轮状病毒肠炎课件

LOGO轮状病毒肠炎护理概述

是由轮状病毒所致的急性消化道传染病，好发于秋、冬季，以秋季流行为主，故又称秋季腹泻。[2大便观察要点生命体征水、电解质和酸碱平衡肛周皮肤123431、生命体征观察1

体温2脉搏3呼吸42、水、电解质和酸碱平衡紊乱絮乱

脱水代谢性酸中毒低血钾低血钙和低镁血症5脱水6精神眼泪尿量皮肤前囟眼窝末梢循环体重减少轻度稍差少稍少弹性可稍凹陷正常<5%中度萎靡烦躁明显减少明显减少弹性差明显凹陷四肢稍凉<5%~10%重度表情淡漠无极少或无弹性很差深凹陷四肢冷>10%脱水的分类血钠mmol/L影响部位临床表现高渗脱水（失水>失电解质）>150细胞内为主口渴烦躁高热幻觉抽搐等渗脱水（失水=失电解质）130-150细胞内外出现一般脱水现象循环障碍低渗脱水（失水<电解质）<130细胞外为主脱水重易休克并有头痛嗜睡昏迷抽搐脱水程度分类脱水性质分类7低血钾低血钙和低镁血症钾3.5---5.5mmol/L钙2.25—2.75mmol/L镁0.8—1.2mmol/L低钾表现⒈精神萎靡反应低下⒉肌肉无力⒊腱反射减弱或消失⒋腹胀、肠鸣音减弱甚至麻痹⒌心率增快、心音低钝低钙表现

多在补液后出现

震颤

手足搐搦

惊厥低镁表现

若补钙后抽搐

仍不见缓解，

注意

低镁8代谢性酸中毒的表现正常血PH值：7.35---7.45轻度：仅表现呼吸稍快中、重度：口唇樱桃红或发绀、呼吸深快、精神萎靡或烦躁不安、嗜睡甚至昏迷。93、大便的观察大便次数量颜色性状104、肛周皮肤情况有无潮红或破溃11治疗要点调整饮食预防和纠正脱水控制感染预防并发症12护理措施护理重点一、调整饮食二、纠正脱水三、病情观察四、控制感染13一、调整饮食

母乳喂养继续母乳喂养

混合喂养

人工喂养暂停辅食的添加给予米汤、粥、面等流质或半流质食物改用豆制代乳品、不含乳糖的奶粉吐泻严重患儿禁食、不必禁水、静脉补液14二、纠正脱水Text量50～60毫升/公斤体重，4小时喂入轻度中度70～100毫升/公斤体重，6小时喂入少量多次服用，最好每2～3分钟喂1次，每次10～20毫含有氯化钠碳酸氢钠氯化钾葡萄糖成分适应症：轻、中度脱水而无腹胀、呕吐者优点：纠正脱水、减少大便、呕吐次数和量

口服补液期间，如患儿呕吐剧烈、腹胀或脱水程度加重，应立即改用静脉液如出现眼睑水肿，改喂白开水，水肿消退后，如需要仍可继续服用口服补液盐15二、纠正脱水静脉补液补液原则

三定三先三见定量定性定速先盐后糖先浓后淡先快后慢见尿补钾见酸补碱见惊补钙16静脉补液

补液种类低渗性脱水：补2/3张含钠液等渗性脱水：补1/2张含钠液高渗性脱水：补1/3-1/5含钠液17静脉补液补液速度取决于脱水程度先快后慢重度脱水患儿先用2：1等渗含液20ml/kg于30-60分钟内快速推注或滴入其余一般8-12小时内输完输入速度约为每小时8·10ml/kg.18三、病情观察生命体征脱水情况低钾、酸中毒等情况准确记录出入量19四、控制感染严格执行消毒隔离措施，包括患儿排泄物用物、标本的处置护理患儿前后认真洗手，防止交叉感染注意保持病房空气流通，每日开窗通风，加强地面清洁。20ThankYou!YourcompanysloganinhereLOGO222324HowdoIincorporatemylogotoaslidethatwillapplytoalltheotherslides?-Onthe[View]menu,pointto[Master],andthenclick[SlideMaster]orNotesMaster.Changeimagestotheoneyoulike,thenitwillapplytoalltheotherslides.[Imageinformationinproduct]-Image:mowolf-Notetocustomers:ThisimagehasbeenlicensedtobeusedwithinPowerPointtemplateonly.-Youmaynotextracttheimageforanyotheruse.Introduction25DiagramRealityIdentityCreativityDescribeavisionofcompanyorstrategiccontents.Describeavisionofcompanyorstrategiccontents.Describeavisionofcompanyorstrategiccontents.RealityIdentityCreativityThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.Atitleaboutcontent26DiagramDescriptionofthecontentsDescriptionofthecontentsTextTextTextDescriptionofthecontentsDescriptionofthecontentsThemeGallery

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