Graduation thesis of nursing of traditional Chinese medicine Part I: Nursing experience of fumigation therapy of traditional Chinese medicine. In recent years, fumigation therapy of traditional Chinese medicine is a further extension and development of external therapy of traditional Chinese medicine by using modern scientific and technological means to act the effective components of traditional Chinese medicine on the local or whole body in the form of drug vapor ions, so as to achieve the function of relaxing meridians, promoting blood circulation and dredging collaterals and relieving pain. Clinically, it is widely used in rheumatism, lumbar disc herniation, osteoarthritis, scapulohumeral periarthritis, cervical spondylosis, soft tissue injury, muscle strain, deficiency-cold gastrointestinal diseases, apoplexy sequelae, diabetic peripheral neuropathy and peripheral vascular diseases, gynecological chronic pelvic inflammatory disease, dysmenorrhea, chronic prostatitis, capillary inflammation and Raynaud's disease and other connective tissue diseases. Since the implementation of this treatment method in our hospital in 2005, nurses have achieved satisfactory results by using nursing procedures to implement individualized care. The nursing experience of 2,892 patients with traditional Chinese medicine fumigation is summarized as follows:
1 clinical data
March 2005 1 month--20 10/March 2005 * * 2,892 patients were treated with steaming therapy of traditional Chinese medicine in the Department of Integrated Traditional Chinese and Western Medicine in our hospital, the oldest being 78 years old and the youngest being 12 years old, including 352 cases of lumbar disc herniation, 263 cases of rheumatoid arthritis, 487 cases of osteoarthritis and scapulohumeral periarthritis. Cervical spondylosis 125 cases, stroke hemiplegia 130 cases, soft tissue injury 50 cases, deficiency-cold gastroenteritis 76 cases, chronic pelvic inflammatory disease 78 cases, chronic prostatitis 152 cases, diabetic peripheral neuropathy 272 cases, diabetic peripheral angiopathy 232 cases, diabetic peripheral neuropathy and peripheral angiopathy/kloc-.
2 methods
2. 1 preparation before fumigation treatment of traditional Chinese medicine: ① visit before treatment: after receiving the notice from the ward, the nurse in the fumigation room went to the ward 1 day before treatment to check the patient's condition, talk with the patient and make an appointment for fumigation treatment; (2) preparation of fumigation room, routine disinfection, preparation of different fumigation liquid medicines for different patients according to the agreed prescriptions prescribed by doctors, and preparation of sphygmomanometer, stethoscope, warm water, physiological saline solution and oral rehydration salt.
2.2 fumigation procedure of traditional Chinese medicine: add 3000ml of water to the crushed traditional Chinese medicine formula in advance, soak it in a fumigation pot for 30 minutes, then heat and boil it until the temperature in the fumigation chamber reaches 45℃. Put the fumigation part of the patient in the fumigation chamber, adjust the temperature between 45℃ and 52℃ according to the patient's tolerance and illness, and position it for 30-45 minutes. During the fumigation process, measure the blood pressure and heart rate/kloc-0 according to the patient's self-feeling.
2.3 Nursing care after fumigation of Chinese medicine After the fumigation time of Chinese medicine reaches the set time, open the fumigation cabin when the temperature drops to 37℃, help the patient out of the cabin, rinse the liquid medicine with warm water, dry the whole body skin with a dry towel, get dressed, rest in the fumigation room for 10-20 minutes, and send the patient back to the ward after the whole body shows no signs of sweating.
3 indications and contraindications of fumigation of traditional Chinese medicine
3. 1 indications: Chinese herbal fumigation is suitable for rheumatic diseases, muscle strain, degenerative joint diseases, lumbar disc herniation, deficiency-cold gastroenteropathy, chronic pelvic inflammatory disease, dysmenorrhea, chronic prostatitis, capillary inflammation, Raynaud's sign and other connective tissue diseases, diabetic peripheral neuropathy and peripheral vascular diseases.
