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Irinotecan in the treatment of metastatic colorectal cancer and nursing observation

Level medical units, there is no CT, MRI facilities,[link widoczny dla zalogowanych], medical staff carefully refined observation is particularly important. Will observe the results of detailed medical records and timely information in order to make a reasonable deal. 2.1 The vital signs measured every 1 to 2 hours time,[link widoczny dla zalogowanych], if necessary, at any time measurements. If the temperature increased in the present high fever, excessive heat; blood pressure> 180/ll0mg; breathing slow and deep change from the fast, irregular; pulse slow and strong performance of bleeding has not stopped or associated with cerebral edema. 2.2 The general state of consciousness with acute cerebrovascular disease in varying degrees of disturbance of consciousness, must be continuous observation. Early understanding of patients through the interrogation of thinking, reactions, emotional activity, orientation; the same time for pain, pupil size of the reflex, tendon reflex to determine the degree of consciousness. Disturbance of consciousness in patients with cerebral hemorrhage often occurs early and heavy, if after a few hours into the hazy state of lethargy, coma, pupil larvae reduced after the first expansion of L, blood pressure, irregular breathing, you should consider not stop the bleeding. If the patient irritability, contralateral limb was touching the head, frequent vomiting, unequal pupil size on both sides or extremely narrow, there tidal breathing or breathing that has occurred intermittently herniation. * 65.2 .3 If the patient has frequent gastrointestinal bleeding, vomiting, vomit that is dark brown with black stool stress ulcer upper gastrointestinal bleeding. 2.4 after the onset of the disease have some improvement after treatment, the body temperature normal or slightly increased, if the re-emergence of high fever, cough, phlegm, shortness of breath, wheezing, may be complicated by a lung infection. 2.5 Other changes in urine attention, hip skin changes, whether urinary tract infection and bedsores. 3 acute care and incidence of cerebral hemorrhage,[link widoczny dla zalogowanych], patient's condition is characterized by fast but slow recovery. According to the current reality of hospital care is divided into acute and convalescent home care, this article introduces the acute phase of care. 3.1 Students observe the signs: (Qian Wenyi above) 3.2 heat of care: patients with cerebral hemorrhage fever,[link widoczny dla zalogowanych], high fever, bleeding site in the thalamus, cerebral edema, or ventricular compression body temperature regulation center, increased brain hypoxia, the disease progression. Central high fever, antipyretic antipyretic drugs is difficult, so take more physical cooling. Used warm water, alcohol, brush, if necessary, place the ice pack the head. There has to be swallowing the water, and oral care, to prevent concurrent oral infection. 3.3 is absolutely quiet in bed: bed rest of the time there is no uniform standard, the general idea is appropriate for 3 to 4 weeks. Quiet bed rest to prevent further bleeding as an important means, which aims to reduce this chance of a sudden increase of blood pressure. At the same time and pay attention to smooth stool, to prevent defecation hard, dry stools can relax agent. Also to prevent a bad cough, cough feeding can timely to cough agents, analgesic agents and small doses of sedatives to relieve discomfort caused by postural headache or irritability. In short, do everything possible to reduce blood pressure to prevent further bleeding. Disturbance of consciousness were not too deep, often restless, causing increased blood pressure and intravenous drip difficult to maintain. The reason may be due to abdominal distention, bed wet, postural discomfort, cough with sputum is not easy, as long as the elimination of these factors, the patient be quiet. Conscious patients, the biggest threat comes from the spirit of the event, think about yourself too much, and some come to visit family members or units. After the increase in blood pressure often visit, insomnia, not sleep very late, almost a law. Therefore, to strengthen the management of the disease, so that family members, colleagues, patients do not recover before the condition is not conducive to talking about the content, and more comfort to patients. 3.4 keep the airway clear, timely and properly given oxygen inhalation in patients with cerebral hemorrhage is the main pathophysiology of brain cells caused by hypoxia in functional and organic changes. Whether the early onset of coma or oxygen must be timely and correctly, keep the airway open, natural space is conducive to the inhalation of oxygen and artificial oxygen inhalation. Position: Generally taken supine, the neck slightly elevated. Coma in patients with respiratory and oral secretions and more often, accompanied by vomiting and even more often turn their heads to the healthy side, is conducive to discharge secretions or vomit. Many suction secretions in time, can be a sticky one chymotrypsin when inhaled. Cough reflex deep coma, in particular, pulmonary infection associated with a tracheotomy to facilitate breathing possible. Oxygen: conscious patients with early onset, airway, breathing steadily, you can temporarily oxygen; the event of a disturbance of consciousness, respiratory frequency law and the rhythm of change, oxygen must be timely. Oxygen mask oxygen to the best method. But the discharge should be adopted more oxygen sterile catheters, endotracheal intubation, adequate oxygen to protect oxygen inhalation, but not the universal application of more complex operations. Oxygen flow currently using 4 ~ 6L/rain; severe hypoxia, especially those with respiratory failure, central nervous system 6 ~ 8L /
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