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General nursing care of vulvar melanoma
Nursing care of vulvar melanoma
1. Psychological care
It is necessary to strengthen psychological nursing, give patients psychological comfort, help establish positive emotions, eliminate anxiety, fear and uneasiness, avoid unnecessary mental pressure, cooperate with diagnosis and treatment with normal psychological state, exercise strong will and be full of hope for life, which is an important spiritual pillar for overcoming cancer. More close to patients and more heart-to-heart communication is the best way to guide, because it is conducive to understanding the psychological state of patients. Doctors, nurses and their families should master verbal communication and non-verbal communication, which refers to attitude, posture and behavior.
First of all, be compassionate, kind in language and sincere in attitude, and strive to create a good atmosphere. Make the patient feel that people around him, especially nurses and family members, sympathize with and understand him. Sometimes just sitting beside a patient shows his spiritual support and comfort. Let the patient be willing to tell his true thoughts, and don't force the patient who doesn't want to talk or when he doesn't want to talk at that time. Some advanced patients have the loneliness of being afraid of being MoMo and abandoned, especially at night. In this case, it is best to allow family members to accompany them and make patients feel comforted. At any time, we should maintain the dignity of patients and improve the quality of life as much as possible. It is necessary to understand that the patient's family members are also working hard and suffering for the patient. Therefore, it is also a great comfort to the patient to arrange proper rest and diet for the family members when possible.
2. Diet Care
Cancer is a consumptive disease, especially in surgery, radiotherapy and chemotherapy, proper diet nursing is a necessary condition to ensure the smooth progress of treatment. According to the condition and digestion and absorption capacity, ordinary rice, soft rice, semi-flowing juice and flowing juice diet should be provided respectively. Patients receiving radiotherapy and chemotherapy may have poor appetite or abnormal taste. They should create a pleasant and comfortable dining environment, do some publicity and education to ensure the necessity of nutrition for treatment, and add condiments appropriately.
During hospitalization, different ways of supplying nutrition can be selected according to the patient's condition. Oral diet is used for oral administration, and nasal diet is used for nasal feeding. The food can be thicker than that of nasal feeding by tube feeding through stomach or enterostomy. Intravenous nutrition is suitable for people with gastrointestinal failure or insufficient feeding. Patients' conditions are different, so it is not advisable to insist on uniformity. According to the specific situation, consult doctors, nurses and nutritionists, and give proper diet with good quality and quantity.
3. Pain care
There are many reasons for pain caused by tumors, which may be related to the following factors:
(1) The tumor grows rapidly, causing tension and traction of organ capsule.
(2) Tumors compress nerve roots, nerve trunks or nerve plexuses.
(3) Obstruction of hollow organs caused by tumor.
(4) Hemorrhage and perforation caused by rupture of digestive tract tumor.
(5) The tumor itself breaks and infects and causes necrosis of surrounding tissues.
(6) Tumor infiltrates blood vessels and local hypoxia.
(7) Sequelae of radiotherapy or surgery.
The causes of pain are different, and the treatment methods are different. Some can be radiotherapy, some need surgery, and some need drug treatment. If the patient is excessively nervous and anxious, the pain is often aggravated, so it is necessary to achieve the effect of reducing pain by means of firming. It can also distract attention and remove patients' irritability and anxiety by discussing issues of interest to patients, listening to music and watching TV. Cold and wet compress and hot and wet compress are also available auxiliary analgesic methods. Eager care and consideration can also relieve pain. Therefore, doctors, neglecting to care for patients, staying at the bedside for a while, wiping their faces with hot water, and changing the patient's position are all spiritual comforts for patients and can relieve pain. The use of painkillers should also be assisted by kind language and kind attitude.
At the same time, we should also pay attention to the prevention of bedsore: if there are advanced patients with malnutrition, intestinal fistula, urinary fistula, or edema, etc., they will compress a certain part of the body for a long time when sleeping, but bedsore is prone to occur. Once there is bedsore, it will develop rapidly, further increasing the patient's pain and nutrition consumption.
The basic principles of preventing bedsore are: reducing local pressure and keeping patients clean and dry. If the condition permits, the patient should be encouraged to get up or help the patient sit up on time. For critically ill patients who stay in bed for a long time, they should change their positions on time. For those who are very weak, they can use duck down pads or other soft pads at their coccyx. If necessary, use a folded cotton pad to suspend the sacrococcygeal region to prevent further compression. The bed is flat, clean and dry, and the pressed parts are often scrubbed with warm water and soap. Patients with urinary incontinence should change diapers in time, be not afraid of trouble, encourage patients to drink plenty of water, and reduce their psychological burden. If bedsore has formed, it is necessary to eliminate local pressure and treat it strictly according to wound dressing change.
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