3.2 Contraindications: ① Patients with severe cardiopulmonary dysfunction; ② Patients with purulent dermatosis or skin ulceration ③ Patients with acute inflammatory and infectious diseases. 4 Chinese medicine fumigation care precautions
4. 1 Do a good job of psychological counseling for patients before fumigation. Fumigation with Chinese medicine is a traditional therapy that has emerged in recent years. Many patients are worried about this therapy. Therefore, before fumigation treatment 1 day, according to the patient's condition, it is necessary to carefully explain the role of fumigation treatment and the safety of fumigation process to patients, so as to gain their trust and cooperation.
4.2 Before fumigation, the fumigation cabin should be strictly disinfected to prevent some undiscovered infectious diseases from cross-infection.
4.3 For the patients who are fumigated for 1 time, nurses should accompany and communicate with them all the time to understand their own feelings and prevent skin burns. Generally, the temperature should be controlled to the minimum tolerance point of 42℃ and then gradually increased according to the patient's tolerance during fumigation, generally not exceeding 52℃. For patients with hypertension, heart disease and chronic lung diseases, the principle is to sweat slightly all over the body, and blood pressure and heart rate should be monitored in time to prevent sudden increase of blood pressure and heart rate.
4.4 During fumigation, 250-500ml of normal saline or warm boiled water can be given orally frequently according to the patient's sweating amount, so as to prevent excessive sweating from causing a sudden drop in blood volume and inducing insufficient blood supply to the heart and brain or even infarction.
4.5 After fumigation, don't let the patient leave the cabin in a hurry to prevent sudden drop in temperature, causing general discomfort or even catching a cold. After leaving the cabin, you should understand the patient's self-feeling, monitor blood pressure and heart rate, and compare them with those before entering the cabin to prevent the sudden rise and fall of blood pressure and heart rate from causing damage to the body.
5 discussion
Traditional Chinese medicine fumigation therapy has a wide range of applications, good clinical efficacy, safety and comfort, and it is a non-toxic and harmless green therapy. In recent years, this business has been widely carried out in our hospital, and the requirements for nursing process and quality have been improved year by year. Through clinical nursing observation of more than 2,800 patients, targeted nursing has been carried out from the above aspects. Through evaluation before and after fumigation therapy, nursing methods have been continuously summarized and improved, aiming at patients with different diseases and patients of different ages. Patients with different cultural levels and different psychological qualities have been given individualized care, and satisfactory results have been achieved, which has made great progress in the treatment of fumigation of traditional Chinese medicine.
TCM Nursing Graduation Thesis Part II: Application of TCM Nursing in triage. TCM nursing is an applied discipline, which is guided by TCM theory, based on nursing procedure, uses holistic concept, and uses traditional nursing techniques and methods to care for patients and people and protect human health [1]. It has rich content and valuable experience in daily life, emotion, diet, health care and prevention. Traditional Chinese medicine nursing has the following advantages.
1 advantages
1. 1 theoretical advantages
Traditional Chinese medicine nursing advocates conditioning patients from the aspects of human body, psychology, spirit and society. It was not until the end of last century that modern medicine changed biomedical model into biological, psychological and social medical model, emphasizing? Holistic care? I didn't know the concept until today. People? Centered. Traditional Chinese medicine nursing meets the needs of prevention, health care, treatment and rehabilitation, so it has been loved by people. Today, when human beings are most eager to return to nature and enjoy their natural life, TCM nursing will surely play an increasingly important role.
Advantages of 1.2 method
There are eight methods to treat diseases in TCM: sweating, vomiting, purgation, warming, clearing, eliminating and tonifying. These eight methods point out the direction of treatment according to the etiology, symptoms and the location of the disease. In traditional medicine, doctors and nurses are not separated, that is? Three-point medicine, seven-point care? Compared with western medicine nursing, Chinese medicine pays more attention to the coordination of medication time and diet. In terms of non-drug treatment methods, acupuncture, moxibustion, massage, cupping, hot compress, fumigation and washing, picking and cutting, medicated pillow, face bath, foot bath, sunbathing and hot spring bath all belong to traditional Chinese medicine nursing methods. These techniques have the characteristics of simple instruments, convenient operation, wide application range, quick effect, low cost and no toxic and side effects, and are well received by the masses.
