静脉输血后四级静脉炎,氧疗+水胶体贴敷轻松搞定!

2020-08-11 芳芳 护士网

静脉炎是静脉输液治疗最常见的并发症,发生率可达75%,严重者可发展为深静脉血栓、败血症等严重并发症。

静脉炎是静脉输液治疗最常见的并发症,发生率可达75%,严重者可发展为深静脉血栓、败血症等严重并发症。

相关研究报道,静脉炎的发生不仅增加患者的痛苦,延长住院时间,同时也增加了护士的工作量。

在此,与大家分享一例使用氧疗+水胶体透明贴治疗四级静脉炎的病例,希望给大家提供借鉴。

病例分享

基本资料:患者女性,77岁

入院诊断:急性心力衰竭、重度贫血、低蛋白血症、多浆膜腔积液。

发生及处理经过:2020-7-4 15:20 患者与左肘正中输注悬浮红细胞2个单位,结束后0.9%氯化钠注射液冲封管,于 7-5 该留置针通畅,穿刺处有血性渗出,予以更换3M贴膜后输注血栓通等常规药物,输液结束拔除该留置针,于 7-6 08:00 发现穿刺点出现脓性分泌物,并伴有以穿刺点为中心3*3cm的硬结,伴有疼痛。

局部处理:

1.先用碘伏消毒,范围超过硬结部位,防止穿刺点感染

2.待干后用0.9%氯化钠注射液冲洗碘伏,待干。

3. 取水胶体透明贴以穿刺点为中心,覆盖整个硬结部位(注意水胶体无张力贴敷,不利气泡,并用手掌轻轻按压片刻,是水胶体透明贴与皮肤完全贴合)。

4.嘱其抬高患肢。

治疗经过:7-7 16:00 发现水胶体内有脓性渗出,硬结大小无改变,仍有局部疼痛,遵医嘱更换更换敷料。

1. 先用碘伏消毒,范围超过硬结部位。

2.待干后用0.9%氯化钠注射液冲洗碘伏,待干。

3.给予高流量氧疗30分钟。

4. 取水胶体透明贴以穿刺点为中心,覆盖整个硬结部位(注意水胶体无张力贴敷,不利气泡,并用手掌轻轻按压片刻,是水胶体透明贴与皮肤完全贴合)。

5.嘱其抬高患肢。

7-9 15:00 水胶体内有少量脓性渗出,硬结范围较前缩小,仍有局部疼痛,遵医嘱更换更换敷料。

7-15-09:00 再次给予患者更换敷料,穿刺处无脓性分泌物渗出,局部硬结较前缩小,大小约0.5*0.7cm,患者自诉无疼痛,嘱其适当抬高患肢。

7-18 患者撤除敷料,穿刺点已愈合,局部无疼痛。

原因分析:①患者自身血管条件差,感知能力弱,未及时表达疼痛感;②该患者责任护士为低年资护士,对于输血后注意事项相对匮乏,护理组长对危重患者的病情把控不严;③穿刺点出现渗出时未及时上报上级护士,缺乏预见性思维。

经验总结:加强全员输血相关知识的培训,护理组长参与病情交接,为低年资护士把好关;提高预见性思维,工作中出现问题及时向上级护士报告。

总之,静脉炎作为静脉输液治疗中最常见的并发症之一,护理人员应采取积极有效的预防和处理措施,认真执行护理技术操作规范,减少静脉炎的发生,减轻静脉炎给患者带来的痛苦。

 

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    2021-09-05 pyunzhen

    学习了

    0

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    2021-02-03 zhaojie88
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    2021-01-12 班崽在线学习

    学习

    0

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    2020-08-13 windight
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    2020-08-13 jichang
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    2020-08-13 rgjl

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