Work nurse in the endocrinology department
Must record all patient complaints, of which the most characteristic are: sweating, tachycardia, changes in body weight, change in shape of the neck, irritability, thirst, itching, weakness.
In an interview with the patient to find a family history of endocrine diseases, especially food of the patient, past illnesses, occupation, working and living conditions, the presence of trauma, addictions and stress.
Examining the patient should pay attention to the "eye symptoms," enlargement of the thyroid gland, depletion, obesity, pigmentation of the skin, hand tremor, the condition of hair and nails, the presence of boils.
In a conversation with patients suffering from thyrotoxic goiter, you need to pay attention to the specific complaints: increased excitability, irritability, sweating, sleep disturbance. Need to find out what factors contributed to the development of the disease.
On examination, patients with endocrine nurse should pay attention to the triad of symptoms: swelling of the thyroid gland, exophthalmos, tachycardia.
Patients with hyperthyroidism usually have expressed disorders of the nervous system and the psycho-emotional sphere, so the part of the nurse requires patience, attention and sensitivity to such patients.
When working with patients with diabetes should pay attention to the initial symptoms of the disease: increased thirst, increased urination, dry skin, itching. On examination, patients pay attention to the condition of the skin: scratches, pustular disease.
Patients with long-term diabetes mellitus are predisposed to the following complications: neuropathy, angiopathy, gangrene of the extremities, coma, retinopathy, kidney disease, neuralgia. To get a complete picture of the disease, the nurse should know the results of additional methods of examination. Based on these data the nurse develops a plan of care for patients. The nurse explains to patients with diabetes mellitus of adhering to diet, principles of prevention comatose states, introduces measures which the patient himself can take.
Blood tests carried out strictly in sugar on an empty stomach, as warn the patient. In the appointment of a patient "sugar curve," the nurse warned the patient about the time of blood sampling, as well as on minimal exertion on the day of the study.
Urine for sugar patient collects during the day in a large container. Before you go to the lab nurse mixes urine and molds 150-200 ml.
A nurse must be able to promptly assess the condition of the patient on the basis of his complaint. Timely recognition precomatose and comatose states can correctly and quickly provide the necessary assistance.
Caring for patients with diabetes, the nurse must remember that negative emotions can lead to decompensation of diabetes. The nurse teaches the patient methods of use insulin syringe and self-administration of insulin.
The nurse must monitor compliance with the sick diet, so as of eating disorders can lead to the breakdown of compensation of diabetes. Nutrition of patients must be complete, with only a restriction of carbohydrates. Food must contain sufficient amounts of vitamins, it is necessary to accept small portions: 5-7 times a day.
Food patients with thyrotoxicosis should be varied, rich in vitamins. Should limit consumption of meat, fish, drinks, stimulating the nervous system.
The nurse should monitor adherence, personal hygiene, the condition of the respiratory and cardiovascular system (counting the number of breaths, the definition of pulse, blood pressure).
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