1.3 application advantages
Easy to understand, simple, participatory and easy to popularize. The convenience and practicability of traditional Chinese medicine nursing are incomparable to other modern nursing, so it has a wider use. Massage, qigong, medicated bath and other methods are easy to master and use; Chinese medicine? Four smells and five flavors? It is easy to understand and use the theory to classify diet and guide patients to take care of their diet. Traditional Chinese medicine (TCM) has a very broad application prospect, and some diseases that cannot be effectively controlled by western medicine will have a good curative effect by using TCM.
2
2. 1 unique diagnosis and treatment technology
Look, smell, ask and feel are the most basic and effective means for Chinese medicine to collect medical history, collect disease data, make diagnosis and implement treatment, and it is also the most effective way for us to fully understand the patient's condition, accurately reflect the condition, and correctly preview and triage.
2. 1. 1 Observe the patient's spirit, color, shape, posture, head, facial features and skin. If there are signs of hyperthyroidism, the patient will be referred to the endocrinology department.
2. 1.2 Listen to the patient's voice, breathing, cough, vomiting and hiccup to judge the depth, deficiency, cold and heat of the affected area, so as to take appropriate nursing methods, give appropriate medication guidance and relieve the pain of patients. For example, hoarseness is referred to the otolaryngology department.
2. 1.3 q By asking patients and their families, we can know the general situation, life, eating habits, family history and past history of patients. According to these data, timely and accurate triage should be carried out, and patients should not be subjectively asked or hinted, so as to avoid inaccurate triage. For example, headache is only a symptom, which can be caused by many reasons. Therefore, when asking about medical history, we should understand the causes, nature and laws of headache. If it is a persistent headache with progressive aggravation, you should consider arranging for medical treatment in neurology. If it is a headache caused by trauma, it may be a sequela of brain injury, which is caused by the nerve.
Examination is more appropriate. If you have high fever, headache and purulent discharge in your ears, it should be caused by otitis media, so you should be referred to the otolaryngology department for medical treatment.
2. 1.4 When outpatients report palpitation and fatigue, we should feel the pulse to find out whether it is an emergency.
3 diet care?
Traditional Chinese medicine diet maintenance: refers to the treatment, nursing and prevention of diseases through diet, including medicated diet, medicated wine, medicated tea, medicated porridge, medicated drink, etc. Diet therapy is not only conducive to the treatment and nursing of diseases, but also conducive to the growth and development of children and the beauty of women. Longevity and anti-aging of middle-aged and elderly people [2]. For example, in Danggui Mutton Ginger Soup, mutton gets ginger, which plays a synergistic role in strengthening warming and tonifying, and can treat abdominal pain due to deficiency-cold. For example, some patients with hypertension and hyperlipidemia like big fish and big meat. At this time, they should patiently explain the dangers, change their eating habits, and should enter a light diet. Obese patients should eat light and expectorant food: thin people should eat more foods that nourish yin, promote fluid production and replenish blood, and the elderly and chronically ill people should be given light, nutritious and digestible food, and pregnant women and lactation period should eat light and nutritious and digestible food; During the period of children's growth and development, it is advisable to eat nutritious foods such as cereals, fruits and vegetables; Asthma patients and allergic people should not eat fish, shrimp and other seafood, as well as some sweet and dry products.
4 basic nursing operation application?
For example, patients with rheumatoid arthritis, dyspepsia and dysmenorrhea can be treated with warm moxibustion according to the doctor's advice, and patients with weak constitution can be taught to massage Zusanli point frequently to play a health care role. Hiccup patients can stop hiccups by pressing Hegu point.
5 conclusion?
To cultivate the TCM nursing quality of triage nurses, it is required to care for patients everywhere, devote oneself to patients, treat triage work meticulously, always care about patients' condition, strengthen the study of TCM theory, implement the holistic view of harmony between man and nature and the TCM nursing concept of dialectical nursing, so as to make the theoretical knowledge of Chinese and Western medicine complementary and use it in clinic, and benefit patients. ?
Take part in the examination and contribute
[1] Li Yuxia, Li Liping. Analysis and discussion on the teaching status of TCM nursing course. Qilu Nursing Journal, 2009,17: 90-91.
[2] Ren Juan, Zeng Yuan. Application of traditional Chinese medicine nursing in community hospitals. Xinjiang Traditional Chinese Medicine, 2009, 5: 51-52.
> > > More exciting on the next page? On the graduation of traditional Chinese medicine?