The nursing of cancer ache

The ache is an individual to experience or the description have severity unwell or uncomfortable of felling, if don't give the necessary control then will bring appetite to lower, the malnutrition, activity be subjected to limit, and influence sleep...etc. and make the weak sufferer have already been getting weaker.The majority of cancers pain can be safe and availably be alleviated.While controling a treatment method, we still need to be controled several nursing knowledge contents is as follows.
A, control ache
(A)because parts of sufferer's knowledge lack, not ability accurate expression ache, therefore nursing personnel first should encourage a sufferer will express sore part and strong or weak, ache of the process of property(keep on sex, by fits and starts, limit sex, fill the air sex, piercing, bright pain, Rui pain, dull pain etc.) and ache, result in a factor of ache aggravate and ease.
(Two)church the sufferer will describe ache grade, property and regulation and evaluate a sufferer to ache of reaction, the effect, side effect of the usage pain reliever, result in ache to build up or extenuatory impact factor, for the purpose of assurance ease sore of effective plan.
(Three)attention observation sufferer because of ache to the life body advertises for of change, the heart leads change, blood pressure to go up, the sufferer's noodles permit, body, act a way, attention, outward boundary stimulate reaction and to the influence of the daily life, the losing of change(worry anxiously, fear, cut up rough, sorrow, languid, standing alone, despair), social status of the mental state and personality and the influence of the social activity.
(Four)the target of establishment nursing, make the sufferer believe that the medical personnel believes his ache is definite to exist, and can carry out to effectively relieve pain a method, the maintenance eases of appearance.The target of treatment ache divides three stages to carry out:
First target, promise that the sufferer doesn't feel ache into the sleep at the night calmness;
Second target, at sufferer calmness the ache can disappear;
Third target, the sufferer is in the erection or the activity the ache disappear.
(Five)use various relieve pain medicine of can match with to use some intervention techniques in the meantime, adopt a music therapy, transfer or scatter attention, mental state support, puncture, cold treat, hot treat, skin stimulate etc. physical therapy.The nursing personnel wants to encourage participation of sufferer and family members, church some nursings and the method of match, attention and their communications and exchanges, establishment rise can trust a relation, set up the confidence that can control since the ache.
(Six)usage medicine want to notice to decide to the bestly use medicine path, if take orally, the muscle inject, the vein, rectum is used a medicine.Give medicine front should measure life body advertise for, especially breath number of times, should understand medicine of function, and possibility and other medicine take place of Jie anti- function, for the sake of exaltation to efficacy of medicine fruit, should to use medicine empress of reaction carry on observation, to hospitalized sufferer give medicine after half an hour should understand effect, request sufferer to use medicine front and back of circumstance carry on comparison, point out ache strengthen of time, if need and change the partition that amount of or change are used a medicine application for for time beg the doctor's opinion.The opposite door diagnoses a sufferer to work well to take a medicine for time and the record of painful effect in the town.
(Seven)help the family members' ache to the sufferer to do an aggressive reaction, rectify some false concepts such as meaning a doubt to the ache, fear an addiction but not to medicine etc., at adopt some painful measure obtain the family members' cooperation possibly, carry on encouragement and speak favorably to the family members' concern and participation in the meantime.
(Eight)after the ache relieves, the encouragement sufferer tallies up experience and ignore a sufferer how performance is, can bear with ache to take into to affirm and speak favorably to him the attention carry on relevant healthy education in the meantime.
(Nine)if the sufferer has to lie a bed, should set out environment possibly and carry on living quarters such as the encouragement family members with the flower, plant and painting decoration, encourage family members to wear the color fresh gorgeous clothes, provides the amusement program of music and accommodation for sufferer, help while being ache to be placed in lowest level the sufferer is for an everyday of activity plan, encourage a sufferer to carry on a kind of activity every day, had better be an outdoor activity.
Two, promise nourishment
(A)be subjected to a limit because of the tumor ache, activity, disgusted, vomit, the bowel peristalsis weaken, bad liquid quality etc. easily result in the sufferer's malnutrition.The ache influences the sufferer's digest to the nourishment material, absorption and utilization to lower.Consequently want to notice valuation sufferer in the nursing whether have have a poor appetite, be disgusted with a food and absorb quantity shortage, the weight eases to reach an original weight of 10-20% is even much lower, whether exist an activity the heart rate increase quickly, lowering of serum egg white number, water and electrolyte metabolism out of tune.
(Two)bring trouble the nursing target that the establishment can carry out, identify a relevant factor that cause nourishment appearance's descends, the taking of increment nourishment is with the demand that adapts to metabolism.
(Three)work well a plan nursing, press to cure Zhu before taking a meal half an hour to give painful, provide joyful, relaxedly have meal environment.If the table up puts fresh flowers and reduces to cure before the meal and guides a sufferer to avert from to cook smell under the possible condition and suggest at be disgusted with a food the period don't want to cook excessive food.
