老痴呆病人安全护理课件.ppt

1、Safety Care For The Client With Senile Dementia老年病人的安全护理老年病人的安全护理皖南医学院第二附属医院朱广萍皖南医学院第二附属医院朱广萍随着人口老龄化的加速，老年痴呆病人的发病率有上升趋随着人口老龄化的加速，老年痴呆病人的发病率有上升趋势。据预测到势。据预测到20302030年，全球患老年痴呆的人数将达到年，全球患老年痴呆的人数将达到60006000万，仅我国就将有万，仅我国就将有12001200万。万。Recently,it is advocated that nursing for senile dementia should be peo

2、ple-oriented.We should take measures to prevent possible mental and physical obsessions to avoid all kinds of accidents effectively.近年来，对老年痴呆的护理提倡近年来，对老年痴呆的护理提倡“以人为本以人为本”，防止病人可能产生的一切心理和生理的困扰，有效避防止病人可能产生的一切心理和生理的困扰，有效避免各种意外的发生。免各种意外的发生。The clients are prone to get falls,scald,asphyxia etc.for physica

3、l and mental causes.It is of great importance to maintain their safety,thus slow down the process of disease and improve quality of life.老年痴呆病人由于心理、生理老年痴呆病人由于心理、生理方面的原因，易发生跌倒、烫伤、方面的原因，易发生跌倒、烫伤、窒息等。保证老年痴呆病人的安窒息等。保证老年痴呆病人的安全，延缓疾病的发展，改善病人全，延缓疾病的发展，改善病人的生活质量，具有非常重要的意的生活质量，具有非常重要的意义。义。心理护理心理护理Psychologic

4、al Implementation1 亮出你自己亮出你自己不要让患者猜疑。简单地说明来意。不要让患者猜疑。简单地说明来意。lIdentify yourselfdo not make the client guess.Tell the person what you are going to do in simple language.2 语气缓慢柔和，声音清晰。避免问语气缓慢柔和，声音清晰。避免问“为什么为什么”。lMake your voice slow,soft and clear.Avoid asking“Why did you”3 不和生气的病人理论。不和生气的病人理论。lDont r

5、eason with client who is aggressive.4 注意非语言交流：微笑、点头、抚摩等。注意非语言交流：微笑、点头、抚摩等。lBe aware of nonverbal language:smile,nod head,gently touch the person,etc.5 鼓励家属和朋友来医院看望。鼓励家属和朋友来医院看望。lEncourage family members and friends to visit.防止跌倒防止跌倒Prevent Falls A comprehensive assessment is necessary after admissio

6、n.For the person with history of fall,we must strengthen daily care.A striking sign above the bed is needed.老年痴呆病人入院后老年痴呆病人入院后应进行全面评估。对有应进行全面评估。对有“跌倒跌倒”病史的病人应病史的病人应加强生活护理。在病人加强生活护理。在病人床头贴一醒目标志。床头贴一醒目标志。The ward should be simple furnitured and rational distributed.病室内的家具要尽量简单，布局合理。病室内的家具要尽量简单，布局合理。We

7、ar suitable and safe clothing.Avoid flowing sleeves or floppy slippers.穿合适、安全的衣服。不要穿长袖、松软的拖鞋。穿合适、安全的衣服。不要穿长袖、松软的拖鞋。lBathrooms can be equipped with anti-slip surfaces,hand bars,and rails.l卫生间里可配防滑地面，扶手和护栏。卫生间里可配防滑地面，扶手和护栏。lHelp the client to stand up slowly to avoid postural hypotension or dizziness.

8、l帮助病人缓慢地站起身以避免体位性低血压或眩晕。帮助病人缓慢地站起身以避免体位性低血压或眩晕。Prevent the client from falling off the bed.防止病人坠床防止病人坠床lKeep the bed in low position.l床铺位置要低。床铺位置要低。lSide rails on both sides of the bed can be used.l床两边的护栏可以防止病人跌落。床两边的护栏可以防止病人跌落。饮食护理饮食护理Nursing Of DietlThe clients are not well aware of hungry and ful

9、l,or may have difficulty in ingesting,so the diet should be soft but digestible,containing enough nutrition.l 病人不能自知饮食饥饱，或有摄食困难者，食物应软病人不能自知饮食饥饱，或有摄食困难者，食物应软而易消化，保证足够的营养。而易消化，保证足够的营养。lEating position should be comfortable,sitting or semi-supine is advisable.The feeder should be patient and careful,ma

10、king it few and frequent.l进食的体位要舒适，尽量采取坐位或半卧位，喂食者进食的体位要舒适，尽量采取坐位或半卧位，喂食者要耐心、细心，少量多餐。要耐心、细心，少量多餐。防窒息防窒息Prevent AsphyxialWarm water can go with dry food.l吃干食物易发噎时应准吃干食物易发噎时应准备温开水。备温开水。lThe sleeping position should be better on right to help empty the stomach.l夜间睡眠以右侧卧位为夜间睡眠以右侧卧位为好，以帮助胃排空。好，以帮助胃排空。防烫伤防

