention to, the oral cavity is cleaned by tooth brushing and gargling after meals and before sleeping every day, if tooth brushing is painful, a cotton swab is used for dipping 60% of hydrogen peroxide, teeth are lightly scrubbed, or a plurality of drops of lemon juice are dripped in glycerin sold in a pharmacy, the cotton swab is used for dipping the oral cavity to scrub the oral cavity, the oral ulcer pain influences swallowing and eating of a patient, 2% lidocaine is used for spraying or is prepared into suspension for gargling, the stimulation of smoke and wine is forbidden, if the oral mucosa has white spots and is infected by mildew, the oral cavity stops using antibiotics, the oral cavity can gargle 3% -6% of soda water, and the anti-poison medicine is applied according to the advice of a doctor;

(7) Dysphagia is caused by inflammation and swelling caused by stimulation of chemotherapy drugs on mucous membranes of throat parts or esophagus parts, or mechanical obstruction of esophagus, paralysis of nerve muscles governing swallowing functions and the like, and the following nursing needs to be carried out: according to the etiology and degree of obstruction of a patient, different dietary measures are adopted to keep the oral cavity and the esophagus clean and fed, the patient needs to take a sitting position and sit upright, when the patient chews food, the patient chews the throat carefully without worrying, other people can not urge the patient, the patient can be reheated when the patient is cool, reasonable and enough nutrition is not guaranteed in the whole chemotherapy process, a treatment plan cannot be smoothly implemented, and the principle of selecting food is as follows: the high-calorie, high-vitamin and low-fat light diet can ensure that patients with chemotherapy have severe inappetence and frequent vomiting, and can timely carry out intravenous nutrition or essential diet in hospital to ensure water electrolyte balance and nutrition supply.

As an improvement, the psychological nursing before hospitalization is used for making a nursing scheme which accords with the characteristics of the psychological nursing before hospitalization, taking corresponding psychological nursing according to the difference of tumor patients in knowledge culture, personal quality and the like, and taking nursing and protecting measures for patients with lower culture level and weak psychological bearing capacity: the true condition of the patient is hidden, especially when talking with them, the patient needs to be enthusiastic and patience, and the fear of the patient is relieved in the aspect of spiritual

The feeling helps build confidence, simultaneously avoids the opportunity of knowing the state of an illness of a patient as much as possible, prevents the patient from having low emotion, loses confidence in treatment, carries out tentative communication on some patients with higher cultural nourishment and lively and optimistic characters first, and uses related medical knowledge and psychological guidance to communicate with the patients when knowing that the state of an illness is known.

As an improvement, the food which avoids eating the gas easily generated is sweet potato, corn, sorghum, beans, sugar, cabbage, cucumber, garlic, green pepper, no soda water and the like.

The invention has the beneficial effects that: the clinical tumor nursing and treating method is carried out in three aspects of psychological nursing, physiological nursing, drug nursing and the like in the process of chemical therapy tumor nursing, in the psychological nursing, the psychological pressure of a patient is relieved as much as possible, the anxiety emotion is overcome, the psychological condition is kept positive and upward, the recovery of the disease condition is facilitated, in the physiological nursing, the diet of the patient is very important, a diet plan which is suitable for different patients with different constitutions and the generated diseases is made, the proper diet plan is very important for the physical recovery of the patient, in the drug nursing, the side effect of the drug on the patient is fully considered, different patients have different constitutions, the reaction to the side effect of the drug is also different, and the nursing staff needs to fully know the condition of the patient and carry out the optimal nursing on the patient.

Detailed Description

The present invention is illustrated below by way of specific examples, which are not intended to be limiting.

A clinical oncology care treatment method, comprising the steps of:

psychological nursing before admission, arousing the patient's confidence in treatment, receiving the patient's enthusiasm when the patient is admitted, and paying attention to civilized terms when the patient is introduced to the patient, so that the patient can feel the care of the nursing staff when stepping into the ward. At the early stage of the disease, the patient should be informed in stages according to the situation, and a nursing scheme conforming to the characteristics of the patient is formulated.

