Common nursing problems and measures

In the hospital, the people who spend the most time with patients are doctors and nurses. The doctor makes an accurate diagnosis for the patient and then gives medical advice, and the nurse takes care of the patient according to the doctor's advice. The close cooperation between the doctor and the nurse is the guarantee for the patient's quick recovery. Although people often believe that doctors make the greatest contribution to the recovery of diseases, without the dedicated care of nurses, the patient's recovery will also be affected. Below we introduce common nursing problems and measures.

1. Coughing due to drinking water

Precautions:

⑴ When feeding water, be careful not to feed too fast and feed in small amounts each time.

⑵ Pay attention to the patient's reaction when feeding water. If you find the patient choking, immediately tilt the head to one side to prevent water from accidentally entering the respiratory tract.

⑶ For patients who frequently choke, the nurse should remind the doctor to insert a gastric tube.

2. Dysphagia

Precautions:

⑴ Feed slowly and in small amounts, and make sure the patient has swallowed before continuing.

⑵ Give the patient food that is easy to swallow.

⑶ When feeding a sleepy patient, you must wake the patient up completely and make sure there is no food in the mouth before leaving.

⑷ Pay attention to communicating with the patient and closely observe the patient's reaction when eating. If swallowing difficulties occur, stop eating immediately, take out the food in the mouth, and tilt the head to one side.

Common problems in oxygen inhalation

3. Barotrauma

Precautions:

⑴ Adjust the oxygen flow rate first and then insert the oxygen tube into the patient's nostrils.

⑵ When changing the oxygen flow, remove the catheter first and then insert the catheter after it is adjusted.

4. Oxygen poisoning

Precautions:

⑴ Correctly adjust the oxygen flow according to the doctor's instructions.

⑵ When using high-flow oxygen inhalation, be careful not to let the inhalation time be too long.

⑶ Regularly check whether the oxygen flow meter is accurate.

5. Pipeline fall off

Precautions:

⑴ Use a double-lumen oxygen tube to facilitate fixation.

⑵ Regularly inspect patients receiving oxygen, and promptly plug and secure the tube if it is found to be detached.

⑶ Instruct conscious patients not to remove the oxygen tube by themselves.

Common problems in dispensing oral medications

6. People in the same ward received the wrong medications

Precautions:

⑴ Strictly follow the three checks and seven comparisons, and call on the patient until he agrees when dispensing medicine.

⑵ Do not bring more than two medicine cups into the ward to give to patients at one time. The medicine cart must be pushed to the bedside for one-on-one distribution.

⑶ Each medicine cup must have a medicine cover with a conspicuous bed number on it and no one must be left out.

⑷ Oral medication should be checked by two people before being issued by one of them.

7. Wrong medication dosage

Precautions:

⑴Copy the oral card correctly.

⑵ Be serious when checking medicines, avoid joking while checking, and it is forbidden to check alone.

⑶ Avoid the fixed mindset that the dosage of medicine taken by some individual patients is more or less than the regular dosage and cannot be dispensed according to the regular dosage. (For example, each tablet of Kaibotun is 12.5 mg, and some patients take 6.25 mg, so they cannot be given one tablet as usual.)

⑷ When the dosage of some drugs changes, the field nurse should notify everyone in time and draw attention.

⑸Some medicines have two dosages, so you must check them carefully and know the exact amount.

8. Missed delivery (mostly because the patient is not present)

Precautions:

⑴ Prepare a card to register the bed number and name when the patient is not present.

⑵ The two people on the shift remind each other to distribute the medicine in time when the patient returns to the room.

⑶ If this class has not distributed it, it must strictly hand over to the next class.

9. Re-issuance (mostly designated drugs)

Precautions:

⑴ Establish a designated drug distribution registration book and fill it out promptly before dispensing the medicine.

⑵ Fill in the medicine bag before dispensing the medicine, and bring the execution card and medicine bag when dispensing the medicine.

⑶ Clear division of labor and conscientious implementation of job responsibilities of each class.

10. Drug expiration

Precautions:

⑴ Check the expiration date of the medicine before dispensing it.