11、烫伤、烧伤烧伤 Prevent Scald and BurnlDue to insensitivity,the clients perception to hot and cold declines,more attention should be paid to prevent scald when using hot-water bag.Putting cloth-pocket outside it to avoid contacting skin directly.l老年痴呆病人由于感觉迟钝，皮肤对冷、热敏感性下老年痴呆病人由于感觉迟钝，皮肤对冷、热敏感性下降，使用热水袋时应避免发生烫伤

12、。在热水袋外加布降，使用热水袋时应避免发生烫伤。在热水袋外加布袋，避免直接接触皮肤。袋，避免直接接触皮肤。危险物品需去除，如：危险物品需去除，如：火柴、香烟、玻璃器皿火柴、香烟、玻璃器皿等。病区内禁止吸烟。等。病区内禁止吸烟。We should get rid of these hazardous materials,such as matches,cigarettes,glassware,etc.It is prohibited to smoke in the ward.安全给药安全给药 Safety Medication Administration Administer medicati

13、ons according to the doctors order.Implement the principles strictly.Check carefully and master the effects,dosage and side effects.要根据医嘱给药，严格执行用药原则，认真做好要根据医嘱给药，严格执行用药原则，认真做好药物核对工作，掌握作用、剂量及不良反应等药物核对工作，掌握作用、剂量及不良反应等。l It is necessary to watch the client to swallow the pills and observe for the reacti

14、on.l 指导病人用药，不能让病人自己服药指导病人用药，不能让病人自己服药,必须送药到口，必须送药到口，看其入肚看其入肚,观察用药后的反应观察用药后的反应。预防压疮预防压疮Prevent Pressure UlcerlUse air cushion for the bedfasted clients.Change position every 1 to 2 hours.l对长期卧床病人应用气垫，对长期卧床病人应用气垫，1-2h翻身翻身1次，预防压疮次，预防压疮的发生。的发生。lKeep the bed unit dry and clean,keep the skin of perineum a

15、nd perianal area dry.l保持床单位干燥、清洁，保持病人会阴部、肛周皮肤保持床单位干燥、清洁，保持病人会阴部、肛周皮肤干燥。干燥。Braden评分表评分表 12分属高危患者分属高危患者 感觉感觉 潮湿潮湿 活动活动 方式方式 活动能力活动能力 营养营养 摩擦摩擦 1 1 完全完全 受限受限 1 1 持续持续潮湿潮湿 1 1 卧床卧床 1 1 完全不能完全不能移动移动 1 1 非常非常差差 1 1 已存在问已存在问题题 2 2 非常非常受限受限 2 2 潮湿潮湿 2 2 坐椅坐椅 2 2 重度受限重度受限 2 2 可能可能不足不足 2 2 潜在问题潜在问题 3 3 轻度轻度受限

16、受限 3 3 有时有时潮湿潮湿 3 3 偶而偶而行走行走 3 3 轻度受限轻度受限 3 3 充足充足 3 3 没有明显没有明显问题问题 4 4 未受未受限限 4 4 极少极少潮湿潮湿 4 4 经常经常行走行走 4 4 没有改变没有改变 4 4 非常非常好好Braden ScaleSensory perception MoistureActivityMobilityNutritionFrictionCompletely limited 1 Constant moist 1Bedfast 1Completely immobile 1Very poor 1Problem 1Very limited

17、2Very moist 2Chairfast 2Very limited 2Probably inadequate 2Potential problem 2Slightly limited 3Occasionally moist 3WalksOcasionally 3Slightly limited 3Adequate 3No apparent problem 3No impairment 4Rarely moist 4Walks frequently 4No limitation 4Excellent 4躯体症状的护理躯体症状的护理Nursing of Physical SymptomslF

18、or the client with hypertension:Monitor the blood pressure.Prevent cerebral infarction.Stabilize the clients mood.l老年痴呆病人伴有高血压者，应注意病人血压的监测，老年痴呆病人伴有高血压者，应注意病人血压的监测，预防脑梗塞，并且注意稳定病人的情绪预防脑梗塞，并且注意稳定病人的情绪。lFor the client with diabetes:Be aware of the blood sugar.Pay attention to the diet.Prevent Hypoglycem

19、ia.l伴有糖尿病者，应注意血糖的检测，同时应注意饮食，伴有糖尿病者，应注意血糖的检测，同时应注意饮食，严防低血糖的发生严防低血糖的发生。户外活动户外活动Outdoor Activities It is beneficial for the demented client to take suitable outdoor activities.对老年痴呆病人来说，适当的户外活动是有益的。对老年痴呆病人来说，适当的户外活动是有益的。The preparation is important:knowing the possible weather,getting the necessities l

20、ike umbrella,medications,and so on.要做好各种准备工作：了解天气情况，准备必须的要做好各种准备工作：了解天气情况，准备必须的物品，如雨具、药品等。物品，如雨具、药品等。The clients must wear some sort of identification with address and telephone number on it in case they wander and become lost.病人应随身携带标记住址、联系电话等的身份卡片，病人应随身携带标记住址、联系电话等的身份卡片，以防走丢。以防走丢。The length and intensity should not raise fatigue.活动时间和强度以不引起病人疲劳为限。活动时间和强度以不引起病人疲劳为限。Thank YouThank You！