護(hù)理查房(肺氣腫)-2

1、thriftofexcellenttraditionalstylelackdeepofunderstingonesidedthinkinnowofgoodsituationXiaeconomicsmoothmefastdevelopmentrefmmademajprogresspeoplelivingsignificantlyimprovesocialthecareermadenewprogressnonecessaryalwaysha

2、rdhasnoawarenesstoChinaalsohasmanypovertyareaalsohasmanypovertypopulationofexistsmelivingimprovehasmeneedkeephardofstyle.Threeisnotstrictlyhonest.Totalthoughtunitsisawatersectcleanselfdisciplineawayfromhimselftoofarnorea

3、lprocessinggoodlivingofimprovehardthriftexcellenttraditionalofrelationshipnoeffectivedocomplywithConstitutionpartyofregulationsmustfromIdoupnorightmercygoodbitterLewealthofrelationshipnorightawarenesstoincomplywithConsti

4、tutionpartyofregulationsaspectseveryonehasaccountability.Fourfuturedirectionimprovementmeasures1belieffaithstrengthenpartyspirit.Oneistofirmlyestablishthenobleidealsofstruggleftheidealsofcommunismcommuniststruggleflifere

5、adytosacrificeeverythingfthepartythepeople.SecondistocontinuouslyimprovethequalitystardofpoliticalconscientiouslystudyDengXiaopingthey“threerepresents“imptantthoughtthescientificOutlookondevelopmentimplementthepartysbasi

6、cprogramftheprimarystageofsocialismadheretothecrectpoliticalientationmaintainhighlyconsistentwiththeCPCCentralCommitteeisgoodattheiesofsocialismwithChineseacteristicstoanalyzesolveproblems.Thirdstrengtheningthepartyspiri

7、tthewldtransfmationperseveranceofthepartyConstitutionrelivePartyvowstoestablishcrectwldOutlookOutlookonlifethewldpracticallyembodiesidealsbeliefsintoactioncombineloftyidealspracticalactivitiestransfmingtheobjectivewldact

8、ivelyparticipateinthegreatpracticeofbuildingsocialismwithChineseacteristics.2keepthepurposeinconceptchangingthestyleofwk.Firstkeepinmindthatthepurposeofservingadheretoassumingpowerfthepeoplekeepinmindthepeoplecareaboutpe

9、oplethejoyssrowsofthemasses...AccdingtocitydisciplinemunicipalganizationDepartmentrequirementstodayweheld“implementimplementationindependentCommissionagainstcruptionguidelineseffectivestrengtheningledcadresstyleconstruct

10、ion“topicdemocraticlifemaintaskisclosecontactthoughtwkactualcontrolcheckdistrictStingCommitteeteamthepersonalinimplementationindependentCommissionagainstcruptionguidelinesShangexistsofproblemindepthcarriedoutcriticismsel

11、fcriticalfurtherclearrectificationdirectionmeasureseffectiveenhancedcleanpoliticsofconsciousnessinitiativefirmsetgoodofrulingimage.Befethemeetingthewaywetakesurveyssolicitedaviewscombedrelatedtoteambuildingprojectwkcadre

12、scadresionotheraspectsofatotalof19furtherdefinedthedirectionofrectificationenhancingthepertinenceeffectivenessofdemocraticlife.GoodfthismeetingwerequestedtheStingCommitteeofthemunicipalpartyCommitteemunicipalSecretaryGen

13、eralTangWenjintheCityCommissionfdisciplineinspectionStingCommitteeYangXuJiangJixueDeputyDirectofthepersonnelofficeotherleadingcomradespresentguidanceallowsustowarmapplauseftheirwelcomethanks!BelowIfirstDistrictCommitteem

14、emberofthe20XXteamannualdemocraticmeetingimplementationofthecrectivemeasuresaswellasmemberoftheteamofmyownreptguidelinesftheimplementationoftheindependentCommissionagainstcruptionstatementinvitedleaderscomradescriticism.

15、Firstannualpartyonthe20XXteamMemberofdemocraticlifeactionplanimplementationyear20XXdistrictdemocraticmeetingamemberoftheteamon“studypracticethescientificOutlookondevelopment“themefindaprojectsupptingstrongenoughtheindust

16、rywellenoughurbanconstructionmanagementlevelneedstobeimprovedlivelihoodimprovementneedstobestrengtheneddistrictteamitselfsuchasthefiveaspects.Yearof20XXwefindouttheproblemsmentionedabovebasedonactualShunqingconstructiond

17、evelopmentconscientiouslysumupimprovementsachievingsignificantdevelopmentresultseffectivenessoftheirwk.(A)highlighttheprojecthlemaintainhighgrowthofinvestment.AdheretothestrategyasaFoundationcarryingoutprojectstopromotei

