What should I look for in the care of patients with brain hemorrhage?

  Routine care: 1, bed rest, head elevation 15-20 °; avoid unnecessary moving, turning slowly and gently to avoid painful stimulation caused by changes in blood pressure; 24-hour guard, to help meet the needs of patients.  2.Avoid or reduce all kinds of unnecessary stimulation, keep the environment quiet, eliminate all kinds of noise, soft light, prevent environmental factors on the patient’s emotional stimulation; ask the patient’s family and friends to visit, not to carry on unnecessary conversations with the patient’s life, work and other aspects, avoid emotional excitement.  3, timely removal of secretions and vomit in the respiratory tract to prevent asphyxiation.  4.Keep the bowel movement smooth: give high calorie, high vitamin, high fiber diet, eat more fresh vegetables and fruits. For constipation, use cork, paraffin oil or laxative; for difficult urination and coma, leave a catheter in place.  5, stabilize blood pressure: stabilize blood pressure is an important measure to prevent cardiovascular and cerebrovascular accidents. However, the blood pressure should not be lowered too low, in order to prevent insufficient perfusion of cerebral tissue. If the blood pressure is too high, medication should be given as prescribed by the doctor to slowly lower the blood pressure.  6, observation of vital signs: closely observe the patient’s consciousness, pupils, body temperature, pulse, respiration, blood pressure, headache, vomiting and other conditions, and pay attention to the water-electrolyte balance.  7.Patients with nervousness, irritability, headache and insomnia should be given sedatives or analgesics as prescribed by the doctor.  8.Psychological care: Patients with long illness, easily irritable, so nursing staff should care for patients, according to the specific circumstances of the patient to develop a psychological care case, timely psychological guidance work, patient comfort, so that they eliminate pessimism, establish confidence to overcome the disease. At the same time, guide patients to learn to self-regulate, maintain emotional stability, avoid emotional excitement and sudden exertion.  Care of common complications: 1. Re-bleeding: It is the main acute complication, and should focus on observation of consciousness, pupil, pulse, respiration, blood pressure, headache and emotional changes of the patient. Once the patient is found to be agitated, pupil size and shape are abnormal, blood pressure rises again, heart rate and respiration slow down, severe headache, vomiting and other aura of rebleeding, the patient should immediately consult a doctor or report to a physician, and give appropriate treatment.  2.Cerebral vasospasm: Cerebral vasospasm may occur after cerebral hemorrhage. If the patient suddenly develops or worsens neurological dysfunction such as impaired consciousness, headache, hemiparesis, hemianopia, aphasia and sensory impairment, the patient should be alerted to the occurrence of cerebral infarction.  3. Hydrocephalus. Chronic hydrocephalus mainly manifests as indifference, unresponsiveness, mental retardation, psychiatric symptoms, headache with unsteady gait, urinary incontinence, hyperactive tendon reflexes and positive pathological reflexes. Once the above manifestations are found, hydrocephalus should be considered first, and timely contact with the specialist to report changes in the condition for early diagnosis and treatment.  4.Pulmonary infection: It is a common complication of cerebral hemorrhage, mostly occurs in patients with poor general condition and long-term smoking history. Regularly turn and pat the back to promote sputum discharge.  5. Pressure sores, urinary tract infections, etc.: Keep the body surface clean and dry, turn regularly, and observe the skin condition of the sacrococcygeal area, buttocks, heels and other pressure areas. Pay attention to the color and volume of urine, the presence of frequent urination, frequent urination, painful urination or cloudy urine, hematuria.  6.Deep vein thrombosis of lower extremity: the early manifestation is swelling and pain of the affected extremity, and the dislodged embolus can cause pulmonary embolism, myocardial infarction, cerebral infarction, etc. Pulmonary embolism is the most serious complication in the acute stage of deep vein thrombosis of lower extremity, and the patient’s condition should be closely observed, such as sudden respiratory distress, chest pain, cough, hemoptysis, cyanosis, and even shock, which should be considered first. Pulmonary embolism should be considered first. Pay attention to moving the joints of the affected limbs regularly and massage both lower limbs to prevent the formation of deep vein thrombosis in the lower limbs.