The method comprises the following steps of performing psychological nursing before admission, formulating a nursing scheme according with the characteristics of the patient, taking corresponding psychological nursing according to the difference of the tumor patient in knowledge culture, personal quality and the like, and taking nursing and protecting measures for the patient with lower culture level and weak psychological bearing capacity: from which the true phase of the condition is concealed, especially in relation to them

When talking, they need to be enthusiastic and have patience.

The fear of the patient is relieved in the aspect of spirit, the patient is helped to build confidence, meanwhile, the patient is prevented from having the opportunity of knowing the state of an illness as far as possible, the patient is prevented from having low emotion, the confidence of treatment is lost, certain patients with higher cultural nourishment and lively and optimistic characters are firstly subjected to tentative communication, and when knowing that the patient knows the state of an illness, the patient is communicated with the patient by related medical knowledge and psychological guidance.

Nausea, vomiting, nausea and vomiting are common clinically, most patients have normal reactions, the nausea and vomiting generally disappear after taking the medicine out of the way, in order to relieve the reactions, the medicine can be taken before fasting or sleeping, the patients are fasted for several hours before treatment, the used chemotherapy medicine stimulates gastric mucosa, and baking soda, aluminum hydroxide gel and the like can be simultaneously given to the chemotherapy medicine, so that the gastric mucosa can be protected, thought worry is relieved, a small amount of habits of having more meals and chewing slow pharynx are gradually met for the patients with heavy mental burden and fear, and light and watery diets such as apple juice, orange juice, tea water and the like are selected, and the foods with excessive sweetness, greasiness, pungency and unpleasant smell are avoided.

When the patient is in bed with vomiting before or after meals, the patient should lie on his side to prevent vomit from being sucked into the trachea by mistake, after vomiting, the patient should be assisted to gargle, and the amount and nature of vomiting should be noted, a small amount of vomit should be left for laboratory test and examination if necessary, for the patient who vomits frequently, the patient should be noted to supplement liquid, and if necessary, the patient should be given intravenous transfusion to maintain the balance of water and electrolyte, and if the patient vomits continuously or vomits by jetting, the doctor should be informed in time.

Anorexia, which is a condition that patients often feel a feeling of being full after meals, even anorexia, although they eat little food, is caused by a direct relationship with the mood of the patients, mainly stress and anxiety, and may be related to gastrointestinal dysfunction, irritation of medication, lack of activity, constipation, and food intake. Efforts should be made to do the following: the method overcomes negative emotion, definitely recognizes the special importance of dietary nutrition, is an important means for ensuring that treatment is smoothly carried out and the resistance of a human body is not reduced, and can be used by strong patients to play spirit.

In order to ensure that enough nutrition is taken, the quantitative intake is planned, the food consumption is reduced, the food consumption is increased, the frequency is increased, the burden of the patient on eating each time can be reduced, and the food which the patient likes is selected

The sweet food can promote appetite, and is less in consumption, less in consumption because the sweet food is easy to produce acid and gas, less in consumption because of being not easy to digest because of not being easy to eat greasy and fried food.

When abdominal pain and diarrhea occur, and the patient has digestive tract symptoms such as abdominal pain and diarrhea, the following care should be taken: attention is paid to observe the nature and frequency of abdominal pain and diarrhea, mucous membrane necrosis and abscission can be caused due to severe toxic reaction, perforation can be caused, if abnormal conditions exist, defecation is difficult to check, soft food, little residue, low fiber and nonirritant food are required to be eaten, the food which is easy to generate gas is prevented from being eaten, corn, sorghum, beans, sugar, cabbage, cucumber, garlic, green pepper, soda water and the like are not drunk, attention is paid to drinking sanitation, gastrointestinal tract infection is prevented, and much water is drunk to supplement water lost by diarrhea.

Can be used for intravenous transfusion to avoid imbalance of water and electrolyte, keep perineum skin clean, clean with warm water after defecation, lightly dry to avoid skin injury, and topically apply zinc oxide ointment to prevent skin around anus from being corroded.

