动静脉内瘘的护理（nursing care of arteriovenous fistula）

动静脉内瘘的护理（NURSINGCAREOFARTERIOVENOUSFISTULA）NURSINGCAREOFHEMODIALYSISPATIENTSWITHINTERNALFISTULAARTERIOVENOUSFISTULAISTHENECESSARYVASCULARACCESSFORDIALYSISTREATMENTITISALSOYOURLIFELINEINTHEDAILYDIALYSISTREATMENTBEFORE,SHOULDTRYTOPROTECTALLTHEBLOODVESSELSINTHEARM,IFMUSTCHECKORBLOODTRANSFUSION,TRYTOUSETHEHANDORANKLEARMBLOODVESSELS,VASCULARPROTECTIVESTOMAISGOOD,WILLINCREASETHESUCCESSRATE,FORTHEGOODFOUNDATIONOFLIFELINENURSINGCAREOFAPATIENTWITHARTERIOVENOUSFISTULA1,THEUSEOFSOFTPILLOWTORAISETHESIDEOFTHEBODY,GENERALLYSLIGHTLYHIGHERTHANTHEHEARTPOSITION2,AVOIDTHESIDEOFTHEBODYEXPOSEDTOOVERHEATINGORCOLDENVIRONMENT,LOOSESLEEVE,BANDAGETIGHTNESS,SIDEPRESSURE,NOTCONDUCIVETOLIMBBLOODCIRCULATION,PREVENTFINGERTIPSWELLING3KEEPTHEOPERATIONWOUNDCLEAN,DRYANDPREVENTINFECTION4,PAYATTENTIONTOOBSERVETHESITEOFBLEEDINGANDOTHERABNORMALITIES5PROHIBITTHEVOLUME,BLOODPRESSURE,BLOODTRANSFUSION,TRANSFUSIONANDBLOODCOLLECTIONINTHESIDEOFTHESTOMA6,EVERYDAYTOCHECKWHETHERTHEARTERIOVENOUSFISTULAPATENCY,LEARNTOMONITORVASCULARTREMORS,VASCULARMURMURS,ABNORMALTIMELYREPORTTOTHEDOCTOR7,THIRDDAYSAFTERTHEOPERATIONCANBESTARTEDCLENCHING,ALSOBEHANDPINCHTHESPONGEBALL,HOLDINGJIANLIETC,INORDERTOPROMOTETHEMOVEMENTOFFOREARMFISTULAVASCULARFILLING,PROMOTEFISTULAMATURATION8REMOVESTITCHESABOUT710DAYSAFTEROPERATION4WEEKSAFTEROPERATION,YOUCANSTARTTHETESTACCORDINGTOTHEMATURITYOFINTERNALFISTULAMETHODFOREXERCISINGARMAFTERTWOINTERNALFISTULA1,THEOPERATIONSIDEARMNATURALPROLAPSE,FISTORHOLDASOFTBALLSQUEEZEPRESSURE,THENUMBEROF1TO10ANDTHENRELAX,REPEAT5TIMES2,THEABOVEACTIONTODOFIFTHTIMES,THEUPPERARMFORCEDBENDING1TO5SECONDS,THENRELAXUNBEND,REPEATTHEABOVE12MOVEMENTSFORABOUT15MINUTES3,IFYOUDONOTHAVETHESTRENGTH,MAYASSISTTHEARMMOVEMENTBYTHEFAMILYMEMBERPRESSESTHEPATIENTUPPERARM,PRESSESFORAPPROXIMATELY510SECONDSTORELAX,ANDMAKESTHEANNULARCENTRIPETALDIRTYMASSAGE,SOREPEATEDACTION,ABOUT15MINUTESTHREEWHATARETHEMAINCAUSESOFTHELOSSOFARTERIOVENOUSFISTULAASARESULTOFDIABETES,HYPERTENSION,HYPERLIPIDEMIA,HYPOTENSION,HEARTDISEASE,INFECTION,INJURYANDBLOODVISCOSITY,MANYFACTORSCANDIRECTLYCAUSETHROMBOSISOFARTERIOVENOUSFISTULAFOURARTERIOVENOUSFISTULALOSSOFPERFORMANCE1,“CATFLUTTER“DISAPPEARED,2,“VASCULARMURMUR“CANNOTHEAR3,THEINTERNALFISTULADEFLATEDFIVE,ARTERIOVENOUSFISTULALOSTWORK,HOWTODOPLEASECALLYOURDOCTORATTHESAMETIME,THEFISTULASIDEARMSOAKEDINWARMWATER,ORIMMEDIATELYTOTHEHOSPITALFORTREATMENTOFADOCTORIFTIMELYTREATMENT,ARTERIOVENOUSFISTULARECANALIZATIONMAYALSOBEPROTECTED,LIFELINE073185600739WECALLSIXHOWTOPROTECTTHEINTERNALFISTULA1CLEANTHEINNERSIDEOFTHEFISTULAWITHSOAPANDWATERBEFOREDIALYSISKEEPTHEINNERSKINOFTHEFISTULAANDTHESIDEOFTHEBODYCLEAN2,AVOIDTHEFISTULASITEEXPOSED,REDUCEACCIDENTALFRICTIONANDCOLLISIONINJURYORSKINDAMAGE,THEREISDAMAGESHOULDBEIMMEDIATELYDISINFECTED3,24HOURSAFTERHEMODIALYSISTREATMENTDONOTCONTAMINATEORFISTULAPUNCTUREPOINTINWETSKIN,SUCHASSKINFISTULAPUNCTUREPOINTWASIMMEDIATELYSOAKEDWITH75ALCOHOLORPOVIDONEIODINE2TIMESWITHSTERILEGAUZEORWITHACOVER,SOASNOTTOINCREASETHECHANCESOFINFECTION4,FOROTHERTREATMENT,THEINTERNALFISTULA,BLOODVESSELSCANNOTBEINFUSION,INJECTION,BLOODCOLLECTIONANDOTHEROPERATIONS,SOASTOAVOIDPUNCTUREINJURY,DRUGSTIMULATION,SUCHASPHLEBITIS,THROMBOSISANDOTHERCOMPLICATIONS5,AVOIDTHEFISTULALIMBSVASCULARCOMPRESSION,INCLUDINGAVOIDWEARINGTIGHTSLEEVECLOTHES,SLEEPINGISINWARDSIDENOTNANEIFISTULA,FISTULALIMBSWHENTHEPILLOWISCAUSEDBYLONGTERMCOMPRESSION,FISTULALIMBSDONOTMEASUREBLOODPRESSURE,NOTHEAVYLIFTING,WITHOUTVIOLENCE6,COMBINEDWITHOTHERDISEASESSUCHASHYPERTENSION,HYPOTENSION,HYPERLIPIDEMIA,DIABETES,HEARTDISEASE,SHOULDBETREATEDACTIVELY,AVOIDTHEPRIMARYDISEASEOFBLOODVESSELSANDCAUSEFURTHERDAMAGE,SMOKEDAMAGETOBLOODVESSELS,SOYOUSHOULDGIVEUPSMOKINGDIALYSISTREATMENTSHOULDPAYATTENTIONTOPREVENTIONOFHYPOTENSION,ARRHYTHMIA,SUCHASACUTEATRIALFIBRILLATIONANDSOON,SOASTOAVOIDTHEFORMATIONOFARTERIOVENOUSFISTULATHROMBOSIS7、REASONABLEHEMOSTASISANDBANDAGINGISONEOFTHEKEYSTOPROLONGTHEUSEOFARTERIOVENOUSFISTULAIMPROPERHEMOSTASISMAYCAUSEHEMATOMA,PROLONGEDPRESSURETOBLOCKBLOODFLOWORSLOWBLOODFLOWCANLEADTOTHROMBOSISANDVASCULAROCCLUSIONTHEENDOFEACHDIALYSISTREATMENT,YOUSHOULDPAYSPECIALATTENTIONTOTHESITEOFVASCULARFISTULAANDBLEEDINGTIMETREMORTREMORDISAPPEAREDIMMEDIATELY,IFSLIGHTLYLOOSENINGTOURNIQUET,UNTILREACHINGFARTOOTIGHTTOPREVENTTHETREMOR,RESULTINGINCOMPRESSIONOFARTERIOVENOUSFISTULAOCCLUSION,SUCHASHALFANHOURAFTERTHERELEASEOFTHETOURNIQUETPUNCTUREPOINTISSTILLBLEEDING,SHOULDINFORMTHEDOCTOR,INATIMELYMANNERTOADJUSTTHEDOSEOFANTICOAGULANT8,YOUANDYOURFAMILYMEMBERSSHOULDBEAWAREOFINTERNALFISTULABLEEDINGEMERGENCYTREATMENT,INCLUDING1LOCALHEMOSTASIS,PAYATTENTIONTOLOCALCOMPRESSIONSHOULDINCLUDEPUNCTUREPUNCTUREPOINTANDVASCULARSKIN,THECOMPRESSIONSTRENGTHOFTHEBLOODTHROUGHTHEBLOODVESSELS,CANFEELATREMOR,ANDNOBLEEDINGASTHESTANDARD,GENERALLYABOUT10MINUTESOFOPPRESSION2OPPRESSIONCANALSOELEVATELIMBS3IFITSTILLCANNOTSTOPBLEEDING,ITSHOULDBEBANDAGEDIMMEDIATELYATTHESAMETIMEOFCOMPRESSIONANDSTRESSITSHOULDBENOTEDTHATTHEFISTULACANNOTBECOMPRESSEDFORALONGTIMESOASTOAVOIDINTERNALFISTULATHROMBOSIS9,ARTERIOVENOUSFISTULABLOODFLOWCAUSEDBYTOOLARGEINCREASEDCARDIACLOAD,ALONGTIMEWILLLEADTOHEARTFAILURE,ENLARGEMENTOFCARDIACCOMPLICATIONS,THEREFORE,IFTHEFISTULAYOUREXPANSIONISTOOLARGE,USUALLYCANUSEELASTICBANDAGECOMPRESSIONCONSTRAINTMODERATE,THEDECREASEDBLOODFLOWTOREDUCECARDIACLOAD,THENTOUNLOCKDIALYSISTHATSHOULDBEPAIDATTENTIONTOWHENUSINGELASTICBANDAGESWHENTHEFISTULASHOULDBEABLETOTOUCHTHEVASCULARTREMOR,IFYOUHAVECONSTRAINEDTHEFISTULAANDOPPRESSION,ACHIEVEDRYWEIGHTAFTERSTILLFEELGOTHEDOCTORSHOULDCONTACTTHEDOCTORANDNEEDAMINOROPERATIONTOREDUCETHEFLOWOFBLOODSOASTOREDUCETHELOADOFTHEHEART10,USUALLYYOUANDFAMILYMEMBERSSHOULDPAYMOREATTENTIONTOOBSERVETHEARTERIOVENOUSFISTULA,FISTULAENCOUNTEREDSUCHASTREMORSKINFISTULASITEDISAPPEARED,FISTULA,SUDDENPAINSWELLINGANDHEATPAIN,PUNCTUREPOINTBLEEDING,IRREGULARHEARTBEATANDOTHERABNORMALSITUATIONS,WEMUSTPROMPTLYTOTHEHOSPITAL,BECAUSEEVENAFEWHOURSTHEDELAYMAYBECAUSEDBYARTERIOVENOUSFISTULAIRREPARABLEDAMAGESEVEN,AFTERDIALYSISTREATMENTOFINTERNALFISTULA,VASCULARHOTCOMPRESSANDMASSAGEHOTCOMPRESSDIALYSISTREATMENTAFTER24HOURSCANBEHOTCOM