CAC TIT THE NGHi NGOI TRj LIEU THONG THUONG
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M yc n e u
1. Trinh bay ditdc mot so tit the nghi ngdi tri lieu thdng thitbng.
2. Trinh bay ditdc quy trinh ky thuat dat ngitcfi benh d cdc tit the nghi ngcfi tri
lieu thich hcfp.
1. TIT THE NAM NGUA THANG
- Trtfdng hdp ap dung: tu the tri lieu sau ngat, soc, chong mat.
- Trtfdng hdp khong ap dung: ngtfdi benh hon me, ngtfdi benh non (de
phong chat non lac vao dtfdng ho hap).
- Ky thuat: dat ngtfdi benh n&m th&ng ltfng, dau khong co goi, chan duoi
thSng, ban chan dtfdc gitf vuong goc vdi cang chan.
2. Tir THE nAm NGtfA DAU THAP
2.1. Trtfdng hdp ap dung
- Sau xuat huyet de phong ngat, soc.
- Sau choc ong song.
- Lao dot song co.
- Keo duoi trong trtfdng hdp gay xtfdng dui.
2.2. Trtfdng hdp khong ap dung
Ngtfdi b§nh hen phe quan, ngtfdi benh hon me, ngtfdi benh non...
2.3. Ky thuat
- Dfit ngtfdi benh nam thing tren gitfdng, dau khong co goi, chan gitfdng phia
chfin ngtfdi b£nh dtfdc k§ cao hay tha'p (nhieu hay it) tuy theo chi dinh.
- Cung c6 thi ke g6i dtfdi vai ngtfdi benh va ke cao hai cing chan bang mot
gdi to.
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3. TU THE NAM NGUA DAU HOI CAO
3.1. Trtfdng hdp ap dung
- Benh dtfdng ho hap, benh tim.
- Thdi ky dtfdng benh, ngtfdi gia.
3.2. Trtfdng hdp khong ap dung
- Ngtfdi benh co roi loan ve nuot.
- Ngtfdi benh ho kho khan.
- Ngtfdi benh hon me, sau gay me.
3.3. Ky thuat
- Cho ngtfdi benh nam ngtia, nang nhe nhang dau ngtfdi benh len, ke goi
dudi dau va vai ngtfdi benh. Trong trUdng hdp ngtfdi benh nam lau nen
lot mot vong dem chong loet dudi mong.
4. TU THE NLfA NAM - NLfA NGOI (FOWLER)
4.1. Trtfdng hdp ap dung
- Sau mot so phau thuat o bung.
- Benh dtfdng ho hap: Kho thd, hen phe quan.
- Benh tim.
4.2. Trtfdng hdp khong ap dung
- Ngtfdi benh co roi loan ve nuot.
- Ngtfdi benh hon me, sau gay me. v
4.3. Ky thuat
- Ngtfdi phu nang ngtfdi benh ngoi day.
- Dieu dtfdng nang cao phia dau gitfdng len ttf 40°- 50° (neu gitfdng co gia
dd). Dat goi va cho ngtfdi benh n&m xuong.
- Neu gitfdng khong co gia dd co the dat goi to, day de d3 ngtfdi benh.
- Lot vong dem cao su dtfdi mong ngtfdi benh khi can thiet.
- Dat mot goi cting phia cuoi gitfdng cho ngtfdi benh ty gan ban chan len de
ngtfdi benh khoi tut xuong va chan khoi do ra (ban chan khoi do ve ttf the
xau).
• Chu y :
Trtfdng hdp ngtfdi benh bi benh tim nang hoac hen suyin, ngtfdi benh
ngu d ttf the ngoi, dung goi chong len ban con dat tren gitfdng de ngtfdi benh
dat tay va dtfa ngtfc vao goi cho thoai mai.
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5. TU THE NAM SAP
5.1. T r u in g hdp ap dung
- Loet ep vung lung, vung cung cut.
- ChUdng hdi d bung.
Ngudi benh co thai hay ton thudng vung long ngUc.
5.3. Ky thuat
- NgUdi phu dUng ben giudng doi dien vdi dieu dUdng vien.
- Dieu dUdng vien dUng d mot ben giudng dat ngUdi benh nam ngUa sat
ben giUdng doi dien giap vdi ngUdi phu.
- NgUdi phu dd ngUdi benh khoi nga.
- Dieu dUdng vien dat mot tay d ba vai, mot tay d mong ngUdi benh.
- Giup ngUdi benh nam nghieng ve phia dieu dudng roi nhe nhang dat
ngUdi benh nam sap, dau nghieng ve mot ben, mot ben ma dat len goi
mem, de hai tay ngUdi benh dat len goi phia dau.
6. TU THE nAm NGHIENG SANG BEN PHAI HOAC BEN TRAl
6.1. Trtfdng hdp ap dung
- Nghi ngdi.
- NgUdi benh viem mang phoi (nghieng ve phia viem).
- NgUdi benh sau mo: than, dUdng tieu hoa co dan lUu o bung.