Constipation, constipation is accompanied by symptoms such as anorexia and abdominal distension, and is caused by a variety of reasons such as a lack of food intake, a too fine and delicate food, a lack of cellulose, lack of activity, use of anesthetic, and mental stress, and the following care should be paid to the proper exercise: under the condition that the patient's state of an illness allows, can assist the patient to leave the bed and move about, so not only can increase the wriggling of gastrointestinal tract, but also can adjust mood, disperse nervous mood, improve the atmosphere of life, regularly go to the lavatory: according to the past defecation habits, even if the user does not have the defecation habit, the user can go to the toilet on time to induce defecation.

Experience proves that the method helps to prevent constipation, fresh vegetables, fruits and coarse food grains are eaten more, drinking water is encouraged to be drunk more, 200 ml of white boiled water is drunk particularly in the morning, the white boiled water is preferably cold, the body is not suitable for slightly high temperature, the intestinal tract can be effectively lubricated, if defecation does not occur in 3 days, a laxative is used, 30 ml of liquid paraffin can be used for oral administration for 1 day and 3 times, enema can also be used, and when the defecation is dry, oil can be used for retention enema to soften the excrement and promote the defecation, or manual defecation is carried out by nurses or family members who care at the sides of the body wearing gloves.

The prevention measures of the oral ulcer are to clear broken teeth and residual roots in the oral cavity before chemotherapy begins, which is very easy to cause

The most accepted food is rice porridge, oatmeal porridge, vegetable paste, milk and egg paste, dried meat floss, ice cream and the like, if solid food can be eaten, soft food or boiled food can be selected, food which is too hard, too coarse, too cold, too hot and spicy can be prevented from being eaten during chemotherapy, oral mucosa can be prevented from being damaged, oral hygiene is paid attention to, and teeth are brushed and gargled every day after meals and before sleeping.

If the teeth are brushed to be painful, a cotton swab is dipped in 60% hydrogen peroxide to lightly scrub the teeth, or a plurality of drops of lemon juice are dripped into glycerin sold in a pharmacy, the cotton swab is dipped in the glycerin to scrub the oral cavity, the lemon juice can be moistened and protect oral mucosa, careful oral care and long-term balanced nutrition are realized, the healing of oral ulcer and the pain of the oral ulcer are facilitated, the swallowing and eating of a patient are influenced, 2% lidocaine can be sprayed, or suspension gargling is prepared, the stimulation of smoke and wine is forbidden, if the oral mucosa has white spots and mycotic infection, most of the results of long-term application of antibiotics are obtained, the oral cavity can contain 3% -6% of soda water while the use of the antibiotics is stopped, and anti-toxic bacteria medicines are applied in the oral cavity according to the advice.

Dysphagia, the mucous membrane of the throat or the esophagus part is stimulated by chemotherapy drugs to cause inflammation and swelling, or the esophagus has mechanical obstruction, the neuromuscular paralysis which governs the swallowing function and the like cause the dysphagia, which not only brings great pain to patients, but also influences the intake of nutrition, and the following nursing needs to be carried out: according to the etiology and the degree of obstruction of a patient, different dietary measures are adopted to keep the patient to take a sitting position and sit upright when the patient takes clean food in the oral cavity and the esophagus, when the patient chews food, the patient chews the throat carefully without hurting, other people can not urge the patient, the patient can be heated again when the patient is cool, and various nursing contents of the oral ulcer are needed to be referred to for nursing the oral ulcer.

During the whole chemotherapy process, without reasonable and sufficient nutrition guarantee, the treatment plan cannot be smoothly implemented, so that the diet care cannot be ignored no matter in a hospital or at home, and the principle of selecting food is as follows: the high-calorie, high-vitamin and low-fat light diet can stimulate appetite by paying attention to increase the taste, such as sweetness, sourness and the like, reduce nausea, vomiting and inappetence caused by chemotherapy, and patients who suffer from chemotherapy such as extreme inappetence and frequent vomiting can timely carry out intravenous nutrition or essential diet in hospital to ensure the water electrolyte balance and the supply of nutrition.

The above description is only a preferred embodiment of the present invention, but the scope of the present invention is not limited thereto

Therefore, any person skilled in the art should be able to substitute or change the technical solution of the present invention and its inventive concept within the technical scope of the present invention.

