Warm reminder: The reply is only to provide you with reference opinions and cannot replace clinical diagnosis. For final diagnosis, please go to the relevant hospital for treatment! It is only provided as a reference and cannot be used as a basis for diagnosis and medical treatment. When seeking medical treatment, please follow the doctor’s diagnosis. Daily life guidance for the late stage of lung infection: 1. In terms of diet, you should pay attention to choosing foods that are easy to digest, rich in protein, high in calories, and rich in vitamins. To ensure the intake of nutrients and increase the body's resistance to infection, avoid spicy and greasy foods. Vegetables and fruits such as radish, cucumber, lily, tremella, celery, watermelon, and orange are more suitable. For smoking patients, patients should be persuaded to actively quit smoking. Pay attention to environmental hygiene and avoid the impact of smoke, dust and irritating gases on the respiratory tract. During climate changes, especially when the temperature drops, you should keep warm to prevent colds. 2. Psychological guidance: Due to the patient's weak constitution, sleep, diet, and activities are affected, and the patient is prone to negative, pessimistic or irritable emotions, which is detrimental to treatment and recovery. Therefore, we should pay attention to the patient's emotional changes, explain to the patient the negative impact of emotional fluctuations on the disease, and encourage the patient to maintain an optimistic attitude and actively cooperate with treatment. Through psychological guidance, the negative impact of patients' emotional changes on the disease can be reduced and the body's recovery can be promoted. 3. Rehabilitation exercise guidance: (1) Physical exercise. After the patient's condition is stabilized, the patient should be guided to perform appropriate exercises every day based on the patient's age, cardiopulmonary function, and comorbid diseases. The exercise methods can include walking, running, cycling, fitness gymnastics, etc., to enhance the patient's resistance and reduce the risk of Or delay the onset and progression of the disease. Choose exercise items and intensity step by step, and don't do it too hastily. (2) Breathing exercises. Breathing exercises can increase the strength of respiratory muscles, eliminate the ineffective function of muscles, especially auxiliary respiratory muscles, thereby reducing oxygen consumption during breathing, increase the elimination and defense of the airway, reduce chest movement, and reduce the discomfort of patients with asthma. And can help patients build confidence in daily activities. Breathing exercise methods include: developing chest or abdominal breathing gymnastics, breathing gymnastics that extend the exhalation or inhalation time, and traditional Chinese medicine health breathing gymnastics. (3) Acupoint massage. In daily life, you can often choose to gently massage acupuncture points such as Shuzusanli, Yingxiang, Taiyang, and Baihui, which will be helpful to reduce or delay the onset and progression of the disease. This is a specific acupoint map: http://www.mifang.org/am/pic/ Elderly patients with pulmonary infection are prone to multi-system complications, leading to aggravation and deterioration of the condition. During the nursing process, the patient's state of consciousness, body temperature, respiration, pulse, blood pressure, heart rate, heart rhythm, intake, urine output, sputum volume and color, stool characteristics, liver and kidney function, electrolytes, blood routine, blood gas, etc. Observe and record the indicators systematically, and contact the doctor promptly if any abnormalities are found. Observation and care of patients with high fever. Pulmonary infection and high fever in elderly patients are more likely to cause water and electrolyte disorders, heart failure, shock, disturbance of consciousness, and even stroke. Therefore, for elderly patients with high fever, the body temperature should be measured every 4 hours or at any time, and the changes in the patient's complexion, blood pressure, heart rate, and state of consciousness should be observed. If there are any abnormalities, the doctor should be contacted in time. When fever occurs, antipyretic analgesics or physical cooling must be given as soon as possible. Patients are also encouraged to drink more water and pay attention to intravenous rehydration to maintain water and electrolyte balance and ensure nutrition. Strengthening sputum elimination, guiding and helping elderly patients with pulmonary infection to cough and expectorate correctly and effectively can improve the effects of treatment and care. First, the patient should be encouraged to cough as hard as possible to expel phlegm, and the following methods should be used to assist phlegm expulsion: (1) Postural drainage. When both lungs are infected, often turn over and change positions. When one lung is infected, lie down on the healthy side. (2) Pat the back to help expel phlegm. Make a hollow fist with your hand, pat it moderately, and vibrate the patient's back from bottom to top, from the outside to the center, repeat this for 5 to 10 minutes, and then ask the patient to take a deep breath and cough hard to expel the phlegm (3) Elderly patients with pulmonary infection cannot expel phlegm on their own. If there is more phlegm, it will affect the treatment effect and may cause suffocation. At this time, the phlegm should be suctioned in time. For patients who cannot expel sputum on their own, a suction device should be prepared in advance.
