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Selection of ideal tidal volume according to pressure-volume curve for instruction of mechanical ventilation nursing

Aimin WANG ; Yunbo SUN ; Yi SHEN ; Yunxia JIANG ; Liping SONG

Chinese Journal of Practical Nursing.2009;25(34):25-27. doi:10.3760/cma.j.issn.1672-7088.2009.12.010

Objective To study the influence of the different tidal volume on hemodynamics,pulmonary ventilation and pulmonary mechanics during mechanical ventilation in patients with acute lung injury.Methods To adopt contrast method,making use of the VIIP +0.196 kPa of P-V curve to decide PEEP,then according to the VUIP of P-V curve,obtaining the three different data of humidity 100%Vt,85% Vt and 70 Vt.At the same time,monitoring the change of static compliance,the changing of hemodynamics and P-V curve.Results 85%Vt group was better than 100%Vt group and 70%Vt group in the heart rates,CVP,PaO_2,the peak airway pressure(PIP) and mean pressure(Pm),Cst,PaO_2/FiO_2.Conclusions When insuring the PEEP data in low inflection point pressure (Pinf) of breathing system P-V curve,and 85% humidity in upper inflection point pressure,which is in accordance with individual protecting breathing strategy.The curative effect is the best for improving static compliance and decreasing the harm of lung injury.The change of pressure-volume curve should be paid attention to in nursing.

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Nursing of patients with AIDS complicated with penicillium marneffei infection

Zhuxin LU

Chinese Journal of Practical Nursing.2009;25(34):14-15. doi:10.3760/cma.j.issn.1672-7088.2009.12.005

Objective To discuss the nursing and experience of patients with AIDS complicated with penicillium marneffei infection.Methods Medicine treatment,medication nursing and psychological nursing were given to 66 patients with AIDS complicated with penicillium marneffei infection through clinical diagnosis,and then the alleviation of clinical symptoms were observed.Results 8 patients abandoned treatment after symptoms improved,13 patients died of multiple organ failure because of their critical condition at admission and complication of drug-resistance bacteria infection.Conclusions Medicine nursing and psychological nursing have pivotal significance for patients with AIDS complicated with penicillium marneffei infection.

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Application of insulation blanket in the esophageal cancer radical surgery

Lijun ZHANG ; Xuyun ZHAO

Chinese Journal of Practical Nursing.2009;25(34):36-37. doi:10.3760/cma.j.issn.1672-7088.2009.12.016

Objective To discuss the application of insulation blanket in the esophageal cancer radical surgery.Methods 40 cases of esophageal carcinoma patients were divided into two groups at random,20 cases involved in the control group (non-use of insulation blankets) and 20 cases in the experimental group (use of thermal insulation blanket).The changes in body temperature of all patients were monitored with nasopharyngeal temperature probe and analyzed in statistics.Results Compared to the control group,the body temperatures of the experimental group were higher.By heating with insulation blanket,the body temperatures were increased obviously in 30 minutes after entering the operation room,but no significant difference appeared at different time points after 30 minutes.Conclusions In radical surgery of esophageal cancer,the use of blanket insulation is an effective way to maintain a constant body temperature of patients and reduce post-operative complications,and promote early recovery of patients.

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Research in effect of oral cavity nursing on senile patients with diabetes mellitus

Yanli YU ; Jidong LI

Chinese Journal of Practical Nursing.2009;25(34):31-32. doi:10.3760/cma.j.issn.1672-7088.2009.12.012

Objective To discuss oral cavity nursing in senile diabetic patients with oral disease.Methods 80 senile diabetic patients were offered diet control and treatment for lowering blood glucose with simultaneous oral nursing for 4 weeks.The blood glucose,blood lipid before and after nursing were observed.Results The total effective rate reached 91.3% after oral nursing,blood glucose and blood lipid greatly lowered after nursing.Conclusions Prevention of oral disease is important for preventing diabetic complications,appropriate oral nursing contributes to prevention and treatment of diabetes mellitus complicated with oral disease.

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Impact of psychological intervention on response and defense style of AIDS patients

Wenna CHEN ; Yunxian LIAO ; Guangxiu WANG ; Yufeng PAN

Chinese Journal of Practical Nursing.2009;25(34):16-17. doi:10.3760/cma.j.issn.1672-7088.2009.12.006

Objective To explore the impact of psychological intervention on response and defense style of AIDS patients.Methods 88 AIDS patients were selected and investigated using medical response (MCMQ) and defense style (DSQ) survey,the scores before and after psychological intervention were compared.Results Mental health problems included fear,afraid,pessimism and worry,the response style included face,avoid,yield.Scores showed significant difference before and after intervention among patients choosing immature-type,mature-type and cover-up defense styles.Conclusions Psychological intervention can promote rehabilitation and health of AIDS patients as well as improve their life quality and prevent disease relapse.

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The suppressing effect of Shenkang 2 on HPA axis of rats model

Qiongxian WEN ; Yanqiang CHEN ; Lin YE

Chinese Journal of Practical Nursing.2009;25(34):12-13. doi:10.3760/cma.j.issn.1672-7088.2009.12.004

Objective To observe the inhibition effect of Shenkang 2 on rats'HPA axis,and provide theoretical basis for clinical application of steroid withdrawal and maintenance in the treatment phase.Methods To built the HPA axis suppression rat model by using high-dose glucocorticoids,when the hormone reduced to low-dose,traditional Chinese medicine Shenkang 2 were administrated.Serum ACTH,cortisol levels,adrenal index,adrenal pathological differences were observed before and after the treatment of Shenkang 2 among the treatment group,hormone control group and normal group.Results Serum ACTH,cortisol and adrenal index slowly recovered after hormone withdrawal in beth treatment group and the hormone control group,serum ACTH,cortisol and adrenal index in the treatment group rebounded faster than that in the control group,the atrophy of fascicular zone of adrenal cortex and cell disarrangement was lighter in the treatment group than that in the control group.Conclusions Shenkang 2 can improve the suppression effect of glucocorticoid-induced HPA axis suppression.

