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Traumatic hyphema nursing intervention


Abstract Objective implementation of nursing intervention, prevention of complications of traumatic hyphema improve the cure rate. Methods 83 patients on close observation of disease in a timely manner for effective nursing measures, such as to prevent further bleeding, promoting blood in absorption, the prevention of infection and various complications. Results The patients with no complications, visual acuity satisfaction. Conclusion timely and correct care can effectively prevent and reduce traumatic hyphema complications. Keywords traumatic hyphema nursing Chinese papers League finishing. traumatic hyphema caused by contusion suffered because of the eye is more common eye diseases, clinical treatment, care, timely and correct or not, directly affect the disease prognosis. Our department since January 2002 ~ December 2003 were treated patients with traumatic hyphema 83 cases of the disease according to the characteristics of our implementation of proper care, satisfactory results, will now report the following experience. 1 clinical data the group of 83 patients (83 eyes) were male and 81 cases, female 2. Aged 7 to 43 years, children under the age of 14 in 6 cases, anterior chamber blood on admission were as 2mm depth of at least up to those who fill the anterior chamber, visual acuity decreased to varying degrees, serious only light perception. Hemorrhage absorption time as short as 3 days and the longest 6 days, no complications. 2 nursing 2.1 psychological care injured because of eye pain, visual impairment, the prevalence of fear, anxiety and other adverse psychological state. Therefore, the timely and effective psychological care is very important. Attitude of the nurse kind, stable manners, initiative to ask the patient's condition, its about clarifying the treatment of this disease and nursing knowledge, this vision be absorbed by the blood volume will return, do not worry, so that they can properly treat the disease, eliminate fear psychology, peace of mind for treatment, and timely communication with family members to obtain their active support. 2.2 limited supine, and promote blood in absorption give the injured admitted to hospital after taking a half lying, will head up 40 ° ~ 45 ° bed rest, the blood sinking membership of gravity, not only prevents the accumulation of blood in the pupil, but also to reduce neck and eye venous congestion [1]. General semi-recumbent position to absorb the bleeding can be changed to automatically position the rear. But the longer semi-recumbent position, the patient will feel discomfort, often secretly transform supine, nurses have to take them of the importance of semi-recumbent position, and more inspections in a timely manner to correct. Child patients, is for parents actively cooperate. 2.3 to take effective measures to prevent further bleeding 2.3.1 bandaged eyes injured after admission gauze bandage both eyes to give pressure to make the iris and ciliary body inactive, reduced eye movement, eye movement and thus avoid the eye when the eye muscles and increase blood pressure. Nurses should inform patients of the importance of this measure, let not arbitrarily remove the bandage with privately, and has asked the patient if the injured eye with discomfort, to reflect the time for timely diagnosis and treatment. 2.3.2 or negative pressure to prevent the collision of the eye to minimize the head to tell the injured person is prohibited by hand squeezing his eyes, to cooperate or children to wear special eye to eye protection. Bedside kept free of obstructions, the commonly used items could reach out and put in place, instruct patient to get out of bed carefully, to prevent the collision of the injured eye again. Operation in the care and treatment (such as corneal injection, eye drops, etc.), action should be lightweight, accurate, and to avoid pressure on the eyeball. 2.3.3 to enhance life care, to avoid excessive force fasting patients excellent food, to avoid excessive chewing teeth increase vibration transmission to the anterior chamber eye hemorrhage. Encouraged to eat more fruits and crude fiber-rich foods to prevent dry stool, avoid defecation spurts of blood vessel rupture occurs when the intraocular pressure re-bleeding. 2.4 closely observed, and actively prevent complications (1) In addition to eye pain in patients admitted to hospital, another expression for the sleepy, the reaction insensitive, and even showed sleepiness. Therefore, we must regularly inspect and care for patients, close observation, a merger of brain trauma alert for early detection of early treatment. (2) carefully observe the tightness of his eyes bandaged, ask the patient the extent of injury eye pain, eye pain complaints increased if the patient with headache, nausea and vomiting and other symptoms of increased intraocular pressure, intraocular pressure lowering drugs should be given time to prevent secondary glaucoma. 2.5 proper use of the intraocular pressure lowering drugs to reduce side effects currently hypotensive drugs most commonly used mannitol and acetazolamide. 20% mannitol injection is a hypertonic dehydration organization diuretics, can reduce intraocular pressure, but also because of the rapid dehydration caused by diuretic hyponatremia, hypokalemia, clinical manifestations of hypovolemia, arrhythmias, low blood pressure, disturbance of consciousness, intestinal paralysis, muscle weakness, etc. [2]. Therefore, we assigned responsibility for and control the speed of liquid drops, and close observation of changes in heart rate and blood pressure, so that can achieve therapeutic effect, and also to avoid side effects. In addition, mannitol can cause leakage of extravascular tissue damage, the infusion should be chosen thick, straight vein puncture to ensure accurate, Do not allow liquid leakage outside the blood vessels. And acetazolamide can lead to urine crystals, damage to kidney function, therefore, patients with oral acetazolamide baking soda to the same services, Nursing and more water, and to strengthen the inspections, to observe the urine, unusual and timely report processing. 2.6 prevention of infection 2.6.1 eye drops eye drops routinely given ofloxacin eye drops and to dexamethasone eye drops, eye each 4h1 times alternately, points should be observed whether the jealous eyes eye pain, corneal opacity is, with or without inflammatory secretions. Or swelling of the eyelid laceration, should observe whether the wound dehiscence,[link widoczny dla zalogowanych], bleeding exudate and so on, such as unusual, should be promptly reported. Operation, action should be steady, accurate, light, and pay attention to aseptic technique. 2.6.2 corneal injection current room appears cloudy exudate, to 2 million U of gentamicin and dexamethasone 2.5mg cornea injection, depending on the condition day 1 or 2 days 1, the cornea after injection of a small amount of bloody effusion, is a normal phenomenon, to advance to the patients and their families to help prevent the unnecessary fear. 2.7 discharged missionary instruct patient after discharge from hospital should pay attention to eye health, not to hand Rouyan, avoid strenuous exercise, to prevent the collision eyes, regular out-patient referral . In case of eye pain or vision changes, headache and other symptoms, should be timely treatment. Require patients to take medicine and eyedrops, and teach patients and their families the right way to use eye drops. 3 results this group of patients without complications. 81 cases of eye injury visual acuity at discharge to 4.2 above. 2 cases because of financial problems, the plot is not fully absorb the blood from the hospital without authorization. 4 Experience traumatic hyphema can be cured after treatment, but if not handled in a timely manner, prone to complications, prolonged treatment, increased patient pain , or even result in adverse consequences. Therefore, nurses must attach great importance to take active measures to prevent further bleeding and prevent complications. Proper use of drugs, close observation of changes in condition, so that early detection of problems and timely Treatment, so that patients can be successfully recovered.