Reasonable oxygen therapy: Elderly patients with pulmonary infection often have extensive lesions, leading to an imbalance in the ventilation/blood flow ratio. They are often combined with multiple basic diseases such as cardiovascular and cerebrovascular diseases, chronic pulmonary diseases, etc., which can easily cause hypoxemia. Oxygen inhalation is commonly used. One of the auxiliary treatment methods, but the correct oxygen inhalation method should be mastered: Oxygen therapy should generally be performed under the monitoring of arterial blood gas to correct hypoxia. For those with simple hypoxia, the oxygen concentration and oxygen flow can be appropriately increased. Those who have underlying diseases such as emphysema and cor pulmonale and develop type II respiratory failure after infection should be given continuous low-flow (1-2L/min) and low-concentration (24-25) oxygen. Note: Do not adjust without authorization. Oxygen flow; if there is a lot of nasal secretions, they should be removed frequently to prevent the catheter from being blocked and losing the oxygen inhalation effect; the inhaled oxygen should be maintained at a certain humidity, so that it is close to the humidity of the air to prevent the upper respiratory tract from drying out and the phlegm being sticky , drainage obstruction. Nursing methods for pulmonary infection: 1. Humidify the respiratory tract ("moist"). Elderly people often have weakened respiratory mucosal cilia movement, low lung function, and inability to cough up sputum, which prevents secretions from drying and solidifying into scabs to promote the discharge of sputum. Methods: (1) Oxygen aerosol inhalation, add 10 ml of physiological saline, 4000 u of α-chymotrypsin, and 40,000 u of gentamicin to the nebulizer. When inhaling, ask the patient to take deep breaths repeatedly, hold the breath for 5-10 seconds, and then take deep breaths until the atomized liquid is exhausted. In this way, the medicinal solution can settle into the terminal bronchi and alveoli with deep and slow inhalation, playing a local therapeutic role. When patients with severe dyspnea undergo atomization treatment, stay with them and closely observe the patient's inhalation. Once the sputum is diluted and the amount of sputum increases and the patient is unable to cough it up, assist in clearing the sputum in time to avoid suffocation. (2) Warming and humidification of oxygen. Inhaling conventionally humidified oxygen for a long time is prone to drying of the airway, thickening of sputum, and even formation of phlegm plugs that block the airway. While suctioning sputum, we heat the oxygen to 40°C to 60°C to humidify it. After the patient inhales it, we can achieve the purpose of humidifying the airway and diluting the sputum. (3) Replenish water. The patient's breathing speeds up and mouth breathing causes part of the water to be lost through the respiratory tract. The patient should drink plenty of water (small amounts and multiple times, about 30 to 50 ml each time, once every 10 to 20 minutes), and be given intravenous rehydration to increase body moisture and prevent dryness of the airways and thick sputum from aggravating lung infection and causing achieve better results. 2. Turning over regularly ("turning") While moistening phlegm, 162 patients were turned over every 1 to 2 hours. When turning over, it should be done slowly, and at the same time, pat the back and cough up phlegm, and gradually turn the patient over. to the desired position. 3. Percussion on the back ("pat") Vibrates the patient's back by percussion, indirectly loosening and falling off the sputum attached to the alveoli and bronchial walls. Back patting method: Put the five fingers together, flex the metacarpophalangeal joint to 120°, and touch the fingertips to the thenar eminence. Use the wrist joint to tap the patient's back rhythmically from bottom to top, from the edge to the center, and at the same time ask the patient to take a deep breath. . 4. Effective expectoration ("coughing") After the above three measures, most of the sputum has entered the airway from around the alveoli. At this time, the patient is encouraged and guided to effectively cough and expectorate. Instruct the patient to take a deep breath and cough about 2/3 of the time. Repeat several times. Deep exhalation can bring out a small amount of secretions from the bottom of the lungs, and coughing can produce sputum movement and coughing up effects. 5. Diet management: Instruct patients to eat more vegetables and fruits, eat less fish and meat, and have bowel movements once a day when the phlegm is excessive and sticky. Teach patients and their families how to make therapeutic meals. 6. Psychological analysis: Depression, anxiety, and nervousness are not conducive to the discharge of phlegm. Due to the long course of the disease, patients lack confidence in treatment and have fear of sputum drainage. Therefore, before taking the above measures, patiently persuade patients and their families to understand that antibiotic treatment alone is not enough to control the disease. It is more important to adhere to the "wet, turn, pat, cough" method to combine treatment and care. 7. Comfortable environment. A quiet and comfortable environment is conducive to the recovery of the disease. Ventilate the room once a day (15-20 minutes) and keep it at 20°C and 60% humidity. Create a comfortable and quiet environment for patients to make them feel warm and increase their confidence in overcoming the disease.
Follow-up question: Do you have any specific recipes? Or should I buy some specific fruits? Answer: There is no effective method to treat emphysema, so daily diet is more important. 1. Under normal circumstances, it is advisable to eat a light diet, fresh vegetables and fruits, such as cabbage seedlings, radish, sword beans, loofah, pears, citrus, loquat, banana, grapefruit, etc. Commonly used are honey and maltose. 2. Emphysema patients with excessive and thin phlegm, shortness of breath and wheezing can eat some warm foods, such as nutritious chicken soup, liver soup, lean meat, dairy products, egg custard, etc., which can replenish lung qi. 3. As time passes, emphysema worsens, wheezing worsens, mouth becomes dry, and the tongue becomes red or purple, indicating damage to the lung yin. At this time, you should choose fruits or foods that nourish yin and promote fluid production, such as pears, plums, hawthorns, apples, turtles, lean pork, duck eggs, chrysanthemum brains, eggs, apricots, etc. 4. Dietary remedies that patients with emphysema can take when their yang energy is weak and their phlegm is excessive and thin: duck with cordyceps, quail stewed with cordyceps, roasted pork with ginger, longma chicken (shrimp, seahorse, chicken), stir-fried Philippine vegetables with walnuts, mutton Yam soup, sheep bone soup, yam, wolfberry and beef bone soup, etc. Dietary therapies that can be used when Yin and Jin are deficient: stewed elbows with red dates, chicken with caramel sugar, chicken with millet seeds and ginkgo, stewed fish with yam and longan, longan and bird's nest soup, spinach and white fungus soup, turtle meat, lily, and red dates soup, stewed turtle with cordyceps and red dates, etc. 5. Avoid eating hot peppers, peppers and other irritating substances, quit smoking, drinking alcohol, and eat less fried foods to avoid phlegm and irritating substances.
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