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Difficult Intravenous Access and Its Management 静脉进入困难及其处理
Pub Date : 2021-03-19 DOI: 10.5772/INTECHOPEN.96613
Handan Eren
Difficult intravenous access (DIVA) may occur due to several factors, such as the demographic and clinical characteristics of the patients (age, sex, height, weight, ethnicity, IV drugs history, and medical history), health professional’s experience, device characteristics, site of insertion, and vein characteristics. Difficult intravenous access leads to repeated insertion attempts that might prove to be uncomfortable for the patients, frustrating and challenging for the health professionals, and expensive for the health institutions. The practitioners must develop the awareness of the factors capable of increasing the difficulty of defining the appropriate vein for cannulation through their varied experiences with vein location and vascular access.
静脉进入困难(DIVA)可能是由以下几个因素造成的,如患者的人口统计学和临床特征(年龄、性别、身高、体重、种族、静脉用药史和病史)、卫生专业人员的经验、器械特征、插入部位和静脉特征。静脉注射困难导致反复尝试插入,这可能会让患者感到不舒服,对卫生专业人员来说是令人沮丧和挑战的,对卫生机构来说也是昂贵的。从业人员必须通过他们在静脉定位和血管通路方面的不同经验,培养对能够增加确定适当静脉插管难度的因素的认识。
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引用次数: 3
Self-Management of Blood Pressure Control at Home in Chronic Kidney Disease: Nursing Interventions and Health Gains 慢性肾脏疾病患者家庭血压控制的自我管理:护理干预和健康收益
Pub Date : 2021-03-11 DOI: 10.5772/INTECHOPEN.96416
Dilar Costa, F. Aguiar
One of the advantages of HBPM (Home Blood Pressure Measurement) compared to office measurement is being a strong predictor of cardiovascular morbidity and mortality in hypertensive patients, including those with chronic kidney disease (CKD). However, studies with renal patients not dependent on dialysis are scarce. HBPM is an important tool in the regular monitoring of blood pressure (BP) and in patient’s involvement in its long-term self-management. Nurses have an important role here and their involvement in the process is essential. Nurses must be aware of the latest recommendations as well as they should teach, train, guide and supervise patients. This chapter summarizes information about CKD and hypertension, the importance of measuring blood pressure at home in CKD and describes nursing interventions in this field. Nurses have a role in enabling patients to optimize their self-management skills. Nurse-delivered interventions have been shown to contribute to improved patient outcomes. Nurses can educate patients about proper blood pressure monitoring techniques at home, and also interpreting and evaluating the results and managing the therapeutic regimen. Evidence shows the effects of interventions performed by nurses in improving and controlling BP, such as teaching, training, counseling, motivational interview, coaching, nurse–patient relationship, communication, negotiation, and support.
与办公室测量相比,HBPM(家庭血压测量)的优势之一是它是高血压患者心血管发病率和死亡率的有力预测指标,包括慢性肾脏疾病(CKD)患者。然而,对不依赖透析的肾病患者的研究很少。HBPM是定期监测血压(BP)和患者参与其长期自我管理的重要工具。护士在这里扮演着重要的角色,她们在这个过程中的参与是必不可少的。护士必须了解最新的建议,以及他们应该教导、培训、指导和监督病人。本章总结了CKD和高血压的相关信息,CKD患者在家测量血压的重要性,并介绍了该领域的护理干预措施。护士在使患者优化自我管理技能方面发挥着作用。护士提供的干预措施已被证明有助于改善患者的预后。护士可以在家里教育病人正确的血压监测技术,也可以解释和评估结果,管理治疗方案。有证据表明,护士采取的干预措施,如教学、培训、咨询、动机访谈、指导、护患关系、沟通、谈判和支持,在改善和控制血压方面具有效果。
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引用次数: 2
Features of Diagnostics and Differential Diagnostics of Chronic Heart Failure in Outpatient Clinics 门诊慢性心力衰竭的诊断与鉴别诊断特点
Pub Date : 2021-02-01 DOI: 10.5772/INTECHOPEN.95863
O. Shtegman, M. M. Petrova
The Chapter contains information about the prevalence of heart failure (HF) among patients in outpatient practice. The causal structure of HF, the prevalence of risk factors for HF, and the occurrence of a reduced ejection fraction are described. It describes the frequency of overdiagnosis of HF, the disease most often simulating its symptoms. The difficulties associated with laboratory and instrumental diagnostics of this syndrome are discussed. A pharmacological test for differential diagnosis of the causes of dyspnea in patients with suspected HF is described. Information is provided on the incidence of depressive and anxiety among the patients with this disease.
这一章包含了关于心衰(HF)在门诊病人中流行的信息。本文描述了心衰的因果结构、心衰危险因素的流行以及射血分数降低的发生。它描述了HF的过度诊断频率,这种疾病最常模拟其症状。讨论了与该综合征的实验室和仪器诊断相关的困难。对疑似心衰患者呼吸困难原因的鉴别诊断的药理学试验进行了描述。提供了有关此病患者中抑郁和焦虑发生率的信息。
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引用次数: 0
Needling Therapies in the Outpatient Care: Adverse Effects 门诊护理中的针刺疗法:不良反应
Pub Date : 2020-11-23 DOI: 10.5772/intechopen.94774
Inés Llamas-Ramos, Rocío Llamas-Ramos
The invasive techniques have been used for many years. There is a lot of literature on the advances that have been made, as well as the adverse effects or possible complications that have occurred during the performance of these treatments. Acupuncture and injections (saline, anesthetics, corticosteroids or botulinum toxin) have reported several cases of complications. Dry needling is also beginning to have several publications of this type. The objective of this chapter is to summarize the articles published in relation to adverse effects of needling therapies to promote a good practice and knowledge. Original articles in form of randomized controlled trials, case reports and reviews relating adverse effects and possible complications due to invasive/needling techniques: acupuncture, injections and dry needling have been included. 102 articles met the inclusion criteria between January 2000 and January 2020. The first limitation found in the literature was the huge variety of cases, therapists and incidents to generalize. As a conclusion we can stated the importance of a good knowledge of the anatomy and its variants, the correct application of these techniques and a continuous training of these therapists must be essential.
侵入性技术已经使用了很多年。有很多关于已经取得的进展的文献,以及在这些治疗过程中发生的副作用或可能的并发症。针灸和注射(生理盐水、麻醉剂、皮质类固醇或肉毒杆菌毒素)已报道了几例并发症。干针术也开始有这种类型的出版物。本章的目的是总结发表的文章有关针疗法的不良反应,以促进良好的做法和知识。包括随机对照试验、病例报告和综述形式的原创文章,涉及侵入性/针刺技术的不良反应和可能的并发症:针灸、注射和干针。2000年1月至2020年1月期间,102篇文章符合纳入标准。在文献中发现的第一个限制是病例、治疗师和事件的种类繁多。作为结论,我们可以陈述良好的解剖学知识及其变体的重要性,这些技术的正确应用和这些治疗师的持续培训必须是必不可少的。
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引用次数: 0
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Outpatient Care [Working Title]
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