轮状病毒肠炎ppt课件.ppt

1、LOGO轮状病毒肠炎轮状病毒肠炎 护理护理概述概述 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大便大便观察要点观察要点生命体征生命体征水、电解质和酸碱平衡水、电解质和酸碱平衡肛周皮肤肛周皮肤123431、生命体征观察、生命体征观察1 体温体温2 脉搏脉搏3 呼吸呼吸42、水、电解质和酸碱平衡紊乱絮乱 脱水脱水代谢性酸中毒代谢性酸中毒低血钾低血钾低血钙和低镁血症低血钙和低镁血症5脱水脱水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10%脱水的分类血钠mmol/L影响部位

2、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程度分类脱水性质分类脱水性质分类7低血钾低血钙和低镁血症钾钾3.5-5.5mmol/L钙钙2.252.75mmol/L镁镁0.81.2mmol/L 低钾表现低钾表现精神萎靡反应低下精神萎靡反应低下肌肉无力肌肉无力腱反射减弱或消失腱反射减弱或消失腹胀、肠鸣音减弱腹胀、肠鸣音减弱甚至麻痹甚至麻痹心率增快、心音低心率增快、心音低钝钝 低钙表现低钙表现多在补液后出现多在补液后出现

3、 震颤震颤 手足搐搦手足搐搦 惊惊 厥厥 低镁表现低镁表现 若补钙后抽搐若补钙后抽搐 仍不见缓解，仍不见缓解， 注意注意 低镁低镁8代谢性酸中毒的表现l正常血正常血PH值：值：7.35-7.45l轻度：仅表现呼吸稍快轻度：仅表现呼吸稍快l中、重度：口唇樱桃红或发绀、呼吸深快、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。精神萎靡或烦躁不安、嗜睡甚至昏迷。93、大便的观察104、肛周皮肤情况 有无潮红或破溃有无潮红或破溃11治疗要点治疗要点调整调整饮食饮食预防和纠正脱水预防和纠正脱水控制感染控制感染预防并发症预防并发症12护理措施护理措施护理重点护理重点一、调整饮食一、

4、调整饮食二、纠正脱水二、纠正脱水三、病情观察三、病情观察四、控制感染四、控制感染13一、调整饮食一、调整饮食 母乳喂养母乳喂养继续母乳喂养继续母乳喂养 混合喂养混合喂养 人工喂养人工喂养暂停辅食的添加暂停辅食的添加给予米汤、粥、面等流质或半流给予米汤、粥、面等流质或半流质食物改用豆制代乳品、不含乳质食物改用豆制代乳品、不含乳糖的奶粉糖的奶粉吐泻严重患儿吐泻严重患儿 禁食、不必禁水、静脉补液禁食、不必禁水、静脉补液14二、纠正脱水Text量量5060毫升毫升/公斤体重，公斤体重，4小时喂入小时喂入轻度轻度中度中度70100毫升毫升/公斤体重，公斤体重，6小时喂入小时喂入少量多次服少量多次服用，最

5、好每用，最好每23分钟喂分钟喂1次，每次次，每次1020毫毫含有氯化钠碳酸氢钠氯化钾葡萄糖成分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，如患儿口服补液期间，如患儿呕吐剧烈、腹胀或脱水程呕吐剧烈、腹胀或脱水程度加重，应立即改用静脉度加重，应立即改用静脉液液 如出现眼睑水肿，改喂如出现眼睑水肿，改喂白开水，水肿消退后，如白开水，水肿消退后，如需要仍可继续服用需要仍可继续服用口服补液盐口服补液盐15二、纠正脱水二、纠正脱水静脉补液静脉补液补液

6、原则补液原则 三定三定三先三先三见三见定量定量 定性定性定速定速先盐后糖先盐后糖先浓后淡先浓后淡 先快后慢先快后慢见尿补钾见尿补钾见酸补碱见酸补碱见惊补钙见惊补钙16静脉补液静脉补液 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静脉补液静脉补液 补液速度补液速度取决于脱水程度取决于脱水程度 先快后慢先快后慢 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 810ml/kg.18三、病情观察三、病情观察生命体征生命体征脱水情况脱水情况低钾、酸中毒等情况

7、低钾、酸中毒等情况准确记录出入量准确记录出入量19四、控制感染四、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。20Your company slogan in hereLOGO222324vHow do I incorporate my logo to a slide that will apply to all the other slides? - On the View menu, point to Master, and then click Slide Master or Notes

8、Master. Change images to the one you like, then it will apply to all the other slides. Image information in product - Image : mowolf- Note to customers : This image has been licensed to be used within PowerPoint template only.- You may not extract the image for any other use.Introduction25DiagramRea

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