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1、急诊科护士知识手册二零一三年三月第38页一、肺炎···························································3二、惊厥···························································3三、休克···························································4四、糖尿病·························································5
2、五、婴幼儿腹泻·····················································5六、支气管哮喘·····················································6七、川崎病·························································7八、过敏性紫癜·····················································9九、肾病综合征······················
3、······························11十、急性肾功能衰竭················································14十一、尿毒症患者主要的护理方法····································16第38页六、系统性红斑狼疮··············································16七、新生儿低血糖················································20八、外科急症（脑外伤、肠
4、套叠、先天性巨结肠）·····················21九、常见传染病（手足口病、麻疹、猩红热、出血热）·················22十、意外伤害（婴幼儿捂热综合征、急性中毒、烧伤、呼吸道异物、消化道异物、狂犬病、破伤风）·············································26十一、急诊科急救操作技术（心肺复苏、除颤仪、经鼻/口腔吸痰法、简易复囊、呼吸机使用技术、洗胃技术、血糖测定）·······························31肺炎一、定义：肺炎是由各种病原体感染或其他
5、原因所引起的肺部炎症。二、临床表现：为发热、咳嗽、气喘、鼻翼煽动，不同程度的呼吸困难，紫绀等，全身症状可有精神不振，烦躁，食欲减退，呕吐，腹泻，重症可导致心力衰竭，中毒性脑病，脓、气胸等并发症。三、护理要点：1．按儿科疾病一般护理常规护理。2．按呼吸道隔离，严防医院感染。3．患儿卧床休息，咳喘患儿取半卧位。4．第38页给予患儿富营养、易消化的饮食，鼓励多饮水。呛咳患儿喂奶时应夹紧奶头；人工喂养儿用小孔奶头，喂奶时抬高头部或抱起哺乳。无力吸吮者用小匙或滴管喂奶。重症不能自行进食者，可鼻饲或给予静脉营养。5．保持患儿呼吸道通畅。呼吸困难者及时吸氧，
6、痰粘稠不易咳出时，作超声雾化吸入。6．密切观察患儿T、P、R、BP、HR、神志等变化。发现异常及时报告医师。7．严格控制输液速度和总量，以防心力衰竭和肺水肿的发生。8．有高热惊厥、烦躁、腹胀的患儿对症处理。对心力衰竭患儿，一切治疗护理尽量集中操作，避免过多惊扰。四、健康指导：1、积极治疗，预防并发症的发生。2、加强营养，增强体质，适当休息，保证充足睡眠。3、教育患儿咳嗽时用手帕或纸捂嘴，不随地吐痰，防止病菌污染空气传染他人。寒冷季节或气候骤变外出时，应注意保暖，避免受凉。惊厥一、定义：惊厥指突然发生的全身或局部肌群强直性或阵挛性抽动,常伴有不同
7、程度的意识改变。惊厥是小儿常见的急症之一，婴幼儿尤为多见，为中枢神经系统器质性或功能性异常所致，病因繁多。二、临床表现：突然发作的全身或局部肌群抽动,伴呼吸暂停、不规则,面色苍白、发绀,有时口吐泡沫、双眼凝视、眼球震颤,持续几秒钟或几分钟,抽搐停止后多数入睡。惊厥持续状态:惊厥发作连续30min以上或间断反复发作在间歇期意识不恢复者。三、护理要点：1.去枕仰卧位,头侧向一边,松解衣扣,清除口、鼻、咽分泌物,保持气道通畅。2.给氧。有窒息者及时清除分泌物,必要时人工呼吸。3.保持安静,防止意外,护理操作集中进行。抽搐牙关紧闭时用纱布包裹压舌板,或
8、开口器,放于上下臼齿间,四肢适当约束。4.按医嘱正确对症治疗,如止痉、降温、降颅内压、辅助呼吸等,注意观察疗效。5.严密观察生命体征、神志、面色变化,
