I. Rheumatic heart valve disease
Rheumatic heart disease is valve damage caused by a rheumatic inflammatory process, referred to as rheumatic heart disease. Its progression is often associated with the recurrent occurrence of active rheumatism. Its clinical manifestations vary depending on the damaged heart valves. Common symptoms include: weakness, cough, palpitations, shortness of breath, cyanosis, and chest pain. Common complications include: heart failure, arrhythmia, and embolism. Fan Zhaolong, Department of General Internal Medicine, Duancun District Maternal and Child Health Hospital
Properly instruct the patient and do the following cathartic contents.
[Psychological guidance].
Most of the patients have a heavy burden of thought and worry about the prognosis of the disease. Especially young people think that their heart is damaged and worry whether they can resume normal work and life in the future. The nurse will guide the patient to overcome the anxiety and excessive psychological burden, and actively cooperate with the treatment and care, most of them can be cured and resume normal work and life.
Dietary guidance
1. Give a high-calorie, high-protein, high-vitamin, easy-to-digest diet to promote the recovery of heart muscle cells.
2. Pay attention to eating less and more meals so as not to increase the burden on the heart.
3. Quit smoking and drinking.
[Rest and activity guidance
1. Bed rest should be taken during the acute period, and activity should be gradually increased only after the recovery of symptoms and signs such as -L- electrogram, laboratory tests, etc.
2. Avoid overexertion during the recovery period.
Medication guidance
1. Take the medication on time as prescribed by the doctor, especially the anti-arrhythmic drugs, which must be taken on time and according to the treatment course to ensure the efficacy due to their pharmacological properties.
2. When the symptoms are not reduced or other symptoms appear, report to the doctor, and do not stop or switch to other drugs.
Discharge instruction
Prevent various infections, especially avoid getting cold and prevent respiratory infections to reduce the damage of toxins to the heart.
II. Cardiac arrhythmia
The heart beats regularly at a frequency of 60′-,100 beats per minute under normal conditions. When the occurrence or conduction of impulses in the heart is abnormal, making its rate and rhythm abnormal, it is called arrhythmia. The main manifestations include palpitations, precordial discomfort, chest tightness, air calvary, dizziness, and syncope. Some patients with severe arrhythmias have no conscious symptoms at all and are often detected by an electrocardiogram. The precipitating factors are acute infection, smoking, alcohol, coffee, exercise and mental stimulation.
Occasional arrhythmias in normal subjects may be left untreated for clinical reasons. However, arrhythmias caused by various etiologies, which produce obvious symptoms and affect normal work and life, should be treated seriously. The treatment methods are drug therapy and interventional therapy.
In order to let the patient cooperate well with the treatment and care, the patient should be instructed to master the following related knowledge.
[Psychological guidance]
Cardiac arrhythmia often Chu to carry out continuous ECG monitoring to help diagnosis and treatment. Patients are often fearful and worried about the environment of the monitoring room and a variety of monitoring equipment, and even worried about their own disease severe remote. The nurse should explain to the patient in detail monitoring on the diagnosis and treatment of arrhythmias guidance logic, as well as the introduction of monitoring equipment and the use of methods to eliminate the patient’s unfamiliarity and fear of exhaustion, guidance to patients to learn to control their emotions, avoid mental tension, emotional excitement, so as not to induce and aggravate arrhythmias.
Diet guidance]
Develop good neodymium eating habits, quit smoking and alcohol, and do not drink strong tea or coffee.
Rest and activity guidance
Avoid overwork and strenuous exercise. If you are seriously ill, rest in bed.
Guidance on examination
Dynamic ECG: The common method is to have the patient wear a slow rotating tape box, place electrodes on the chest, and record continuously for 24 hours, from which myocardial ischemia and various arrhythmias can be detected. The following points should be mastered during the monitoring of booster patients.
1. 24-hour ambulatory electrocardiograph is expensive and highly precise, so it should be used with care, avoid touching or dropping it, and not to press the box when sleeping.
2. Do not enter the magnetic field environment, wood contact with magnetic objects. If you do not enter the radiology department, do not use the magnetized cup to drink water, etc.
3. Do 13 notes, that is, 24, j, when the symptoms (or discomfort) and their own activities and time to write in the diary often. For example, headache, dizziness, chest pain, chest tightness, palpitations, shortness of breath, nausea. Keep the activity descriptions simple and concise, i.e., going upstairs, walking, smoking: drinking, sitting, sleeping, resting, pooping, etc. You can go up and down the stairs consciously, but do not do strenuous exercise.
