Liver cancer patients are bedridden for a long time, lose weight, and have general fatigue, which can easily lead to bedsores. The causes of bedsores are: ① local pressure, friction and displacement; ② local tissue ischemia and necrosis; ③ local moisture and stimulation by excrement; ④ insufficient nutrition. The appearance of bedsores is mainly manifested in time as congestion, rashes, blisters, ulcers, local tissue necrosis, and even ulceration, and finally invades the fascia, muscles, bones and other deep tissues. Once bedsores occur, it will not only increase the pain of the patient, aggravate the condition, and prolong the course of the disease, but in severe cases, it may cause sepsis due to secondary infection and endanger life. Therefore, basic nursing must be strengthened to prevent the occurrence of bedsores. The presence or absence of bedsores is one of the important criteria for judging the quality of nursing. 1. Nursing goals 1. Prevent the occurrence or aggravation of bedsores. 2. Promote the healing of bedsore wounds. (II) Nursing measures 1. Prevent bedsores (1) Encourage patients to move or exercise. For patients who cannot move, assist them to turn over once every 2 hours; patients who can move slightly are encouraged to move in bed or do limb exercises with the help of family members. (2) Instruct the patient on the correct method of turning over, and do not drag the patient to avoid friction that may damage the skin. (3) When lying or sitting for a long time, you should place a small pad under the bony protrusion to prevent local pressure, and you can use a gauze pad to support the heel. (4) Massage bony protrusions with safflower ethanol every day to prevent the occurrence of bedsores. (5) Keep your skin clean. Wipe your skin with warm water every day. Change clothes that are soiled by excrement and sweat in time. People with dry skin can apply moisturizing cream. (6) Water mattress or air mattress can be used when necessary. (7) Provide adequate nutrition. Provide a high-protein, high-calorie diet. For those who cannot eat, use nasogastric feeding or intravenous nutrition. 2. Promote the healing of bedsores (1) Stage I bedsores: Massage the local skin with safflower ethanol twice a day. Use an air cushion to lift the congested area to avoid further local pressure, and instruct the patient to do limb exercises in bed. (2) Stage II bedsores: Apply mercurochrome to the ulcer to tighten the skin and promote local skin healing. Or cover the ulcer with egg membrane. For blisters, use a sterile syringe to aspirate the fluid in the blister, disinfect the needle hole and cover it with sterile gauze. (3) Stage III and IV bedsores: The wound dressing should be changed. Choose appropriate dressings to cover the wound and apply direct pressure to the wound to prevent the patient from bleeding (liver cancer patients have poor coagulation function). Use oily antibiotics to change the wound dressing every day and observe the wound healing. If there is no improvement within a week, bacterial culture of the wound can be performed to find sensitive antibiotics. |
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