18、ncreasedstaminaimptant.Oneistoincreasetheintensityofprojectstowards.Activelyseeknationalprovincialpolicysupptsuperispecialtransferpaymentsavarietyofadditionalincomewilltop700millionYuananumberofkeyinfrastructureprojectsl

19、ivelihoodprojectsindustrialprojectsintothecage.Secondincreasingtheprojectattracts.Thisyearatotalof23signedamajprojectofwhich14billionprojectChinaMetallurgicalgroupvankegroupGuangdonghengdagroupTaiwanRuentexgroupontheRIgr

20、oupShenzhenKaisajifengagriculturalmachineryMercedesBenzAudi4SsteotherlargeenterprisesprojectshavesettledinShunqing.Thirdstrengthenprojectconstruction.Annualimplementationfocusproject39afixedassetsinvestmenttotalwillbreak

21、through12billionyuancreateddistrictyilaihistyhighSouthdodamfiveinshopoldcitytransfmationYingChinaindustrialconcentrateddistrictconstructioncitymainroadconstructionNtheaststeamTradeCentermodernfarmersindustryParkvocationa

22、leducationcitylowrentalalsoroomconstructionfeaturesblocksbuildfarmersmarkettransfmation“ruralversion“Streettransfmationfocusengineeringspeedupimplementationeffectivenessobviously.ExpectedtobeachievedthisyearareawideGDP17

23、billion護(hù)理查房——肺氣腫護(hù)理評(píng)估護(hù)理評(píng)估基本資料醫(yī)院華東醫(yī)院科別呼吸內(nèi)科病室新12樓姓名葛維寶性別男年齡58歲住院號(hào)床號(hào)71208民族漢婚姻史已婚文化程度大專職業(yè)職工宗教信仰無(wú)家庭地址江蘇省江都市聯(lián)系人馬高榮聯(lián)系電話入院診斷左肺社區(qū)獲得性肺炎過(guò)敏史青霉素過(guò)敏入院日期2012081209:00入院方式門診步行一般資料生命體征：T37℃P86次分R20次分BP13070mmHg身高178cm體重75kg神智：■清楚□淡漠□嗜睡□煩躁

24、□昏迷體型：■一般□肥胖□消瘦□惡病質(zhì)皮膚：■正?！醍惓函彛骸跤小鰺o(wú)語(yǔ)言：■正?！跽Z(yǔ)言障礙□不能評(píng)論心理狀態(tài)：■開(kāi)朗□欣快□恐懼□焦慮□痛苦□壓抑□緊張吸煙：■不吸□吸煙□戒煙呼吸狀態(tài)：■平穩(wěn)□不規(guī)則□氣促□困難□端坐呼吸呼吸道癥狀：■無(wú)咳嗽□咳痰□咯血口腔黏膜：■正?！跗茡p□潰瘍□發(fā)疹排尿形態(tài)：■正?！跄蝾l□尿急□尿痛□少尿□夜尿增多□尿液潴留□失禁□留置導(dǎo)尿排便形態(tài)：■正?！醣忝亍跏Ы醺篂a□造口睡眠形態(tài)：■正?！跏摺踺o助睡眠飲

25、食形態(tài)：■普食□半流質(zhì)□流質(zhì)□禁食□特殊飲食對(duì)疾病的認(rèn)識(shí)：■認(rèn)識(shí)□不理解□隱瞞安全評(píng)估及應(yīng)對(duì)措施活動(dòng)障礙：■無(wú)□全癱□截癱□偏癱自理能力：■自理□協(xié)助□完全依賴認(rèn)知感覺(jué)（視覺(jué)）：■正?！踅暋踹h(yuǎn)視□弱視（聽(tīng)覺(jué)）：■正?！跞跻暋跏斒孢m程度：■無(wú)不適□稍不適□疼痛思維：■正?！趸靵y□注意力分散□記憶力下降□不能評(píng)估順應(yīng)性：■配合□一般□差□不聽(tīng)從過(guò)去一年曾經(jīng)跌倒：■無(wú)□1次□2次□3次防范意外傷：■宣教□環(huán)境（床位地面照明）□陪護(hù)□床欄□

26、約束帶□警示牌簡(jiǎn)要病史簡(jiǎn)要病史主訴：反復(fù)咳嗽、咳痰、氣促三十余年、發(fā)熱一天現(xiàn)病史：患者20余歲起有反復(fù)發(fā)作性氣喘，當(dāng)時(shí)診斷為“支氣管哮喘”，發(fā)作時(shí)氨茶堿治療科好轉(zhuǎn)。后癥狀逐漸加重，近兩年來(lái)每年均有氣急急性發(fā)作。曾與2013626日因“反復(fù)咳嗽加重伴發(fā)熱三天”入院，給予止咳、消炎、化痰治療后于0706日出院。此次入院前兩周thriftofexcellenttraditionalstylelackdeepofunderstingonesid

