心脏瓣膜置换术病人的出院宣教PPT课件.ppt

,心脏瓣膜置换术患者的出院宣教,12/14/2019,1,病例介绍,患者黄X，女性，27岁，因反复胸闷、气促5月，加重2天入院。诊断：二尖瓣前叶脱垂并中重度返流、心功能级。入院后予以强心、利尿、调整心功能等治疗，心功能好转后于半个月前行二尖瓣机械瓣置换术。术后病情好转于今日出院。,12/14/2019,12/14/2019,12/14/2019,12/14/2019,12/14/2019,2,自我保健,生活指导,心理调节,用药指导,12/14/2019,12/14/2019,12/14/2019,12/14/2019,3,婚姻与妊娠,伤口的保护,饮食指导,活动,预防感染,生活指导,12/14/2019,12/14/2019,12/14/2019,12/14/2019,4,运动,6个月内以休息为主，活动量仅限于不感到疲劳为度。6个月以后，由轻工作逐渐过渡到正常工作。以不引起胸闷、气急为宜。,12/14/2019,12/14/2019,12/14/2019,12/14/2019,5,饮食,12/14/2019,12/14/2019,12/14/2019,12/14/2019,6,预防感染,注意个人及家庭卫生。预防呼吸道感染。如出现皮肤感染、牙周炎、感冒、肺炎等应及时治疗，避免引起感染性心内膜炎。,12/14/2019,12/14/2019,12/14/2019,12/14/2019,7,伤口的保护,拆线后7-10天内避免直接将水喷洒在伤口上。避免摩擦伤口。,12/14/2019,12/14/2019,12/14/2019,12/14/2019,8,婚姻及妊娠,女性病人换瓣术后能妊娠吗,12/14/2019,12/14/2019,在换瓣术后1-2年心功能完全恢复为宜，并在医生指导下方可妊娠。对于心功能III-IV级者则不宜妊娠。,12/14/2019,12/14/2019,9,自我保健,生活指导,心理调节,用药指导,12/14/2019,12/14/2019,12/14/2019,12/14/2019,10,心理调节,12/14/2019,12/14/2019,12/14/2019,自我调节自我控制自我护理,12/14/2019,12/14/2019,11,自我保健,生活指导,心理调节,用药指导,12/14/2019,12/14/2019,12/14/2019,12/14/2019,12,强心利尿药,抗凝药,氯化钾,用药指导,12/14/2019,12/14/2019,12/14/2019,12/14/2019,13,12/14/2019,口服利尿药注意事项,1、准确记录24h尿量（晨7：:00-次晨7:00）成人1000ml/天儿童500ml/天2、同时服用氯化钾；要注意氯化钾适宜在饭后服用，以免引起胃肠道不适。,12/14/2019,14,口服地高辛注意事项,1、每次服用地高辛前必须测心率。大于以下次数才能服药：5岁：80次/分成人：60次/分,12/14/2019,12/14/2019,12/14/2019,12/14/2019,12/14/2019,15,2、观察是否有洋地黄类药物中毒症状，如果出现头晕眼花、食欲减退、恶心呕吐、黄绿视等，及时停药并就诊。3、用药期间注意监测血药浓度、心电图、心率及心律、心功能、电解质。,12/14/2019,口服地高辛注意事项,12/14/2019,12/14/2019,16,12/14/2019,1、生物瓣膜抗凝3-6个月；机械瓣膜须终生抗凝；每天固定在同一时间服药。,口服华法林注意事项,12/14/2019,12/14/2019,17,12/14/2019,口服华法林注意事项,2、定期复查凝血酶原时间，遵医嘱调整用药。,12/14/2019,12/14/2019,18,3、观察有无抗凝不足或抗凝过量。,口服华法林注意事项,12/14/2019,12/14/2019,抗凝不足,抗凝过量,昏厥语言障碍肢体活动障碍,12/14/2019,12/14/2019,19,4、在日常生活中注意避免外伤和其他引起出血的因素。5、因为其他疾病需要进行有创检查或治疗甚至手术时，患者及家属请提前告诉经治医师服用华法林的情况。,口服华法林注意事项,12/14/2019,12/14/2019,12/14/2019,12/14/2019,20,能降低药效的食物,口服华法林注意事项,6、饮食注意事项,能增强药效的食物,12/14/2019,要均衡膳食哦！,12/14/2019,12/14/2019,12/14/2019,21,VitKVitC西洋参口服避孕药,磺胺类别嘌呤片解热镇痛药广谱抗生素,增强华法林药效,Textinhere,口服华法林注意事项,7、合并用药的注意事项,减弱华法林药效,12/14/2019,12/14/2019,12/14/2019,12/14/2019,22,自我保健,生活指导,心理调节,用药指导,12/14/2019,12/14/2019,12/14/2019,12/14/2019,23,自我保健,定期复查，不适随诊,12/14/2019,12/14/2019,12/14/2019,12/14/2019,24,自我保健,生活指导,心理调节,用药指导,12/14/2019,12/14/2019,12/14/2019,12/14/2019,25,思考,1、患者出院后饮食需注意什么？2、患者口服地高辛时应注意什么？3、患者口服华法林过