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1、2020/6/26,1,白 内 障 病 人 护 理 (Nursing for Cataract Patients),Taian Health School 纪 建 光,2020/6/26,2,晶状体在眼球内的位置 (Position of Lens in the Eye),2020/6/26,3,2020/6/26,4,Egg,Pullet,2020/6/26,6,EggShell,2020/6/26,7,2020/6/26,8,晶状体的特性 (Properties of Lens),1.Transparent(透明的) Body 2. Protein pruti:n 3.Convex knv
2、eks (Degree: 1000-1200),2020/6/26,9,Definition: 广义上讲,任何因素导致晶体(lens)出现浑浊(turbidness)t:bidnis 都可称为(cataract),Disease Description,2020/6/26,10,白内障国情 (National Conditions) 1.6000 万( sixty million)白内障患者 2.100万(one million)白内障患者应施行手术 3.每年新增患者40万(four hundred thousand) 4.人口老龄化,患者逐年增加,白内障治疗、 护理任务项繁重 (A burd
3、ensome task),2020/6/26,11,白内障临床分类 (Classification of Clinic),2020/6/26,12,一:Senile Cataract si:nail 年龄相关性白内障(age-related cataract),2020/6/26,13,二: Traumatic Cataract tr:mtik 外伤性白内障:眼球穿孔伤、钝挫伤,2020/6/26,14,三: Metabolic Cataract ,metblik 代谢性白内障:糖尿病,甲状腺疾病,2020/6/26,15,四:Congenital Cataract kndenitl 先天性白
4、内障,2020/6/26,16,五: Medicamentous Cataract 药物性中毒性白内障:长期使用“类固醇”药物 六:Radiated Cataract reidieitid 辐射性白内障:因放射线所致,2020/6/26,17,老年性白内障 Senile Cataract,2020/6/26,18,1.年龄增长,晶状体逐渐混浊,即为老年性白内障。一般起于4045以后 2.主要病因:氧化损害(Oxidative Damage) ksideitiv 3. 临床表现:眼前阴影和渐进性、无痛性视力减退(Visual Deterioration) di,tirirein,2020/6/2
5、6,19,Nursing Assessment,(一)Health History 1. 年龄(Age) 2. 外伤(Trauma) 3. 营养(Nutrition) 4. 遗传 (Heredity) hirediti 5. 代谢(Metabolize) mtblaiz 6. 全身病(General Disease),2020/6/26,20,身体状况 (Physical Condition),1.症状(Symptom),渐进性视力下降 (Gradual Visual Deterioration ) di,tirirein,2020/6/26,21,Clinical Stages,一期(Ini
6、tial Stage) 1、无视力下降(对视力无影响) 2、皮质内出现空泡,水裂和板层分离, 从周边逐渐向中央扩大,呈“羽毛状”或 楔形浑浊 3、此期发展缓慢,可经数年,2020/6/26,22,2020/6/26,23,二期:膨胀期 (Dilatational Stage) 1.视力下降 2.晶体呈不均匀浑浊 3.晶体体积变大,将虹膜向前推移 4.前房变浅 5.诱发急性闭角型青光眼 AACG: ( Acute Angle Closure Glaucoma),2020/6/26,24,2020/6/26,25,三期:成熟期 (Maturity Stage) mtjuriti 1.视力下降至眼前
7、手动/光感 2.晶体灰白色均匀浑浊 3.虹膜投影消失 4.眼底不能窥入,2020/6/26,26,2020/6/26,27,四期:过熟期(Overripe Stage) uvraip 1.视力突然提高(晶体皮质液化外溢 核下沉) 2.前房加深 3.虹膜震颤 4.浑浊晶体纤维分解液化,呈乳白色 5.棕黄色晶体核下沉于囊袋下方 6.诱发晶体溶解性青光眼,2020/6/26,28,2020/6/26,29,Physical Sign 白瞳症(White Pupil) 是最明显的体征,2020/6/26,30,Nursing Diagnosis,1.感知改变(Perceptual Alteration
8、) 2.自理缺陷(Self Care Deficit) 3.受伤危险(Risk for Injury) 4.知识缺乏 (Knowledge Deficit) 5. 潜在并发症(Potential Complications),2020/6/26,31,Nursing Goals,1.病人视力提高 2.自理恢复 3.避免受伤 4.熟悉相关知识 5.避免并发症,2020/6/26,32,Nursing Interventions,一般护理(Ordinary Providence) 1.病房介绍(Ward Introduction) 2.饮食指导(Diet Guidance),2020/6/26,3
9、3,治疗配合 ( Therapeutic Alliance ) erpju:tik lains,一:Nursing of Drug (1)维生素类 VitC, VitB2 (2)滴眼液:白内停,谷胱甘肽,卡他灵 二:Surgical Care,2020/6/26,34,2020/6/26,35,Preoperative Care,1.抗生素(Antibiotic) ,ntibaitik眼液 术前3天 2.镇静剂 3.冲洗结膜囊 4.冲洗泪道 5.降眼压Intraocular Pressure ,intrkjul 6.散瞳孔,2020/6/26,36,2020/6/26,37,2020/6/26
10、,38,2020/6/26,39,2020/6/26,40,Postoperative Care,一:“四位” 一体 (Four Positions) 1.体位(Body) 2.头位(Head) 3.口位(Mouth) 4.手位(Hand) 二:预防感染(Infection Prevention) 氧氟沙星滴眼液 三:定期复查(Regularl Countercheck) one week, one month, six months,2020/6/26,41,Health Education,1.Cause of Cataract 2.Symptoms of Cataract 3.Diagnosis of Cataract 4.Theropy and Nursing Knowledge 5.Prevention of Cataract,2020/6/26,42,Thanks a Lot !,