Сестринский уход при заболевании раке желудка

Непосредственно перед сестринскими вмешательствами необходимо осуществить расспрос пациента и его родственников о:
? Перенесенных заболеваниях.
? Болях в поясничной области.
? Наличие отеков.
? Повышение АД
? Тошнота, рвота
? Утомляемость, общая слабость
А также провести объективное обследование это позволит оценить физическое и психологическое состояние пациента.
Медсестра обязана информировать пациента и его родственников о сути заболевания, принципах лечения и профилактики, так же информировать пациента перед каждым исследованием ход предстоящей процедуры и подготовку к ним.
Основные проблемы пациентов с синдромом новообразований
Пациентов с онкологическими заболеваниями беспокоят боль, стресс, диспепсические нарушения, расстройства функций кишечника, суженные способности к самообслуживанию и недостаток общения. Постоянное присутствие рядом с больным медсестры приводит к тому, что медсестра становится основным связующим звеном между пациентом и внешним миром. Медсестра видит, что приходится испытывать пациентам и их семьям, и вносит в уход за больными сочувственное понимание.
Главная задача медсестры заключается в том, чтобы облегчить боль и страдания пациента, помочь в выздоровлении, в восстановлении нормальной жизнедеятельности. Способность к выполнению основных элементов самообслуживания у пациента с данной патологией сильно ограничена. Своевременное внимание медсестры к выполнению пациентом необходимых элементов лечения и самообслуживания становится первым шагом к реабилитации.
Важную роль в уходе за пациентами с онкологией желудка играют беседа и совет, который может дать медсестра в определенной ситуации. Эмоциональная, интеллектуальная и психологическая поддержка помогает больному подготовиться к настоящим или к предстоящим изменениям, возникающим из-за стресса, который всегда присутствует при обострении заболевания. Итак, сестринский помощь нужна для того, чтобы помогать пациенту решать возникающие проблемы со здоровьем, не допускать ухудшения состояния и возникновения новых проблем со здоровьем.
Особенности ухода за больными раком желудка
При наблюдении за онкологическими больными большое значение имеет регулярное взвешивание, так как падение массы тела является одним из признаков прогрессирования болезни.
Регулярное измерение температуры тела позволяет выявить предполагаемый распад опухоли, реакцию организма на облучение. Данные измерения массы тела и температуры должны быть зафиксированы в дневнике наблюдения.
Важен правильный режим питания. Больной должен получать пищу, богатую витаминами и белками, не менее 4-6 раз в день, причем следует обращать внимание на разнообразие и вкусовые качества блюд.
Подопечного с запущенными формами рака желудка следует кормить более щадящей пищей (сметана, творог, отварная рыба, мясные бульоны, паровые котлеты, фрукты и овощи в размельченном или протертом виде и др.) Во время еды обязателен прием 1–2 столовых ложек 0,5–1 % раствора хлористоводородной кислоты.
Выраженная непроходимость твердой пищи у больных с неоперабельными формами рака кардиального отдела желудка и пищевода требует назначения калорийной и богатой витаминами жидкой пищи (смётана, сырые яйца, бульоны, жидкие каши, сладкий чай, жидкое овощное пюре и др.).
Иногда улучшению проходимости способствует следующая смесь: спирт-ректификат 96 % – 50 мл, глицерин – 150 мл (по одной столовой ложке перед едой). Прием указанной смеси можно комбинировать с назначением 0,1 % раствора атропина по 4-6 капель на столовую ложку воды за 15-20 минут до еды.
Лечение кашля у онкологических больных заключается в устранении его причины, что не всегда возможно при распространенной злокачественной опухоли. Кашель можно облегчить, если устранить присоединившийся воспалительный процесс или заставить кашлевой центр головного мозга не реагировать на раздражение. При скоплении патологической жидкости в плевральной или брюшной полости ее удаление может существенно уменьшить проявления кашлевого рефлекса. Во всех случаях для подбора адекватного способа борьбы с кашлем целесообразно обратиться к врачу.
Основной симптом онкологических больных – слабость.
Нужно помочь пациенту быть максимально активным в течение дня, это даст ему чувство независимости. Контролировать и оценивайть эффективность назначенного лечения, докладывать врачу об изменениях в состоянии пациента:
1. Оказывайте подопечному поддержку, внушайть ему чувство уверенности в своих силах
2. Помогать больному в соблюдении правил личной гигиены, наблюдать за состоянием кожи и ротовой полости, чтобы исключить возможные осложнения
3. Убеждать пациента в необходимости принимать пищу и питье, помогайте ему при приеме пищи
4. Не оставлять подопечного без наблюдения при приеме горячей пищи или питья
5. Помогать ему при посещении туалета, обеспечивая при этом достаточное уединение
6. Проявлять дружеское участие, чтобы повысить самоуважение подопечного и способствовать проявлению интереса к жизни. Следует воодушевлять пациента, но не принуждать его
Чувство слабости, неспособность совершать привычные действия могут вызвать у больного стрессовое состояние. В этом случае помогает спокойное обсуждение создавшейся ситуации.
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