Stones refer to hard lumps formed in certain parts of the human body, mainly composed of calcium, uric acid, cholesterol, etc. Stone disease is a common and frequently occurring disease. According to statistics, about 120 million people in China suffer from stone disease. The main symptoms of stone disease are pain, hematuria, frequent urination, urgency, etc. In severe cases, it may lead to renal failure. Surgery is a common method for treating stone diseases, and preoperative and postoperative care is crucial for the patient's recovery. This article will provide you with detailed nursing guidance before and after stone surgery.
1、 Types of stone surgery
1. Kidney stone surgery: including percutaneous nephrolithotomy, ureteroscopic lithotripsy, nephrolithotomy, etc.
2. Ureteral stone surgery: including ureteroscopic lithotripsy, extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, etc.
3. Bladder stone surgery: including cystoscopy lithotripsy, urethroscopy lithotripsy, etc.
4. Gallstone surgery: including laparoscopic cholecystectomy, common bile duct incision for stone removal, etc.
2、 Preoperative nursing guidance
Before stone surgery, patients need to make the following nursing preparations to ensure the smooth progress of the surgery and postoperative recovery:
1. Complete various examinations: Patients need to complete various examinations before surgery, such as blood routine examination, electrocardiogram, chest X-ray, abdominal ultrasound, etc. These examinations help assess the patient's physical condition and reduce surgical risks.
2. Maintain nutritional status: Patients should maintain good nutritional status before surgery, eat more fresh vegetables, fruits, coarse grains, etc., ensure protein intake, and avoid greasy, spicy, and stimulating foods. Increase water intake appropriately to maintain smooth bowel movements.
3. Preoperative fasting: Fasting should begin 12 hours before surgery and water should be avoided for 4 hours to prevent vomiting and suffocation during surgery.
4. Clean the skin: Keep the body clean before surgery, especially the surgical site. You can take a shower, but avoid scrubbing vigorously and overheating the water temperature.
5. Preoperative psychological care: Patients may experience fear, anxiety, and other emotions during surgery. Medical staff will provide psychological support to help patients relax and face the surgery with a positive attitude.
6. Placement of urinary catheter: A urinary catheter should be placed before surgery for intraoperative urination and postoperative drainage. Patients should cooperate with medical staff to place urinary catheters.
7. Preoperative medication: According to the doctor's advice, patients may need to take some medications, such as antibiotics, anti-inflammatory drugs, etc., to prevent infection and alleviate postoperative pain.
8. Preoperative training: Patients need to learn how to turn over, take deep breaths, cough, etc. in bed to facilitate postoperative recovery.
3、 Postoperative nursing guidance
1. Rest and activity: After surgery, adequate rest should be taken and vigorous activity should be avoided to avoid affecting wound healing. During the recovery period, increase bed turning activities appropriately to promote lung expansion and blood circulation. According to the type of surgery and individual differences, gradually increase the activity of getting out of bed according to the doctor's advice to prevent deep vein thrombosis.
2. Dietary management: Within 24 hours after surgery, patients can start eating after anal exhaust. The early diet was mainly liquid or semi liquid, such as porridge and Congee, and gradually transitioned to light diet. Pay attention to a balanced diet, consume protein and fat in moderation, but avoid high-fat and high cholesterol foods such as animal organs and egg yolks. Increase the intake of vegetables and fruits to provide rich vitamins, help alkaline metabolites in the body, and prevent stone recurrence.
3. Care of urinary catheter and drainage tube: Keep the urinary catheter unobstructed, prevent twisting and blockage, and pay attention to observing urine volume and color. According to the doctor's advice, perform bladder flushing. If there are signs of leakage or infection around the catheter, inform the medical staff in a timely manner. After removing the catheter, pay attention to regular urination and avoid holding urine.
4. Wound care: Keep the wound clean and dry, avoid soaking, and prevent infection. Follow the doctor's advice to change the wound dressing, paying attention to whether the wound is red, swollen, painful, or oozing. After removing the stitches, take a shower two days later and avoid vigorously scrubbing the wound.
5. Observation and prevention of complications: Pay attention to observing indicators such as body temperature and blood routine, and promptly detect signs of infection. Follow the doctor's advice to use antibiotics to prevent infection. Observe for signs of complications such as bleeding, bile leakage, and intestinal perforation, and seek medical attention promptly if any abnormalities are detected.
6. Re examination and follow-up: Postoperative patients need to undergo regular re examinations to understand their recovery status. Generally, follow-up examinations are conducted at 1 month, 3 months, and 6 months after surgery. If there are any abnormalities, seek medical attention promptly.
4、 Preventing the recurrence of stones
1. Increasing water intake: Drinking enough water every day and maintaining sufficient urine can help eliminate excess minerals from the body and reduce the risk of stone formation.
2. Dietary adjustment: Maintain a low salt, low-fat, and low sugar diet, and reduce intake of high calcium, high oxalate, high purine, and other foods.
3. Weight control: Obesity may lead to the occurrence of stone disease, therefore, weight control is an important measure to prevent stones.
4. Avoid holding urine: Prolonged holding urine may lead to urinary tract infections, urine concentration, and increase the risk of stone formation.
5. Regular physical examination: Regularly conduct urinary system examinations to detect and treat stones early and avoid worsening of the disease.
In short, before stone surgery, patients need to be fully prepared, maintain a good mentality, and actively cooperate with the guidance of medical staff to ensure the smooth progress of the surgery. After stone surgery, patients need to closely monitor their physical condition and provide postoperative care to ensure early recovery and reduce the risk of stone recurrence. Nursing guidance should be based on the doctor's advice and the patient's specific situation. If there are any questions or discomfort, timely communication should be made with medical staff.