围手术期护理常规

围手术期护理常规 术前护理 1.做好术前护理评估，内容:生命体征、心理状态、营养状况、睡眠情况、家庭支持、教育需求、治疗依从性等。 2.减轻患者焦虑、恐惧心理，指导患者保持良好的心态，正确对待疾病。以达到患者能认清手术治疗的必要性，对手术要达到的目的及可能发生的并发症与意外事项，有一定的心理准备。 3.遵医嘱监测生命体征，及时发现病情变化。 4.手术前协助患者做好各项检查。 5.遵医嘱进行术前药物皮试、配血、备皮等。 6.根据手术种类、方式、部位、范围，术前给予不同的饮食和术前肠道准备。 7.指导病人进行深呼吸锻炼，吸烟者嘱其戒烟，防止或减轻术后呼吸道并发症的发生。术前有肺部感染者遵医嘱应用抗生素。 8.保持病室干净整洁、空气新鲜，减少噪音，创造良好的休息环境。 9.指导患者床上使用大、小便器，以适应排便方式的改变。 10.讲解相关的疾病知识及术后注意事项。 11.术前一日通知患者及家属不要随意离开病房，等待手术医生、麻醉医生的术前签字和手术室护士的访视。 12.术前一日患者因手术紧张而睡眠不佳时，遵医嘱给予安眠药。 13.术前日洗头、剪指甲、更换清洁衣服，术前晚8时加测量体温、plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 脉搏、呼吸，并询问患者有无不适，如患者有体温发热或女患者月经来潮等情况应及时通知医生。 14.嘱患者夜间零时开始禁食水。 手术当日护理 1.术日晨协助患者更衣，取下义齿、手表、首饰等，将贵重物品交给家属保管，带腕带。 2.排空小便，遵医嘱应用术前药物。 3.准备手术需要的病历、放射线片、CT片、MRI片及药品，与手术室人员共同核对，按手术交接单做好交接。 4.参加手术的护理人员严格执行无菌技术操作规程、患者安全核查和消毒隔离 制度 关于办公室下班关闭电源制度矿山事故隐患举报和奖励制度制度下载人事管理制度doc盘点制度下载 ，保障患者安全，严防差错事故。 术后护理 1.做好术后护理评估，内容:手术情况(手术方式、术中出血、输血、麻醉等);神志、生命体征情况;疼痛及症状管理、切口引流情况;自理能力和活动耐受力;营养状况;心理状态;用药情况，药物的作用及副作用; 安全管理 企业安全管理考核细则加油站安全管理机构环境和安全管理程序安全管理考核细则外来器械及植入物管理 。 2.向医师及麻醉师了解手术中病人的情况。 3.术后病人的搬移:尽量平稳，减少振动，注意保护伤口、引流管、输液管，防止滑脱或受污染。 4.卧位:麻醉未清醒者应有专人守护，去枕平卧，头偏向一侧。腰麻、plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 硬膜外麻醉病人术后需平卧6小时，当病人麻醉恢复，血压平稳，腹部手术后一般可取半卧位，头颈部及胸部手术后取半卧位或坐位。 5.遵医嘱给予心电监护，监测生命体征并 记录 混凝土 养护记录下载土方回填监理旁站记录免费下载集备记录下载集备记录下载集备记录下载 ，发现异常及时报告医生，并配合医生进行抢救与治疗。 6.管道护理:保持各种引流管的通畅，经常挤压引流管，防止扭曲、受压、阻塞，妥善固定防止脱落，及时观察引流液的性质和量并记录。 7.观察手术伤口有无渗血、渗液，敷料有无脱落及感染等情况。保持伤口部位的清洁干燥。 8.保持呼吸道通畅，及时清理呼吸道分泌物，遵医嘱给予氧气吸入。 9.术后恢复饮食的时间根据手术的大小及性质决定。 10.遵医嘱给予静脉输液治疗。 11.定时为患者翻身，观察病人的皮肤情况，杜绝压疮的发生。 12.心理护理:祝贺病人手术成功，做好告知与解释工作，消除病人紧张的心理。 13.疼痛的护理:有效控制疼痛，保证足够的睡眠，必要时遵医嘱应用止痛剂等。 14.早期活动:手术后如无禁忌，应鼓励病人床上自主活动，协助翻身、叩背、活动肢体、鼓励深呼吸，病情许可的情况下，可逐渐下床活动，预防静脉血栓的形成。 15.做好基础护理 plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 围手术期技术 规范 编程规范下载gsp规范下载钢格栅规范下载警徽规范下载建设厅规范下载 可在作充分术前准备的同时，选择合适的时间进行手术。 (一)心理准备 1、对疾病的诊断、手术方法、可能发生的并发症及预防措施进行充分的研究探讨。 2、对病人及家属说明手术的重要性、可能取得的效果、手术的风险、可能发生的并发症，以及术后恢复过程和预后，取得病人信任和配合，并在手术同意书上签字。 3、交待病人如何保持良好的心理素质以确保手术成功。 (二)生理准备 1、适应手术后变化的锻炼 ?练习床上大小便。 ?教会病人正确的咳嗽、排痰的方法。 ?术前2周戒烟。 2、纠正水、电解质及酸碱平衡紊乱。 3、备血。 4、胃肠道准备 ?术前12小时禁食水。 ?术前排空大便或灌肠。 ?胃肠道手术，术前1~2天始进流质。 ?结肠或直肠手术，术前2~3天服用肠道制菌药。 plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 5、手术前夜、手术日的准备 ?手术前夜，病人需保证良好的睡眠。 ?如发现病人体温升高、妇女月经来潮，手术应延期。 ?估计手术时间长或实行盆腔手术，应留置导尿管。 ?病人的活动性义齿、手表、戒指、项链等应取下交给家属。 手术后处理 (一)不同手术后体位不同: 颅脑手术:取15-30度的头高脚低斜坡卧位。 颈胸手术:多采用高半坐卧位，有利于呼吸。 腹部手术:多采用低半坐卧位，以降低腹壁切口张力。 脊柱或臀部手术:常采用仰卧位或俯卧位。 (二)活动 术后应尽早活动，并逐步增加活动量和活动范围。 1、 卧床活动: 病人麻醉消失，已清醒后开始，可进行深呼吸运动、有效咳痰、翻身、四肢屈伸运动。 2、 离床活动: 一般在术后2~3天开始。先坐在床沿做深呼吸和咳嗽，再在床旁站立、行走，逐步增加活动范围、次数和时间。 