27、edthinkinnowofgoodsituationXiaeconomicsmoothmefastdevelopmentrefmmademajprogresspeoplelivingsignificantlyimprovesocialthecareermadenewprogressnonecessaryalwayshardhasnoawarenesstoChinaalsohasmanypovertyareaalsohasmanypov

28、ertypopulationofexistsmelivingimprovehasmeneedkeephardofstyle.Threeisnotstrictlyhonest.Totalthoughtunitsisawatersectcleanselfdisciplineawayfromhimselftoofarnorealprocessinggoodlivingofimprovehardthriftexcellenttraditiona

29、lofrelationshipnoeffectivedocomplywithConstitutionpartyofregulationsmustfromIdoupnorightmercygoodbitterLewealthofrelationshipnorightawarenesstoincomplywithConstitutionpartyofregulationsaspectseveryonehasaccountability.Fo

30、urfuturedirectionimprovementmeasures1belieffaithstrengthenpartyspirit.Oneistofirmlyestablishthenobleidealsofstruggleftheidealsofcommunismcommuniststruggleflifereadytosacrificeeverythingfthepartythepeople.Secondistocontin

31、uouslyimprovethequalitystardofpoliticalconscientiouslystudyDengXiaopingthey“threerepresents“imptantthoughtthescientificOutlookondevelopmentimplementthepartysbasicprogramftheprimarystageofsocialismadheretothecrectpolitica

32、lientationmaintainhighlyconsistentwiththeCPCCentralCommitteeisgoodattheiesofsocialismwithChineseacteristicstoanalyzesolveproblems.ThirdstrengtheningthepartyspiritthewldtransfmationperseveranceofthepartyConstitutionrelive

33、PartyvowstoestablishcrectwldOutlookOutlookonlifethewldpracticallyembodiesidealsbeliefsintoactioncombineloftyidealspracticalactivitiestransfmingtheobjectivewldactivelyparticipateinthegreatpracticeofbuildingsocialismwithCh

34、ineseacteristics.2keepthepurposeinconceptchangingthestyleofwk.Firstkeepinmindthatthepurposeofservingadheretoassumingpowerfthepeoplekeepinmindthepeoplecareaboutpeoplethejoyssrowsofthemasses...Accdingtocitydisciplinemunici

35、palganizationDepartmentrequirementstodayweheld“implementimplementationindependentCommissionagainstcruptionguidelineseffectivestrengtheningledcadresstyleconstruction“topicdemocraticlifemaintaskisclosecontactthoughtwkactua

36、lcontrolcheckdistrictStingCommitteeteamthepersonalinimplementationindependentCommissionagainstcruptionguidelinesShangexistsofproblemindepthcarriedoutcriticismselfcriticalfurtherclearrectificationdirectionmeasureseffectiv

37、eenhancedcleanpoliticsofconsciousnessinitiativefirmsetgoodofrulingimage.Befethemeetingthewaywetakesurveyssolicitedaviewscombedrelatedtoteambuildingprojectwkcadrescadresionotheraspectsofatotalof19furtherdefinedthedirectio

38、nofrectificationenhancingthepertinenceeffectivenessofdemocraticlife.GoodfthismeetingwerequestedtheStingCommitteeofthemunicipalpartyCommitteemunicipalSecretaryGeneralTangWenjintheCityCommissionfdisciplineinspectionStingCo

39、mmitteeYangXuJiangJixueDeputyDirectofthepersonnelofficeotherleadingcomradespresentguidanceallowsustowarmapplauseftheirwelcomethanks!BelowIfirstDistrictCommitteememberofthe20XXteamannualdemocraticmeetingimplementationofth

40、ecrectivemeasuresaswellasmemberoftheteamofmyownreptguidelinesftheimplementationoftheindependentCommissionagainstcruptionstatementinvitedleaderscomradescriticism.Firstannualpartyonthe20XXteamMemberofdemocraticlifeactionpl

41、animplementationyear20XXdistrictdemocraticmeetingamemberoftheteamon“studypracticethescientificOutlookondevelopment“themefindaprojectsupptingstrongenoughtheindustrywellenoughurbanconstructionmanagementlevelneedstobeimprov

42、edlivelihoodimprovementneedstobestrengtheneddistrictteamitselfsuchasthefiveaspects.Yearof20XXwefindouttheproblemsmentionedabovebasedonactualShunqingconstructiondevelopmentconscientiouslysumupimprovementsachievingsignific

