Do you know about aortic dissection? Aortic dissection is the most critical condition among major vascular diseases, with a very high mortality rate. The mortality rate within the first 48 to 72 hours of onset is about 1% to 2%, and patients often experience acute onset between the ages of 40 and 50. When aortic dissection occurs, the situation is extremely critical and is known as the "ticking time bomb" in the body.
Aortic dissection refers to a hematoma formed by blood entering the middle layer of the aortic wall through a rupture in the intima, rather than dilation of the aortic wall. Unlike aortic aneurysm, this condition used to be called aortic dissection aneurysm, but is now commonly referred to as aortic dissection hematoma or aortic dissection separation, abbreviated as aortic dissection.
For aortic dissection, patients should undergo timely examinations, and those aged 40-50 should have regular check ups. If hypertension is detected, it should be treated promptly. Especially for patients with a history of hypertension, they should pay more attention to controlling their blood pressure. Once severe chest, back or waist pain occurs, they should seek medical attention in a timely manner.
How to cooperate with the nursing work of patients with aortic dissection during clinical treatment?
1. Pain management: The severe and unbearable pain caused by aortic dissection is also a factor that stimulates blood pressure increase. When using antihypertensive drugs, appropriate intramuscular injection of 10mg of sedative morphine should be used, and repeated every 4-6 hours if necessary. Assist patients in finding comfortable positions, create a quiet, clean, and fresh air ward environment, and play some soothing music according to the patient's preferences to increase the company of family members. Gently massage, shift attention, and relax the patient's mood.
2. Treatment environment care: Provide patients with a clean and fresh ward environment, with soft indoor lighting, regular ventilation and air exchange, and adjust the indoor temperature to 18 ℃~20 ℃ to avoid blood pressure rise caused by cold and hot stimulation. During the treatment period, absolute bed rest should be taken to avoid emotional excitement. At the same time, electrocardiogram monitoring and blood oxygen saturation monitoring should be provided, and continuous low flow oxygen therapy should be administered. Nutritional support and targeted treatment should be given according to the situation before surgery, and corresponding care should be taken. People with a history of smoking should quit smoking. Obtain the cooperation of family members to reduce visits. Patients in the acute phase should not turn over and change positions. Use an air mattress to massage the compressed area to prevent pressure ulcers and maintain skin integrity. Assist patients with lower limb passive function exercises every 2 hours to prevent thrombosis.
3. Dietary care: A light and easily digestible diet is recommended, with liquid or semi liquid foods rich in vitamins. Eating small amounts of meals frequently and straining during bowel movements can cause a sudden increase in blood pressure and trigger the expansion or rupture of the interlayer. Guide patients to defecate in bed, avoid forcefully holding their breath during defecation, and if necessary, administer laxatives such as glycerin enema or glycerin enema. When the pain is severe, temporarily fast. When the pain is relieved, give a liquid diet. After the blood pressure is stable, gradually transition to a semi liquid diet.
4. Psychological care: Due to the sudden severe pain and tearing sensation caused by aortic dissection, patients may experience fear, anxiety, and resistance. Nursing staff should actively comfort patients, explain disease precautions to patients and their families, establish a good nurse patient communication relationship, and alleviate patients' concerns about surgery.
In addition, after receiving scientific treatment, patients should also pay attention to their own prevention and care in daily life.
1. Develop a good lifestyle: try to eat three less and three more, that is, eat less salt, fat, and starch; Eat more vegetables, fruits, and high-quality protein. Eat small meals frequently, quit smoking and limit alcohol consumption.
2. Moderate exercise: Follow the principle of gradual progress. Suggestions for exercise programs: Aerobic walking and Tai Chi for the first 1-3 months; After 3 months, there will be jogging and cycling. Exercise time, 6-10 minutes per session (initial), 30-60 minutes per session (after adaptation), frequency, 5-7 days per week, 1-2 times per day. Exercise and meals should be separated by at least one hour. (It should also be noted that early morning exercise is not advisable. According to foreign scholars, the time from 6am to 9am is the most dangerous time for cardiovascular and cerebrovascular diseases. Therefore, exercise should be scheduled in the afternoon and evening as much as possible.)
3. Regular follow-up: If fever occurs, skin temperature decreases, foot and back movement and pulse disappear, chest, abdominal, and back pain symptoms appear, and oral anticoagulants may cause bleeding tendencies. For those with bleeding in gums, nasal cavity, oral cavity, and skin congestion, seek medical attention in a timely manner to avoid risks.