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Objective:To explore the nursing points of pneumocystis carinii pneumonia after liver transplantation in infants.Methods:Strengthened artificial airway management for children to improve dyspnea. Adopted nasal high-flow humidifying oxygen therapy to correct hypoxemia. Implemented individual temperature management to effectively control high fever. Strengthened children′s medication management, predictive skin management, using the protective isolation and psychological nursing.Results:After timely treatment and careful nursing, the condition of the three children was improved, SpO 2 was maintained at 0.95-1.00, and the patients were discharged successfully. One patient with respiratory failure died of multiple organ failure due to the deterioration of the condition after receiving extracorporeal membrane oxygen and supportive treatment. Conclusions:The infants with pneumocystis carinii pneumonia after liver transplantation should strengthen airway management, correct hypoxia. At the same time to do a good job of symptomatic care, strengthen the observation of the condition, can promote the rehabilitation.
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Objective:To summarize the nursing experience of a patient with diarrhea associated with Clostridium difficile infection after liver transplantation.Methods:To make individualized nursing plan for patients with diarrhea associated with Clostridium difficult infection after liver transplantation. Nursing measures were carried out from the aspects of prevention and control of infection, adjustment of immunosuppression program, collection and delivery of samples, perianal skin care, predictive first aid nursing, enteral and parenteral nutrition support, rehabilitation activity guidance, psychological nursing and so on.Results:After 22 days of careful treatment and nursing, the patient's condition improved, the yellow soft stool was discharged once or twice a day, the results of laboratory fecal bacterial culture turned negative and the isolation was lifted.Conclusions:The main points of nursing for such patients include prevention and control of infection, reasonable adjustment of immunosuppressive program during severe recurrent diarrhea, vigilance of rejection, correct collection and delivery of samples to ensure correct culture results, close monitoring of defecation, implementation of structured skin care program, improvement of condition warning level, predictive first aid nursing, combined with enteral and parenteral nutrition support to enhance resistance. Formulate individual activity plans to promote rehabilitation; use the concept of shared decision-making to guide the whole process of psychological counseling.
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Objective:To search, evaluate and integrate the available evidence on pediatric sedation monitoring, and summarize the best evidence.Methods:Up To Date, BMJ Best Practice, Canadian Medical Association Clinical Practice Guidelines (CMA Infobase), Registered Nurses′ Association of Ontario (RNAO), National institute for Health and Care Excellence (NICE), Evidence-Based Medicine, Cochrane Library, Yimaitong, PubMed, Embase, Wanfang Database, CNKI were searched to collect evidence related to the monitoring of pediatric sedation, including clinical decision-making, guidelines, expert consensus, and evidence-related original research. The search time limit was from the establishment of the database to August 2020. The quality of the literature was evaluated by the suitable evaluated tool based on their types. The level and recommedation grade of the evidence were appraised by the suitable tools of JBI.Results:A total of 13 articles were finally included. Twenty best evidences were summarized, including three aspects of monitoring content, monitoring timing, and monitoring tools.Conclusions:The research summarized the best evidence for pediatric sedation monitoring, and provided evidence-based references for clinical practice and standard formulation. Most of the evidence was form foreign resource. It is suggested that clinical departments or institutions should fully consider the clinical situation. At the same time, high-quality randomized controlled trials should be conducted one step further.
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Objective:To summarize the nursing points of a patient with enterococcus faecalis infection after living relative small bowel transplantation.Methods:To strengthen the observation and nursing of transplanted enterostomy, to guard against acute rejection. To closely monitor the signs of infection and effectively prevent and control infection.Make reasonable nutrition plan to promote the recovery of transplanted intestinal function. Prophylactic rejection with a combined immunosuppressive regimen. Implement individual psychological intervention to alleviate patients′ bad mood; Electronic follow-up records were established to dynamically monitor the changes of the condition after discharge.Results:The postoperative enterostomy was rosy, the intestinal function recovered well, and there was no rejection reaction. Enterococcus faecalis positive in ascites culture, infection signs were controlled after early detection, active treatment and nursing. Gradually return to normal eating through the mouth, walking rehabilitation discharge. The patient was followed up for 6 months and is now in good condition.Conclusion:For this patient, enhanced observation and nursing care, close monitoring of infection signs, reasonable nutrition plan and combined use of immunosuppression program are effective means to ensure the success of the operation and the safety of postoperative patients.