43、antdevelopmentresultseffectivenessoftheirwk.(A)highlighttheprojecthlemaintainhighgrowthofinvestment.AdheretothestrategyasaFoundationcarryingoutprojectstopromoteincreasedstaminaimptant.Oneistoincreasetheintensityofproject

44、stowards.Activelyseeknationalprovincialpolicysupptsuperispecialtransferpaymentsavarietyofadditionalincomewilltop700millionYuananumberofkeyinfrastructureprojectslivelihoodprojectsindustrialprojectsintothecage.Secondincrea

45、singtheprojectattracts.Thisyearatotalof23signedamajprojectofwhich14billionprojectChinaMetallurgicalgroupvankegroupGuangdonghengdagroupTaiwanRuentexgroupontheRIgroupShenzhenKaisajifengagriculturalmachineryMercedesBenzAudi

46、4SsteotherlargeenterprisesprojectshavesettledinShunqing.Thirdstrengthenprojectconstruction.Annualimplementationfocusproject39afixedassetsinvestmenttotalwillbreakthrough12billionyuancreateddistrictyilaihistyhighSouthdodam

47、fiveinshopoldcitytransfmationYingChinaindustrialconcentrateddistrictconstructioncitymainroadconstructionNtheaststeamTradeCentermodernfarmersindustryParkvocationaleducationcitylowrentalalsoroomconstructionfeaturesblocksbu

48、ildfarmersmarkettransfmation“ruralversion“Streettransfmationfocusengineeringspeedupimplementationeffectivenessobviously.ExpectedtobeachievedthisyearareawideGDP17billion哮喘及肺部炎癥有關(guān)證有效的咳嗽咳痰迭擴(kuò)支氣管及平喘。3、觀察病人用藥后的反應(yīng)，及時(shí)觀察并檢測(cè)患者脈搏呼吸

49、，指末氧飽和度，觀察病人的呼吸形態(tài)有無(wú)改善來(lái)決定進(jìn)一步的治療與護(hù)理。明顯改善。2012081214:00氣體交換受損：與咳嗽咳痰無(wú)效有關(guān)幫助患者有效咳痰，清潔呼吸道保持呼吸道通暢病情觀察：觀察病人咳嗽咳痰的狀況包括痰液的色、質(zhì)、量.觀察病人是否能自己有效咳痰；咳嗽好發(fā)的時(shí)間以及發(fā)作時(shí)的癥狀，2、遵醫(yī)囑及時(shí)足量的給藥，給予靜脈輸入蘭蘇等化痰藥物；霧化吸入，告訴病人正確霧化吸入的方法：打開(kāi)開(kāi)關(guān)→安置合適體位（坐位或半臥位）→鋪治療巾與患者頜

50、下→連接螺紋管道及一次性口含嘴→機(jī)器打開(kāi)的時(shí)候，指導(dǎo)含住吸嘴，把嘴閉緊，深深吸氣，用鼻子呼氣→調(diào)節(jié)時(shí)間（15~20分鐘），調(diào)節(jié)霧量→將口含嘴放入患者口中（也可用面罩），指導(dǎo)患者做深呼吸→交代注意事項(xiàng)（不要搬動(dòng)霧化器、不要調(diào)節(jié)上面的開(kāi)關(guān)，不要拉扯到電線，如果做的過(guò)程當(dāng)中，感覺(jué)有痰的話，把痰咳出，再繼續(xù)做治療，如果治療過(guò)程中有什么不舒服或者有其它需要，按床頭鈴。治療時(shí)保持體衛(wèi)消化系統(tǒng)的準(zhǔn)備：術(shù)前12小時(shí)禁食、術(shù)前3、注意觀察用藥后患者的咳嗽

51、咳痰的效果，是都較用藥前好轉(zhuǎn)，是否更容易咳出，粘稠狀況是否有所好轉(zhuǎn)，痰液狀況是否由農(nóng)轉(zhuǎn)輕等4、協(xié)助拍背：（1）操作者五指并攏呈杯狀，用指腹與大小魚際著落，叩擊時(shí)應(yīng)放松手腕，均勻叩擊，每一分鐘叩擊1分鐘；叩擊順序：應(yīng)沿支氣管走行方向，自下而上，由邊緣到中央，有節(jié)律的扣拍患者背部，同時(shí)矚病人緩慢深呼吸。拍背需注意兩問(wèn)題：飯后一小時(shí)內(nèi)不宜拍背，以免引起嘔吐。拍背時(shí)患者側(cè)臥位，去枕，以利于痰液引流?？梢栽诳人缘拈g隙讓他側(cè)臥，借助腕關(guān)節(jié)的力量，輕