Health education _ prevention and health care of the liver cirrhosis patient

Health education _ prevention and health care of the liver cirrhosis patient
Li ShunZhi Chen XiaoBing 2005-12-13 13:08:51 Western medicine magazine in China Number 7 of Vol. 4 of April of 2003

Liver cirrhosis one common chronic hepatopathy, long-term cause of disease act on person who fill the air of going on etc. that liver lead to the fact repeatedly liver damaged for one or more. The common cause of disease of liver cirrhosis is virus hepatitis, getting drunk for a long time, snail fever, bile depositing, medicine or chemical poisonous substance, damage the liver etc.. Early symptom is light, the patient is not conscientious and uncomfortable; Lose and compensate one and is shown as and received difference, weak, abdominal distension, lower extremities edema, bled inclining and anaemia, endocrine regulation,etc.. The upper digestive tract bleeds for this disease, most common complication. Liver encephalopathy is the most serious complication of liver cirrhosis of advanced stage. Syndrome of the liver that hepatopathy causes with depleted function and causing the supersession disorder, nerve centre to be with unregulated function that it is serious.
Because can't cure ing, the patient needs to live in spite of illness for a long time. So how to make the liver cirrhosis patient appropriate within limited existence time cooperates with drug therapy and assists and treats, obtain quality of surviving best, it is very important to carry on the pointed health education, and assist and should focus on the psychology, diet, behavior, drug therapy and education to treat. The nurse should help patient and relative to know the relevant knowledge of a disease and attend to the method oneself on clinic, analyze and dispel and is unfavorable to individuals and various factors of the family, establish the confidence of curing the disease, keep the happy mood, plan treating to implement to hit to daily life.
Content of a health education
1.1 Education of the patient
1.1.1 Psychological guidance because liver hard to turn chronic to pass, cure, heal for a long time and condition development aggravate gradually, curative effect is uncertain, and necessary there are more nutrition and hospitalization cost, cause the family life of patient and relative, influenced much. The young and middle-aged patient considers one's own work and marriage more, often depressed, lose confidence to the future life; Old man's thought is more conservative and the ability to accept is relatively bad, so the patient produced passive, desperate, pessimistic mood easily, influence daily life. Train the chronic patient to attend to ability, the quality of improving a patient and surviving oneself. Help patients to overcome passivism appearing, desperate, pessimistic mood, establish the confidence of surviving in spite of illness, it is the psychology that attends to an important respect that can't be ignored. So nurses should know that exchange the skill in language, regard emotion as the tie while talking with patient, the focal point of the speech is outstanding, concrete and distinct, use the courteous language while talking, offer to the patient's concrete problem pacifying language,etc. [1] . As the patient learns the possibility not effecting a radical cure, heavier and angrier psychology. Feel right and freedom of depriving life, the emotion is fragile, take the passive attitude in treating at the same time. To the patient's psychological situation, we are doing Xuan JiaoShi should care for the patient, make the patient's trust with the sincere language, establish good protecting and suffering from the relation, let out the law to make the patient give vent to angry mood with Xuan, in order to sublimate the law to shift the psychology of its contradiction, and tell the therapeutic prospect of liver cirrhosis and please resume better patient's introducing the experience repeatedly, dispel patient's passivism, pessimistic, desperate and angry psychology, establish the invincible confidence of overcoming disease. Because the bad psychology can make orthosympathetic excitability increase, even aggravate the condition, the digestive tract of kindling bleeds. Persevere to the patient's education. According to different periods that the patient is in hospital, different conditions carry on overall education. Should combine while attending to and operating with patient's education, attend to and educate the body as an organic whole [2] .
1.1.2 The diet is guided Eat high heat, high protein ' Except liver encephalopathy) , high vitamin, food apt to digest. Regard rice and flour as the staple food, eat the high-quality albumen such as fish, egg, soyfood. Restrain the oil from taking in, every day is less than 20g, there is ascites or edema patient, should control the absorption of moisture, sodium salt according to the indexes of the urine amount, weight. On diet, the intaking amount of the salt is less than 0.5g every day, the diet of less salt, the intaking amount of the salt is less than 2g every day, the intersection of liver cirrhosis and ascites should restrain the intersection of liquid and person who enter from, can urine quantity add 500ml according to the previous day. Avoid taking food coarsely, hard food difficult to bite, for instance: Fried wheaten food, hard melon and fruit,etc.; Avoid swallowing, avoid spicy flavoring agent, avoid drinking chicken's bone, fishbone,etc., or stimulating food. When ammonia of blood is on the high side, should restrain protein from being taken a photograph of and is selected to select the plant albumen, such as the soyfood, because it includes methionine, fragrant amino acid and produces less ammonia amino acid. The fresh vegetables fruit contains abundant vitamin, for example tomato, orange,etc. are rich in vitamin C, daily absorption that ate and guaranteed vitamin. Introduce the compositions of different food to the patient in conformity with the patience, for example; The food with rich sodium is bacon, soy sauce, pickles, sucking sodium gourmet powder,etc., should eat few; Includes sodium less food and is cereal, eggplants, fruit,etc.; The food high in potassium content is fruit, hard dry fruit, potato, meat,etc.. Explain the educational content with the easy-to-understand language. It such as the diet of less salt, under daily 2g, tell patients can cook the measuring tool with beer bottle lid to combine patient's experience of life to explain, every bottle lid is 3g.
1.1.3 Work and rest and behavioral guidance compensate issue, can join lighter job, form have regular life style, strike a proper balance between work and rest, it is overworked to avoid, guarantee the sufficient sleep and not only can save the physical demands, and favorable to improve the liver to circulate, promote physical power to resume, promote hepatocyte regeneration, avoid bleeding. Lose, compensate issue, should stay in bed, or half sit or sleep location in order to lighten abdominal distension, cause uncomfortable, lighten the load of heart and lungs. Live a regular life, pay attention to the cold-proof and personal hygiene, transaminase does the work of isolating well while rising, especially the tableware is by and then wants boiling 30- 60min, can't use with family with ing. Edema person should notice skin protect, it is spacious soft for clothing to take, every daily warm ink wipe the bath, skin pruritus person does not scratch with hand, offer, alleviate pruritus, deal with, skin damage and infect. Keep the stool unobstructed. Find and cough that looks for the reason, use town coughing and antiinflammatory agent; Vomit the frequent ones and use and stop spitting pharmaceuticals, psychotherapy; Appropriate to arrange for reading, daily activities such as a small amount of house work,etc. of taking a walk, cultivating flowers, or slight.
1.1.4 The administration is guided by treating to the ill, forbid employing the medicine harmful to liver. Should use diuretic correctly according to the doctor's order when there is ascites or edema, want disconnected 15( 11) in principle : 695-696.
Author's unit: 510120 Guangzhou Zhongshan University attaches to the second hospital

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