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4. The recorder shows the time south 24 hours continuous time record. If the display does not year after half a year with prevention 1 time. When approaching the late life span of the pacemaker, the follow-up prevention should be strengthened, once a month or even once a week.
Cardiomyopathy
Cardiomyopathy, also known as primary or unexplained cardiomyopathy, is a group of cardiomyopathies of unknown etiology. According to the recommendations of the World Health Organization and others, it can be divided into four categories: dilated, hypertrophic, restrictive and undefined cardiomyopathies.
[Diet].
Restrict diet, limit sodium intake, give a light diet high in protein, vitamins, rich in vitamins and trace elements to promote myocardial metabolism and strengthen the body’s resistance. Instruct the patient to quit smoking and alcohol, less stimulating food, and eat less and more meals. Teach the patient how to calculate the water content of food and accurately record the amount of intake and output.
Rest and activity
Due to different degrees of myocardial damage, the patient’s activities and exertion will increase the burden on the heart to varying degrees, so the patient should try to rest in bed to reduce myocardial oxygen consumption and reduce the degree of myocardial hypoxia. However, those with good cardiac function may engage in appropriate physical activities and do not need absolute bed rest. Those who have shortness of breath, palpitations, coughing with frothy pale, breathing difficulty, inability to lie down at night and other cardiac insufficiency or heart enlargement should reduce their activities or even rest in bed. Ensure the time and quality of sleep, sleep advocates a two-stage system, that is, night sleep and nap, but nap time should not be too long, half an hour to one hour is appropriate.
Medication guidance]
Insist on taking anti-heart failure, anti-arrhythmic drugs or beta-blockers, calcium channel blockers, etc. to improve the survival years. Explain the name, dosage and usage of the drugs, and pay attention to the observation of drug efficacy and adverse reactions.
[Management of complications
1, with heart failure, give diuretics and vasodilators, dilated cardiomyopathy patients digitalis poorly tolerated, the use of dosage needs to be small.
2, pain patients pay attention to rest, apply beta-blockers or calcium channel blockers.
Psychological care]
Patients with cardiomyopathy have a tendency to worry, frustration, depression and other psychological disorders related to the disease, and the patient’s knowledge of the disease, the perception of the effectiveness of treatment and prognosis, that is, self-perception. Therefore, education about the treatment of the disease should not be neglected. Patients with high cultural quality, strong character and self-control should be given comprehensive real education to induce patients to mobilize their own positive anti-disease factors, carry out medication and adjuvant therapy, and arrange their own lives, while patients who do not achieve the above qualities should still adopt a protective medical attitude to avoid pessimism, disappointment, frustration, frustration and other emotions that affect their attitude toward the disease and treatment. The patient’s attitude towards the condition and treatment is still protected by the medical attitude, which obliterates the positive anti-disease factors and avoids serious psychological disorders that affect the quality of survival, while educating the family to provide emotional support, understanding and care.
Discharge guidance]
1. Prevent colds, keep fresh indoor air, ventilate regularly, prevent infections, and develop good living habits.
2, good heart function, can carry out appropriate physical activity, do not have to absolutely lie down to rest, activities do not appear fatigue, dyspnea or chest tightness for the limit, heart rate as a guide exercise indicators.
3, high protein, high vitamin, light diet rich in vitamins and trace elements.
4. Do self-monitoring of the condition and tell the patient to seek medical attention promptly in case of panic, cough, shortness of breath, edema of both lower extremities, inability to lie down at night or when the urine volume is less than the incoming volume for several consecutive days.
IV. Viral myocarditis
The occurrence of viral myocarditis is often closely related to viral infection, autoimmune ability, dietary structure, living environment and psychological situation. If early detection, early diagnosis and early treatment, the prognosis of the disease is mostly good; however, if not treated early, arrhythmias, heart failure, cardiogenic shock, and even sudden death can occur.
Psychological guidance]
1, do not overly delay, viral myocarditis after timely treatment, most can be completely recovered, to build confidence.
2, the patient’s recovery is needed for a while, must not rush, keep optimistic and stable emotions, mental relaxation, so that the body and mind to get sufficient rest, in order to recover early recovery.
3, emotional excitement, excessive excitement, very sad are easy to cause discomfort, thus aggravating the disease.
Rest and activity guidance]
Patients in the acute stage should rest in bed to reduce the burden on the heart until the symptoms disappear, the pulse is less than 100 beats per minute, and the blood myocardial enzymology, electrocardiogram and X-ray examination suggest a return to normal, then the amount of activity can be gradually increased.
1.After the size of the patient’s heart is normalized and the ECG and other laboratory tests are normalized, the amount of activity can be gradually increased, such as taking walks, practicing boxing, sword dancing, raising flowers, reading books, reading newspapers and other physical exercises as appropriate.