Claims

1. A clinical tumor nursing treatment method is characterized by comprising the following steps:

(2) Nausea and vomiting can be taken on an empty stomach or before sleeping, fasting is carried out for a few hours before treatment, the used chemotherapeutic drugs stimulate gastric mucosa, sodium bicarbonate, aluminum hydroxide gel and the like can be simultaneously given, a small amount of multi-meal and a habit of chewing the throat, light liquid diet such as apple juice, orange juice, tea and the like is gradually developed for patients with heavy mental burden and fear, the patients are prevented from eating sweet, greasy, spicy and smelly food, the patients are properly scattered before and after meals, vomiting occurs when lying in bed, the patients are required to lie on the side, gargle after vomiting, the amount and the nature of the vomiting are required to be noticed, a small amount of vomit is required to be kept for laboratory examination, for the patients with frequent vomiting, liquid is required to be supplemented, intravenous infusion is required to maintain the balance of water and electrolyte, and if the patients suffer from continuous vomiting or jet vomiting, doctors are required to be timely notified;

(4) When abdominal pain and diarrhea occur, and patients have digestive tract symptoms such as abdominal pain and diarrhea, the following care should be paid: observing the nature and frequency of abdominal pain and diarrhea, causing mucosa necrosis and detachment due to severe toxic reaction to cause perforation, if abnormal conditions exist, keeping defecating difficult to check, taking soft food, little residue, low fiber and non-irritating food, avoiding eating food easy to generate gas, paying attention to diet sanitation, keeping perineum skin clean, cleaning with warm water after defecation, slightly drying, and locally coating zinc oxide ointment;

(5) Constipation is accompanied by symptoms such as anorexia and abdominal distension, and the following nursing contents should be paid attention to and exercise should be carried out appropriately: under the condition that the patient's state of an illness allows, can assist the patient to leave the bed and move, go to the lavatory regularly:

according to the past defecation habits, even if no defecation is done, the toilet is timely accessed to induce defecation, fresh vegetables, fruits and coarse grains are eaten more, water drinking is encouraged more, if no defecation occurs in 3 days, a laxative is used, 30 milliliters of liquid paraffin can be used for oral administration for 3 times per day, enema can also be used, and when the defecation is dry, oil can be used for retention enema to soften the excrement and promote the defecation, or the nurse or the family nursing at the side wears gloves to manually defecate;

(7) Dysphagia, inflammation and swelling caused by stimulation of chemotherapy drugs on mucous membranes of the throat or the esophagus part, or mechanical obstruction of the esophagus, paralysis of neuromuscular innervating swallowing function and the like cause dysphagia, and the following care should be carried out: according to the etiology and degree that the patient drew, the patient should take the seat and sit upright when adopting different diet measures to keep oral cavity, esophagus clean and eat, when chewing food, chews slowly the pharynx carefully, need not worry, and other people can not urge the patient, can heat again when cool, in the process of whole chemotherapy, does not have reasonable sufficient nutrition to guarantee, will not implement treatment plan smoothly, and the principle of selecting food is: the high-calorie, high-vitamin and low-fat light diet can ensure that patients with chemotherapy have severe inappetence and frequent vomiting, and can timely carry out intravenous nutrition or essential diet in hospital to ensure water electrolyte balance and nutrition supply.

2. The method as claimed in claim 1, wherein the pre-hospitalization psychological care is performed by making a care plan according to its own characteristics, and taking a corresponding psychological care according to the difference of the oncology patients in knowledge culture, personal quality, etc., for a lower level of culture and psychological tolerance

Weak patients take care protective measures: the true state of the disease condition is concealed, particularly when talking with the patient, the patient needs to be enthusiastic and careful and patiently endured, the fear of the patient is relieved in the aspect of spirit, the patient is helped to build confidence, meanwhile, the patient needs to be prevented from having the opportunity of knowing the disease condition as much as possible, the patient is prevented from having low emotion, the patient loses confidence in treatment, certain patients with higher cultural fostering and lively and optimistic characters firstly carry out tentative communication, and when knowing that the patient knows the disease condition, the patient uses related medical knowledge and psychological guidance to communicate with the patient.

3. The clinical oncology nursing treatment method according to claim 1, wherein the food avoiding eating the gas easily generated is sweet potato, corn, sorghum, beans, sugar, cabbage, cucumber, garlic, green pepper, no-drinking soda water, etc.