OVERVIEW
There is a wide range of infectious diseases of the liver, and the main ones related to surgery are liver abscesses, and the common ones are bacterial liver abscess and amoebic liver abscess, both of which can cause different degrees of fever and liver enlargement as well as right upper abdominal pressure and pain, and bacterial liver abscess is more common in clinical practice. In addition, there are some special infections such as tuberculous liver abscess, fungal liver abscess and parasitic liver abscess, which are less common. The detection and management of existing and potential problems such as chills, high fever, and pain in the liver area in patients with liver abscess, and the provision of appropriate physical, psychological, and social care for them can effectively improve their life treatment and prognosis.
Main nursing problems
1. Pain.
2. Fever.
3. Potential complications, such as infection and bleeding.
Nursing care measures
1.Psychological care
After the patients are admitted to the hospital, due to the lack of knowledge about the disease and the change of the environment, they often have a series of psychological reactions such as tension and fear. Therefore, nursing staff should take the initiative to contact with the patients, introduce the relevant knowledge of the disease to the patients, such as the characteristics of the onset of the disease, healing, etc., and give patient psychological guidance according to the patient’s psychological state, so as to eliminate the patient’s nervousness and anxiety, so as to make them set up the confidence of overcoming the disease, and positively cooperate with the treatment.
2. Nursing of chills and high fever
At the onset of liver abscess, due to the intermittent entry of bacteria into the blood, resulting in bacteremia, so that the patient has chills, high fever and other symptoms, to understand the pattern of chills. When fever occurs, patients should follow the doctor’s instructions and prefer drugs to lower the temperature, such as compound aminopyrine intramuscular injection, and then supplemented with physical cooling, including ice packs, cold compresses, alcohol baths. During the cooling process, we should pay attention to observe the patient’s reaction, and after cooling, we should keep the skin clean and dry, and change the wet clothes and bed sheets in time.
3.Medication care
In the process of liver abscess treatment, according to the number and size of abscess foci and the presumption of possible sensitive antibiotics, we need to give combined and adequate amount of long-term broad-spectrum antibiotic treatment. The medication should be given in a timely manner and in strict accordance with the doctor’s instructions, and the adverse effects of the medication should be observed.
4. Pre-operative care of liver puncture
(1) Carry out preoperative examinations and preoperative preparations for the patients according to the doctor’s instructions.
(2) Explain to the patient the precautions for cooperating with the puncture.
(3) Ask the patient to empty the bladder before the operation.
5. Postoperative care of liver puncture
(1) The patient should stay in bed for 24 hours after the operation.
(2) Closely monitor the patient’s vital signs. If the patient has a drop in blood pressure, accelerated pulse, cold sweat, or pallor, immediately notify the doctor for resuscitation.
(3) Sterilize the skin at the puncture site and change the dressing regularly, observe whether the wound dressing oozes blood and fluid.
(4) If the pain at the puncture site is severe, analgesics may be given as prescribed by the doctor.
(5) If amebic liver abscess is suspected, the extracted pus or discharged feces should be sent for examination in time.
(6) Complications The common complications of liver abscess include liver hemorrhage, gallbladder or bile duct injury, colon or kidney injury, secondary infection of peritoneum or pleura. The patient’s condition should be closely observed, and the patient should be instructed to take bed rest during the morbidity period, not to do strenuous activities, but to do moderate bed activities. Do not exert too much force when coughing or defecating, protect the hepatic area, avoid collision, and prevent the abscess from rupturing. If complications occur, notify the doctor immediately for treatment.
(7) Drainage tube care Properly fix the drainage tube to prevent the tube from coming out. Keep the drainage of each drainage tube smooth and squeeze it at regular intervals. Observe and record the color, nature and amount of drainage fluid.
(8) Nutritional support nursing Fasting and water fasting for 1~3 days after operation. During the fasting period, intravenous nutritional support should be given according to medical advice. After the recovery of intestinal function, the patient should be fed with liquid diet and gradually transitioned to normal diet. High protein, high calorie, high vitamin, easy to digest, low fat diet can be eaten.
Health Advocacy
1. Instruct patients to keep a good mood, pay attention to rest, and combine work and rest.
2. Reasonable diet, develop good living habits, overweight people pay attention to reduce weight.
3. Follow the doctor’s instructions for regular outpatient review, and consult the doctor immediately if any abnormality occurs.