2, should not be too tired and overexcited, to achieve the time of living, entertainment, and gradually return to normal life, work and study.
3, the right amount of activity is beneficial to health and can enhance the recovery of patients, to encourage increased activity endurance, but activities such as chest tightness, palpitations, breathing difficulties to immediately stop the activity, and as an indicator of maximum activity.
Fourth, dietary guidance
Diet should not only ensure comprehensive and balanced nutrition, but also avoid excessive calorie intake, which may cause excessive obesity and increase the burden on the heart. Guide the patient to eat soft food with high calorie, high protein, high vitamin, low fat and easy to digest.
1, eat more vegetables, fruits containing a lot of vitamin C such as oranges, tomatoes and foods containing a lot of amino acids such as lean meat, eggs, fish, soybeans, etc.
2, do not overeat and binge drinking, to a small number of meals.
3, avoid fried food, fatty meat and stimulating food such as chili, strong tea, Coffee, etc., quit smoking and alcohol.
4.To reduce the burden on the heart, appropriately reduce the amount of salt and limit/restrict intake, and limit salt to 1 to 2 grams per day for heart failure (no more than 3 grams of salt/d).
[Prevent complications].
The most common complications are heart failure and arrhythmia. Avoid as much as possible respiratory infections, strenuous exercise, emotional excitement, full meals, cold, forceful bowel movements and other triggering factors, and usually observe the color of skin mucous membranes, urine volume, presence of dyspnea, cough, easy fatigue, edema, abnormal pulse rate, etc., and seek immediate medical attention in case they are detected.
The impact of environmental factors on the disease].
The environment has an important role in the condition of viral myocarditis, and patients should avoid going to places with a lot of people, serious air pollution, noise and other poor environments, go to public places less often when the flu is prevalent, avoid contact with patients with upper sensation, you can take plate blue root, blue butt leaves, etc. to prevent; if the symptoms of upper sensation to go to the hospital in a timely manner, so as not to aggravate the infection. Pay attention to climate change, avoid getting cold, prevent colds. Add clothes in time when the weather changes. Reduce environmental stress and keep the environment comfortable and healthy.
V. Intracoronary stent placement
The coronary arteries of patients with coronary heart disease have different degrees of stenosis, which affects the blood supply to the heart and causes myocardial ischemia, resulting in angina pectoris and myocardial infarction. In the last three decades, percutaneous coronary intervention has become a fast and effective method for treating patients with high-risk coronary artery disease, the most common of which is intracoronary stent placement. The procedure is performed in the cardiac catheterization laboratory with the patient lying on the operating table. The surgeon first applies local anesthesia to the site of the vascular puncture, then punctures the artery (usually the femoral artery, but also the radial artery) and delivers a special, very small cardiac catheter to the opening of the left and right coronary arteries. The coronary artery with severe stenosis is then dilated with a balloon and a stent is implanted. This procedure allows the lumen of the narrowed coronary artery to be resized and supported by the stent, thus restoring normal blood flow to the coronary artery. The coronary stents currently in use are made of high-grade alloys, some of which are coated with drugs to prevent restenosis of the stents. The procedure causes minimal damage to the body, and patients can get out of bed and walk around 12 to 24 hours after the procedure, and most patients without complications can be discharged from the hospital within 24 hours after the procedure.
Health tips.
1. Intracoronary stent placement is not a once-and-for-all procedure. Patients should still actively treat hyperlipidemia, hypertension, diabetes and other diseases, and improve their lifestyles to control the risk factors of coronary heart disease.
Some antithrombotic drugs have the effect of preventing the formation of thrombus in the stent, so you should not stop the drugs by yourself, and the adjustment of the drugs should be under the guidance of the doctor. Aspirin has the effect of inhibiting platelet aggregation and should be taken for life if there are no contraindications. Patients taking antiplatelet drugs need to be observed for easy bleeding, such as bruising on the skin, bleeding gums, red urine, deepening or darkening of stools, etc. They need to be seen promptly. If other surgeries require discontinuation of antiplatelet medication, you need to consult with your cardiologist and surgeon to determine the medication regimen.
3. Moderate your diet and maintain a normal weight. Eat less fatty foods and foods with high cholesterol content, such as fatty meat, poultry skin, egg yolk, animal offal, etc., and eat more vegetables and fruits.
4. Quit smoking completely and reduce alcohol consumption.
5. Gradually resume physical activities after discharge from the hospital. The specific exercise program should be formulated according to your condition and physical strength after discussing with your doctor, such as walking, jogging, doing exercises, etc.