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Research in out-patient individual health education prescription on patients with type-2 diabetes mellitus

Yihua WU ; Xiuping FANG ; Hesheng ZHANG ; Jing WANG

Chinese Journal of Practical Nursing.2009;25(34):1-3. doi:10.3760/cma.j.issn.1672-7088.2009.12.001

Objective To evaluate out-patient individual health education prescription by diabetes nurse specialist on related knowledge of type-2 diabetes mellitus and blood glucose.Then combined with patient satisfaction surveys to explore the intervention value of out-patient individual health education prescription.Methods 100 out-patients with type-2 diabetes mellitus were chosen,and gave them individual health education prescription by evaluate individual condition and existing problems with previous treatment protocol unchanged,the prescription content included individual condition,diet,exercise,medication instructions and disease condition monitoring.The grasp of related knowledge of type-2 diabetes mellitus and satisfaction degree with diabetes nurse specialist were investigated by questionnaires.Results 3 months after individual health education,The grasp of related knowledge of type-2 diabetes mellitus,blood glucose and 2 hours' postprandial blood glucose greatly alleviated.Total satisfaction degree of patients reached 94%.Conclusions Paying attention to individualized instruction and out-patient individual health prescription in prevention and treatment of type-2 diabetes mellitus accords with humanization of nursing service,and is a powerful measure to improve health education quality.

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Control study in 0.45% sodium chloride solution and sterile water for injection in airway humidification of patients with mechanical ventilation

Juan WU ; Qingsheng YOU ; Honglin CHEN ; Yanghui XU ; Xiaoli CUI ; Xiaoqin LIU

Chinese Journal of Practical Nursing.2009;25(34):28-30. doi:10.3760/cma.j.issn.1672-7088.2009.12.011

Objective To observe the two different wetting fluid in airway humidification of patients with mechanical ventilation.Methods 40 patients with mechanical ventilation after cardiac surgery in our hospital from January to April,2009,were divided randomly into group A and group B,group A was given 0.45% sodium chloride solution 100ml plus ambroxol 15mg as airway humidification fluid,group B was given sterile water for injection100 ml plus ambroxol 15mg as airway humidification liquid.The amount of sputum aspiration,color,viscosity,the body temperature of patients,the lungs auscultation and chest X-ray were observed.Results No statistical difference was seen in sputum volume,color,viscosity,the body temperature of patients,lungs auscultation as well as chest X ray after mechanical ventilation for 4 hours,8 hours,16 hours,24 hours,1～2 d,3～5 d,6～7 d.No statistical difference was also seen in auscultation of the lung after mechanical ventilation for 4 hours,16 hours,24 hours,1～2 d,3～5 d,6～7 d.But auscultation of the lung in group B was better than that of group A after mechanical ventilation for 8 hours.Conclusions No sufficient fact can prove that different effect exists between 100 ml 0.45% sodium chloride solution plus ambroxol 15mg and 100 ml sterile water for injection plus ambroxol 15mg as airway humidification fluid during mechanical ventilation.

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The impact of health education on negative mood,social support and life quality of patients with breast cancer

Bo WANG

Chinese Journal of Practical Nursing.2009;25(34):22-24. doi:10.3760/cma.j.issn.1672-7088.2009.12.009

Objective To explore the impact of health education on negative mood,social support and life quality of patients with breast cancer.Methods 90 patients with breast cancer receiving chemotherapy were divided into the observation group and the control group randomly,and each group with 45.The regular health education was given to the control group,and personalized health education was provided to the observation group and their related family member,the measures included mental communication,psychological counseling and life guidance.SAS,SDS,SSRS and QOL were carried out at two time points:the time when admission to hospital and 4 weeks after admission.Results Before health education,there were no statistical significance between the observation group and the control group on anxiety,depression,social support and life quality.After health education,the observation group was better than the control group in scores of anxiety,depression,social support and life quality.Conclusions The health education given simultaneously to the patients and their family members can improve their negative mood,increase their social support,and improve their life quality.

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A survey on the quality of life and symptoms of community patients with advanced cancer

Yingyan CHENG ; Yixin WANG ; Qian LI ; Jie SHEN

Chinese Journal of Practical Nursing.2009;25(34):62-64. doi:10.3760/cma.j.issn.1672-7088.2009.12.033

Objective To investigate the quality of life(QOL) and symptoms of community patients with advanced cancer,and analyze their correlation.Methods 94 advanced cancer patients in 3 communities of Yangpu district in Shanghai were surveyed by self-designed questionnaire,FACT-G and MDASI.The correlation between QOL and symptoms was analyzed.Results QOL of advanced cancer patients was poor,and the main influencing factors were gender,age,stage of cancer,KPS score,marital statusand economic burden.There was significant negative correlation between symptoms and QOL.Fatigue,amnesia,uneasy sleep,insensible feeling,distress and dry mouth were the symptoms patients suffered mostly.Conclusions For patients with advanced cancer,evaluation of the influencing factors of QOL and better control of symptoms could improve their QOL.

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