⑵ Check whether the tablets have changed color or deteriorated.

⑶ Check whether the aqueous solution and oily solution are turbid, precipitated or discolored.

11. Failure to take medication promptly after it is given

Precautions:

⑴ Explain to patients the importance of taking medication on time.

⑵ After dispensing the medicine, urge the patient to take the medicine on time and leave only after the patient has taken the medicine.

⑶ Check whether the patient has taken the medicine before dispensing the medicine next time.

12. Incorrect medication method

Precautions:

⑴ Explain to patients the pharmacological effects and precautions of taking medications.

⑵ When dispensing medicine, nurses should give patients correct instructions and help them take the medicine orally.

Problems with intramuscular injections

13. Improper injection site

Precautions:

⑴ Assist the patient to assume the correct position.

⑵Accurately select the injection site.

⑶ For thin patients, the needle should not be inserted too deep.

⑷ Children should choose gluteus minimus muscle injection.

14. Bleeding at the injection site

Precautions:

⑴ Avoid large blood vessels during injection.

⑵ Before injecting the medicine, aspirate to see if there is blood return.

⑶ The time of pressing the injection site after injection should not be too short.

⑷ For patients with poor coagulation function, the pressing time should be prolonged.

15. Induration at the injection site

Precautions:

⑴ Avoid existing nodules during injection.

⑵ If long-term injection is required, inject alternately in multiple sites.

⑶ Special drugs need to be injected deeply, such as chlorpromazine, oil, iron, magnesium sulfate, etc.

⑷ Check the injection site before each injection and deal with any abnormalities promptly.

⑸Apply hot compress to the injection site every day.

16. Injection site infection

Precautions:

⑴ Strictly follow aseptic technical operating procedures during injection.

⑵ Drugs that are not easily absorbed should be injected deeply to prevent infection caused by poor absorption.

⑶Keep clean during daily hot compress.

Common problems with intravenous infusion

17. Liquid mismatch: Drugs and liquids that are easily confused clinically, such as sugar and salt, potassium chloride and sodium bicarbonate, magnesium sulfate and concentrated sodium chloride, and potassium chloride and sodium chloride.

Precautions:

⑴ Adhere to the three-shift checking system, that is, the treatment shift arranges the medicines, the night shift checks, and the treatment shift checks again.

⑵ When preparing the solution, carefully check the name and dosage of the drug and liquid to avoid operating based on subjective impressions.

⑶ Check carefully before infusion and fluid change.

18. Missed Input

Precautions:

⑴ Carry out the three checks and seven comparisons carefully.

⑵Liquids in the treatment room should be placed in an orderly and clear manner.

⑶Strictly implement the shift handover system.

19. Infusion reaction

Precautions:

⑴ Strictly implement aseptic technical operating procedures.

⑵ Before preparing the solution, check whether the medicine and liquid are expired, and whether the liquid is turbid or has precipitation. Check whether there are cracks on the bottle body and whether the bottle mouth is loose.

⑶ The treatment team strictly disinfects infusion equipment and replaces them regularly.

⑷ Strictly control the time of liquid preparation (prepare before use).

⑸ If continuous infusion exceeds 24 hours, the infusion line must be replaced.

⑹The infusion tube used for fluid induction cannot be left in place for a long time.

⑺ Understand the contraindications of drug combinations.

⑻ If an infusion reaction occurs, replace the fluid and infusion line immediately and retain the used medication for testing.

20. Phlebitis

Precautions:

⑴ Understand the degree of drug irritation to veins. For highly irritating drugs, such as fructose, potassium chloride, dopamine, alamin, prostaglandin E1, etc., you can take measures such as slowing down the drip rate and applying hot compresses.

⑵ Find out whether the patient has ever suffered from phlebitis, has a history of diabetes, etc.

⑶ Strictly disinfect and replace the infusion line if continuous infusion exceeds 24 hours.

⑷ Pay attention to observe whether there are signs of redness in the vein at the puncture point. If there is any abnormality, change the infusion site in time.