6. Live a regular life, avoid overexertion and mood swings, keep bowel movements smooth and get enough sleep.
7. Go to the hospital regularly for consultation or examination, and if necessary, have a coronary artery examination to see if restenosis occurs.
8. The implanted stent will not fall off from the vessel wall, so there is no need to worry. The cardiac stents currently used are safe for MRI examination.
VI. Cardiac neurosis
Cardiac neurosis is a clinical syndrome mainly manifested by the symptoms of cardiovascular diseases, and it is a type of functional neurosis. It occurs mostly in middle-aged and young people, and is more common between the ages of 20 and 50; it is more common in women than in men, especially in menopausal women. There is no clinical evidence of organic heart disease and the prognosis is good, but patients with severe long-term symptoms can significantly affect normal life and work. It comes and goes,
Palpitations, precordial pain, chest tightness, shortness of breath, dyspnea, dizziness, insomnia, and excessive dreaming are common. Eliminate causative factors, such as worry, tension and annoyance; correct insomnia; avoid overexertion and the influence of noisy environmental factors. Once suffering from cardiac neurosis, do not need to be too nervous, not to mention bed rest, the following measures can be taken.
First, often participate in physical activities within their reach, such as playing Taijiquan, exercise, to enhance physical fitness;
Second, regular life, reasonable arrangements for life, as far as possible to achieve a combination of work and rest;
Third, avoid excessive stress, should not engage in work that lasts too long and highly concentrated;
Fourth, severe insomnia can be used Valium, Librium, brain, vitamins, multivitamins, and so on, or identify the symptoms of the use of Chinese medicine, such as spleen soup, vermilion tranquilizer pills, Huang Lian Agaric acid soup, Jiaotai pill, etc., can achieve good therapeutic results.
Seven, hypertension
Hypertension is a common, unexplained disease with elevated arterial pressure as the main cause. The current clinical criteria for the delineation of hypertension in adults are: systolic blood pressure ≥ 140 mmHg (18.7 kPa) or diastolic blood pressure ≥ 90 mmHg (12 kPa).
[Psychological guidance].
Maintain a calm state of mind, avoid emotional excitement and excessive tension and anxiety. Be calm and collected when things go wrong, and try to release any mental stress, such as confiding in friends and relatives and talking with them to maintain a stable blood pressure.
Diet guidance
1. Diet is based on the principle of low salt and low fat. Eat less cholesterol-containing foods, such as animal offal and egg yolk, etc.
2. Obese people should reduce their daily calorie intake to reduce weight. Because obesity is related to the increase of blood pressure.
3. Eat more potassium-rich foods, such as vegetables and fruits. Do not exceed 6g of salt per day, as high sodium and low potassium intake is associated with the development of hypertension. .
4. Quit smoking and avoid excessive alcohol consumption.
[Rest, activity guidance] Pay attention to the combination of work and rest.
1. Avoid long-term excessive stressful work and exertion, and ensure sufficient sleep.
2. For patients who are engaged in long-term highly concentrated, over-stressed mental work and work in an environment of excessive visual and auditory stimulation, they should relax themselves and adjust their work and rest appropriately.
3. Choose appropriate exercise and relaxation therapy, such as walking, qigong, taijiquan, music therapy, etc. Physiological research and clinical studies show that they are not only good for the patient, but also good for the patient. Physiological research and clinical studies have shown that they are effective in lowering blood pressure, such as long-term qigong exercise can reduce the sympathetic nerve tension through the regulation of the central nervous system, and thus reduce the need for antihypertensive drugs.
Medication guidance]
1. Anti-hypertensive drugs should be taken orally as much as possible, and gradually lower the blood pressure to prevent sudden drop in blood pressure and produce insufficient blood supply to the heart, brain and kidneys.
2. There are many types and varieties of antihypertensive drugs available, and the pharmacological effects of various antihypertensive drugs are different, so the medication should be taken under the guidance of a doctor, depending on the individual.
3. Must adhere to long-term medication, and understand the role of drugs and side effects. When applying potassium-removing diuretics such as dihydrocodone, pay attention to the appearance of hypokalemia. Captopril has side effects such as dry cough, abnormal taste and rash. When side effects occur, report to the doctor and adjust the medication.
4. During the application of antihypertensive drugs, it is advisable to explain to the patient that when rising from a sitting position or from a lying position, the movement should be as slow as possible, especially when getting up to urinate at night, so as to avoid accidents caused by fainting due to a sudden decrease in blood pressure.