6.2. Ky thuat
- Tu the nay phai co them ngUdi phu.
- NgUdi phu dting ben giUdng doi dien vdi dieu dUdng vien.
- Dat ngUdi benh n lm ngtia sat vdi ngUdi phu va doi dien vdi dieu dUdng
vien.
- Dieu dUdng vien mot tay dd vai, mot tay dd mong ngUdi benh.
- NgUdi phu ho trd dieu dudng vien.
- Giup ngUdi benh n^m nghieng ve mot phia, dau co goi hoac khong, hai
chan co ho&c chan dudi duoi thang chan tren hdi co.
7. MOT SO TI/ THE NGHI NGOl TRI LIEU LONG NGlTC
• • • •
• TU the nam sap nghieng 114
- Ap dung cho thCty phai tren, phan thuy sau cua phoi.
• ■ ht : \ ••
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- Ky thuat:
+ Cho ngUdi benh nim sap.
+ Dieu dudng vien mot tay dd d vung chau hong, mot tay dd d vai ngUdi
benh, nhe nhang lat ngUdi benh d tu the n&m sap, hdi nghieng.
+ NgUcfi phu dat goi d vung ngUc bung va dat mot goi mong d vung ma ty
xuong giudng.
+ Neu d thuy trai tren, phan thuy sau thi ngUdc lai: dat ngtfdi benh n£m
sap, tay phai dat len goi, than ngtfdi benh xoay nghieng 1/4.
• Tit the nam ngita ke goi ho trd ditdi mong
- Ap dung cho thuy phai va trai dudi cac phan thuy day trUdc cua phoi.
- Ky thuat: ngUdi benh nSm ngiia, dieu dudng vien mot tay dd that lung,
mot tay dd dui ngUdi benh nhe nhang nang ngUdi benh len, ngtfdi phu
luon va dat goi dudi mong (cao hay thap theo chi dinh).
• Tii the nam sap thdng ngiidi co ke goi ditdi bung va ban chan
- NgUdi benh n^m sap: dau nghieng ve mot ben.
- Luon mot goi dudi bung va ban chan ngtfdi benh.
• Tit the nam nghieng ke goi ditdi mong
- Ap dung cho thuy phai ho&c trai dudi phan thuy day ben cua phoi. Do
vay ngUdi benh co the n&m nghieng ben phai hoSc ben trai tuy theo chi
dinh cu the.
- Ky thuat: ngtfdi benh n^m nghieng, ngtfdi phu luon mot tay xuong vung
that lUng va mong nhe nhang nang mong ngtfdi benh len, dieu dtfdng
luon goi dtfdi mong ngtfdi benh.
7.1. Chuan bi ngtfdi benh
- Giai thich va htfdng din chd ngtfdi benh biet trtfdc thu thuat sSp lam.
7.2. Chuan bi ngtfdi dieu dtfdng
- Dieu dudng co du ao, mu, khau trang.
- Riia tay thUdng quy.
7.3. Ky thuat tien hanh
- Tuy theo tinh trang ngtfdi benh cu the ma tien h&nh chongtfdi benln&m
ttf the cho phu hdp, cac ttf the nay can co them ngtfdi phu.
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CAU HOI TU LUONG GIA
Chon y dung nhat de tra ldi cho cac cau hoi sau:
1. Khong ap dung tu the nSm ngtia dau hdi cao cho nhting ngUdi benh:
A: Co roi loan ve nuot.
B: Ho kho khan.
C: Hon me.
D: Ca ba trtidng hdp tren.
2. Tu the ntia nSm, ntia ngoi (Fowler) ap dung cho ngtidi benh:
A: Sau gay me.
B: Sau choc dich nao tuy.
C: Suy tim.
D: Lao cot song.
3. Tti the n&m sap dau nghieng mot ben dtidc ap dung cho ngtidi benh:
A: Dau dau.
B: Dau khdp.
C: Kho thd.
D: Loet vung cung cut.
Hoan thien cau sau bang cach chon tti, cum tti thich hdp dien vao cho trong:
4. Khong ap dung tti the n&m ngtia thing cho ngtidi bi hon me vi de
phong chat non vao...A...
5. Khong ap dung tti the nlm sap cho ngtidi co thai va ngtidi co ton
thtidng... A...
6. Khong ap dung tti the n&m ngtia dau thap cho ngtidi benh:
A :
..........................................
B: Hon me.
C: ...........................................
7. Hai trtidng hdp khong ap dung tti the fowler:
A : ............................................
B :............................................
Phan biet dung, sai cac cau sau bang cach dien dau (V) vao cot A cho cau
dung, cot B cho cau sai.
TT N§i dung AB
8Ti/thtf nim ngfta d£u thtfp duoc ap dung cho ngudi benh bj xutft huytft nang.
9Dat ngudi bftnh hen phtf quin nlm d tu thtf Fowler.
10 Ngudi bfinh bi chiidng bung d$t ntim ngCfa d£u hdi cao.
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