3、 早期活动的优点: 增加肺通气量，减少肺部并发症;促进血液循环，防止静脉血栓形plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 成;促进肠蠕动和膀胱收缩功能恢复，减轻腹胀和尿潴留的发生。 4、 不宜过早下床活动: 骨科特殊固定制动、休克、心衰、严重感染、颅脑手术、开胸术后、 肝修补术后、腹外疝修补及肾脏手术后。 plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 围术期术前处理流程图 plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 围手术期术后处理流程 plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional 围手术期护理应急 预案 社区应急预案下载社区应急预案下载社区应急预案下载应急救援预案下载应急救援预案下载 一、预防措施 1、加强护士基础知识、专科知识培训，护士应熟练掌握各项护理技能操作。 2、对围手术期患者，护士应根据病情和手术的种类进行分阶段(入院阶段、手术前阶段、手术阶段、恢复阶段、出院阶段)健康教育指导。 3、手术护士对手术患者进行严格安全核查，遵守消毒隔离制度。护士应做好心理护理、准备、检查，有计划完成各项治疗和护理。 4、严格执行值班交接班制度，认真交接，密切观察围手术期患者病情变化。 5、急救药品、物品做到“五定一及时”(五定:定数量品种，定点放置，定专人管理，定期消毒灭菌，定期检查维修，一及时:及时维修补充)。 二、应急预案 1、临床护理人员发现患者出现病情变化时，要立即报告医生或 护士长，遵医嘱实施各项抢救护理措施。 2、若患者出现呼吸、心跳骤停，应根据病情配合医生进行胸外心脏按压、气管插管或呼吸机辅助呼吸。 3、若出现术后出血，要观察伤口渗血、引流液性质，并遵医嘱 应用止血药，准备第二次手术。 plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional plug up loopholes in management. The members of the leadership team to in accordance with their respective functions and duties, earnestly implement the good charge range of responsibility for production safety, catch hidden investigation and remediation as current a hard task, personally check, supervise and urge the rectification in place. The county Government to implement to ensure that within the jurisdiction of all walks of life of responsibility for production safety, do not stay dead. The relevant government departments to Kaoshi production safety supervision responsibilities, do a good job in the industry in this field investigation and security risks, have to carry out remediation to ensure safety in production. In view of the existing problems, conscientiously do a good job of inspection work in the industry, do in-depth inspection line to really, inspection of law enforcement should be strict, style of work to hard, rectification measures to be implemented. The industry department in charge of the performance of their duties and major safety hazards investigation remediation to conduct supervision and inspection, of work are not effective, the duty not to implement, through interviews, bulletin, accountability and other measures, Zadok Promoting the implementation of the rectification. The county and the park management committee to earnestly implement the territorial supervision responsibility, bear the overall responsibility for production safety work in the region, to further clarify the government leadership and the leadership of various departments of production safety work responsibility, judged the regional