(Four)because of the side effect of the morphine medicine at take a medicine a few days ago inside easily cause disgusted, vomit, so should obtain the sufferer's comprehension, encourage sufferer's jot to take a meal ground ice or the soft drink friendly flavor smaller cold food for many times, give when it's necessary emetic.Avoid even for after meal two hours lie.
(Five)improvement food, stimulate appetite, taking of increment protein quantity, allow the species of pressing personal habit choice food, encourage family members to take a sufferer to specially love of house system food, technique teach to create a food, can bear with to take a meal possibly inside the sore scope at the sufferer.
Three, promise the sufferer is full of sleep
(A)sleep shortage mean in order to causing because of the sleep(break off or shortage) unwell or interference life style.The sufferer of ache perplexs because of paroxysm, ache of existence and usage analgesic of the side effect can not make the sufferer maintain normal sleep.We want to notice the valuation sufferer's face facial expression, rim of eye in the nursing whether delivering is black, eyelids the bottom hangs, usually beat yawn or often transformation body, have have no hard fallen asleep and maintain normal sleep of appearance.(often come to or come to lead early and day and night reverse of sleep circumstance)
(Two)help the sufferer find out the related factor of influencing the sleep and clean to painful factor, increment the movable quantity in daytime, establishment rise the life of regulation.
(Three)such as the ache influence sleep, should appropriate adjustment painful medicine of amount of and time, attain to effectively relieve pain a purpose, take quiet hypnotic medicine in some towns when it's necessary, help sufferer go into sleep.
(Four)clean the other factor of hindering the sleep, for example the side effect of the medicine, dyspnea, excrete an obstacle, disgusted, vomit, the feeling of Sao Yang, paroxysm harassment, mental state fear, despair.
(Five)bring trouble a construction comfort of go into sleep environment, avoid the interference of light and noise, can drink hot drink to anticipate before sleeping, steep feet or use other intervention therapies with the hot water to promote sleep.
Four, the nursing of skin
(A)ache the sufferer is a cancer to accompany with symptom in last phase, the sufferer's activity has lowly ability, lie a bed, malnutrition and add over a long period of time of the skin is damp, excrement secretion of the pollution easily take place bedsore.Bedsore once the formation will quickly expand and increase the sufferer's pain and sufferings and nourishment depletion further, therefore should notice valuation easily being subjected to of the sufferer to press part in the nursing, especially bone Long Tu, have have no continuously of oppress, swollen and inflamed hot pain and ulcerate with debauched.
(Two)the basic principle of prevention bedsore:
The ① eases partial pressure;
The ② keeps sufferer's clothes to sweep aridity and allows such as the condition, should encourage a sufferer to get up an activity or hand a sufferer to start to sit on time;
The ③ lies the Wei of bed to the long term heavy the sufferer should establish to turn over body card, in fixed time replace a body combine record.To extreme crack-up can at Mao tail mat with duck Rong mat or ventilate the cotton turn of sex good material to hang Mao end of the tail empty, in order to prevent is pressed;
The ④ keeps a bed sheet of neat, sweep aridity, with red flower alcohol etc. lives the medicine massage that the blood turns Yu is pressed part.To relieve nature an incontinence the sufferer should prepare a time of wet mat, the attention in fixed time cleans, with protect a hip cream protection.
(Three)the bedsore should prevent°from continuing once forming is pressed.Bedsore's dividing four classes should adopt effective measure to control it develops to the depth.Can use ulcer to stick, the exudation stick etc. material and promote in early days healing of the bedsore.
Five, the nursing of slice medicine side effect
The slice medicine is the most familiar of bad the reaction is a constipation, disgusted, vomit to calm down and wet to accumulate with town, the breath represses, Sao Yang etc., because sufferer for the reaction individual of slice medicine contains great difference, so should notice an observation in the nursing, and badly respond the treatment and nursing of prevention of giving to some ineluctabilities.
(A)be constipated
1, because of usage the slice medicine is the most familiar and unprogressive of bad reaction is a constipation, incidence rate is 90~100%.Inside the Fei Tai Be existed to stomach and intestines nerve to secrete a gland body in, be anaesthesia painful with when these is combined by body can repress a bowel peristalsis and make bowel way the gland body secrete decrease, such as sufferer liquid go into quantity shortage, activity decrease, the food lack cellulose, will make the constipation aggravated.In the nursing we the prevention is most important to be constipated and start using anaesthesia painful before the medicine, should understood a sufferer to have a bowel movement to be use to and used the condition of slow Xie formely, every day record have a bowel movement circumstance.
2, encourage many drinkings, enter rich food with the vitamin, eat vegetable, fruit and just the right amount thick food more.Use boiled water to hurtle to take some honeys to contain certain help everyday morning.Encourage a sufferer to get up activity and life to take care of ～ for oneself to go into Ci on time everyday possibly, develop in fixed time a habit of having a bowel movement.
3, attention valuation the sufferer's bowels circumstance, the light degree constipation can pass adjustment food and take orally to relax bowel a medicine treatment.When moving bowels is hard, take shape, every week at 3 following, abdominal distension, have rectum Chong the Ying, can touch hard then, have already not and to the utmost had a bowel movement to feel and have a bowel movement of ache, should bring trouble the target that establishment can carry out, can soothe ache while making to have a bowel movement.Use a medicine treatment to include:The stimulative leads Xie medicine such as take turns Xie leaf and 20% sweet dew Chuns etc.;The lubricant is like paraffin oil;If the Chinese herbal medicine product relaxs bowel to work properly, hemp Ren capsule etc., or give to open to fill dew, rectum to bolt.Taking orally the Xie medicine had better take before sleeping.Can go oil reservation to infuse bowel or wear gloves while moving bowels Qian to fill will dry then dig.
(Two)disgusted, vomit
1, because the medicine stimulates cerebral of the axis chemistry feel machine, make the ex- court sensitivity increased and the stomach line up empty slow, generally use are disgusted for few days to a week after the medicine and vomit will ease gradually.Want to guide a sufferer in the nursing important cause not is afraid disgusted but defy a medicine.Add to take a town to vomit a medicine after taking certain amount of when it's necessary, disgusted vomit of prevention and cure also important, control disgusted vomit to need to associately use a medicine.Can use the following prevention and treatment method, take while prevent°froming the D Mao 20 mgs+the stomach reply Anne's 20 mgs, can ease disgusted the incidence rate and degree for vomiting.The vein intravenous drop vomit, added to use the vitamin B6200 mg to disgusted what sufferer existed, lend support to stomach to reply Anne when it's necessary 10~20 mg the muscle injects, such as still invalid can change to use 5-the Qian color An Jie anti-(if the Shu replies rather) wait.Such as keep on disgusted, should study with doctor whether this medicine suits or replaces another don't easily cause disgusted medicine or usage to bolt to replace for medicine to take orally.
2, encouragement the sufferer can take the smell and scene of ice-cubes or fresh and cool liquid decrease unpleasantness, the decrease gargles in time after vomiting to the incitement that vomits axis.
3, instruction the sufferer carry on deep breathing and swallow on one's own initiative to repress to vomit a glint, after taking a meal sit to sign don't for a while but not want to lie down right away, ;A little amount take a meal each time, reduce to slowly take a meal speed, ;Avoids a drinking for meal front and back hour, eat the sweetmeat less and fry deep-fried of contain fat food.
4, should bring trouble to create to featly have meal environment, make sufferer's mood relaxed, clothes loose soft, the air is delightfully fresh.
(Three)use quiet appearance in the town in medicine
Start using the possibility to appear an excesssive town to calm down of the several days ago having of the medicine and increase a medicine to measure to also probably appear at the sufferer.
Because the medicine function is at the central nervous system system and appear quiet function in the palliation town and often appear to and then disappear gradually for 2-3 days after starting taking a medicine.Light degree sufferer's ache that love to sleep alleviates a satisfaction and have no other the ability don't be badly subjected to reaction, should encourage a sufferer to continue to insist using a medicine.If the sufferer loves to sleep obvious also serious of bad reaction, should adjust amount of and number of times to the medicine, the decrease measures with the medicine each time.Appearing is serious of the excesssive town is quiet and need to stop the breath circumstance of medicine observation sufferer first and work well a Jie anti- the breath represses of preparation.Want to work well the explanation work toward the sufferer and the family members in the nursing, the attention sufferer's safety.
(Four)the breath repress
Breath's repressing is one of the important obstacles that hinders sufferer's amount of foot to use a medicine, the sufferer takes over a long period of time the slice medicine produced to bear to be subjected to, can't cause breath's repressing.The existence of the ache represses to the breath oneself is the physiology Jie anti-.Use for the very first time at the sufferer the slice medicine and increment should strengthened a symptom observation while measuring for medicine.Should notice of is using other methods to alleviate ache, but still press the original amount of to the medicine, may cause breath's repressing very much, in time reduce amount of medicine is the main method that prevent°froms appearing this kind of problem.
(Five)the urine accumulate
The slice medicine hardly cause urine's accumulating and there is prostate gland increasing a rare old-age and male sufferer to be easy to occurrence.The medicine of the general treatment prostate gland can alleviate urine to accumulate, inducing row urine can be effective to parts of sufferers.The acupuncture can cure urine to accumulate and Be when it's necessary carry on leading urine and reserve for 2~3 days, usually can line up urine by oneself after pulling out urine tube.
(Six)impatient poisoned
Take over a long period of time slice medicine hardly appear to be poisoned to respond, have never used the sufferer of slice medicine, will appear while being to take the morphine 120 mgs or inject the morphine 30 mgs impatient poisoned the symptom, sufferer's confused state of mind or obfuscation, breath number of times decrease, blood pressure descend, the eye pupil narrow.Cure main usage Na Luo Tong the Jie anti- breath to repress.Should notice an observation in the nursing, adopt a homologous nursing.
Six, mental nursing
(A)ache not only bring body unwell, and also cause the variety of a series of mental state.Because the ache sufferer's knowledge shortage, chaperonage last phase symptom, hope of lose, to deadly fear, family economy etc. social milieu variety, the sufferer easily appears worry anxiously, fear, sorrow, despair etc. is various mental reaction, .Consequently we should notice various performance of evaluating the sufferer in the nursing whether has a complexion change, stagnant vision, heart rate speed, blood pressure increment, sleep mess, heart palpitates, perspire, tired, whether the full of energy can not concentrate, restless and diarrhea.Sufferer whether spirit strain, irascibility, anxious and fretful and easy concussion, easily out of control.
(Two)aim at a sufferer of different express we want to adopt homologous mental state to appease a way and well control ache and ease a sufferer painful, increase a sufferer at mentally with the comfortable feeling of the physiology.
(Three)possibly is foolish with sufferer together, slow-moving but calmly talk, inform to sufferer's sympathetic toward feeling that is richer than feelings.For example:Gentle and quiet looks, petting, allow a shout and conversation etc., get rid of excessive incitement.
(Four)the match use an intervention technique, for example:Relax Shu, scatter the method of attention, adopt mental state treatment, cancellation the sufferer's discomfort and sense of incapability, want to notice a safety to the despairing sufferer, progressively carry on effective of mental state appease, discover suicide tendency in time, assurance sufferer safety.
(Five)be a sufferer to appear morphine medicine side effect, the sufferer is uneasy, the medical personnel should give in time necessary elucidation, ease the discomfort of sufferer and family members, and carry on homologous nursing measure.
(Six)encourage a sufferer outward the environment occurrence interest, restriction and other of boundary contain anxious sufferer or family's contact.Help a sufferer to look for family and society support system to give the sufferer win sore confidence.
(1)the influence ache of body will cause the successive emergence of cancer patient a lot of problems, descend such as the sleep appearance mess, appetite, the activity is subjected to a limit etc..As well there is influence in ability and relationship of cancer ache to patient's daily life, the ache contains high strength, to life the ability and satisfaction influence more big, win, heavy degree ache will influence its daily life, 60%-65% hit cancer patient's lord's telling ache will influence its sleep, consequently cancer patient's severity of ache to the breakage a little bit generally chronic ache of patient's body.
(2)mentally influence a cancer pain to mentally produce to influence very greatly to the cancer sufferer's spirit, the ache sufferer can make personal amusement and amusement lowered, worry anxiously, fear increment, the performance suppresses Yu, distress and can not concentrate spirit and excessively consider bodily ache but lose interest in the life, sufferer ego the control abilities descend.The ache can make cancer the sufferer is getting more standing alone, anxious, suppresses Yu, turn worse cancer thus to the sufferer mentally of wound.
(3)the society support the influence of system for the cancer ache that can not control, the influence of the social level is count for much, in many cancer sufferers, the ache becomes them and replies in the home life of point, many cancer sufferers because of disease make progress but have to stop a work, as a result not only result in the loss of economy, also result in the pressure, emotion of spirit of dependence and aware of self useless feeling.Sufferer because the body external appearance and behavior change appeared by ache, will cause family members the pressure and pain and sufferings on the spirit, subsequently then in addition weigh the sufferer's pain and sufferings and ache, some sufferers will because of the ache of serious and hard processing but lose living confidence.
The cancer sufferer's family members also need to bear spirit mental state and look after various pressures of ability while sharing sufferer's pain and sufferings.The nursing patient's family members need to sleep, need to work in the heavy nursing in slightly make a rest, they may because of care patient but appear a social economic difficulty.Even if have no mental state, the pressure of emotion and physical strength, the family members will also feel hard to satisfy the patient's various demands at patient of the in home nursing cancer ache, such as they want to continuously evaluate ache and help a patient to use a medicine on time and reply complicatedly to the medicine method, the side effect after observing a processing to use a medicine etc..
How face the cancer patient's ache, this is to the challenge of tumor nurse professional ability, the cancellation is painful, curing the disease should be seen make is the dual responsibility of medical personnel that dedicates body medical science business.The tumor nurse should understand the related knowledge of cancer ache completely, solution involves in the ache to control a medium related problem and raise a sufferer the control is to the ache satisfaction.