[Discharge instruction
1. Monitoring of blood pressure: The estimation of blood pressure level cannot be made by the occurrence of symptoms. Blood pressure must be measured to understand the situation of blood pressure, as a basis for adjusting medication. Blood pressure measurement should be done in a fixed position, at a fixed location, and with a fixed sphygmomanometer.
2. Hypertension often coexists with obesity, lipid and blood glucose abnormalities, and should be regularly monitored for changes in lipid and blood glucose. Long-term hypertension can cause renal decompensation, and regular urinary routine and renal function tests should be performed.
3. In case of sudden increase in blood pressure, the whole body should be relaxed, rest quietly, and immediately take 1 tablet of cardiac pain under the tongue or other oral antihypertensive drugs, and then go to the hospital after feeling slightly relieved. If there is pain in the precordial region or numbness or weakness in one side of the limb, distortion of the corners of the mouth, and increased nocturia or oliguria, etc., you should seek medical attention promptly.
VIII. Coronary heart disease
Coronary artery disease, also known as coronary heart disease, is a heart disease caused by atherosclerosis or spasm of coronary arteries that block the lumen of blood vessels, resulting in myocardial ischemia and hypoxia. Clinical common for angina pectoris type and myocardial infarction type.
Psychological guidance]
1, maintain a good state of mind, because mental tension, emotional excitement, anxiety and other adverse psychological state, can make the body catecholamines release increased, heart rate accelerated, the heart burden plus hair and aggravate the disease.
2, for patients with myocardial infarction, it is more important to overcome anxiety, fear and other emotions. Because the critical symptoms of the disease make patients feel near death, and then enter the intensive care unit and the isolation of relatives, a variety of instruments, equipment, the impact of the patient is extremely nervous, fear, anxiety, so the nurse should guide the patient from many aspects, change this bad psychological state, so that the patient temporarily do not consider the work family complicated things, so that the mood is completely relaxed, at ease treatment, with the best psychological state, through the dangerous period.
Diet guidance]
1. The diet of patients with angina pectoris should be light, easy to digest, low salt, low fat, low cholesterol diet, avoid overeating.
2. Patients with myocardial infarction should eat liquid food for the first 3 days, and gradually change to semi-liquid, soft food and general food after the symptoms have been reduced, and should not eat too much because eating indigestible food or eating too much can increase blood flow in the gastrointestinal tract and increase the burden on the heart.
3. Quit smoking and drinking.
Rest and activity guidance]
1. Rest immediately when angina attacks, or rest in bed if attacks are frequent.
2. Patients with myocardial infarction must keep the environment absolutely quiet and strictly limit visits and adverse stimuli.
3. Absolute bed rest within 1 week after myocardial infarction, all daily life by others care. In order to reduce the oxygen consumption of the heart and prevent the expansion of the infarct; without serious complications, passive movement of the limbs can be done in bed in the second week, bedside activities in the third week, and indoor activities in the fourth week.
Care method guidance]
Keep the bowel movement smooth, do not force to defecate. Because of the increase in abdominal pressure when straining to defecate, the amount of blood returned to the heart increases, coupled with breath holding and straining, which increases the oxygen consumption of the heart and increases the burden. Patients with myocardial infarction should actively prevent constipation. If necessary, low-pressure enema with warm saline can be used to make the stool easy to pass.
Discharge guidance]
1. Avoid overexertion in daily life. Avoid cold stimulation in winter, such as not eating cold drinks, not using cold water to wash face, hands or clothes. Bathing water temperature should be comparable to body temperature, and the time should not be too long.
2. Obese people need to limit dietary calories and increase physical activity to reduce weight.
3. Prevention and control of various diseases that can aggravate the condition, such as hypertension, diabetes, anemia, hyperthyroidism, etc.. Especially to control hypertension, so that blood pressure is maintained at a normal level.
4. Patients with angina should carry nitroglycerin tablets with them for emergency use.
5. If the number of angina attacks increases, the duration lengthens, the pain increases, and nitroglycerin is ineffective, it may be a precursor of myocardial infarction, and the patient and family members should be instructed to do a good job of home rescue: ① let the patient rest in bed immediately, do not exert, in order to reduce myocardial oxygen consumption. ② Use the usual anti-anginal drugs, such as sublingual nitroglycerin tablets, one every 3 to 5 minutes (generally controlled within 5 tablets) to reduce pain. ③If the condition is critical, request the emergency center to come to rescue in place as soon as possible, and wait for the heart rate, heart rhythm and blood pressure to stabilize before lifting and carrying lightly and sending the patient to the hospital to continue treatment. ④Inhale high concentration (4-6L/min) of oxygen to the patient as soon as possible if possible.
IX. Chronic pulmonary heart disease
Chronic pulmonary heart disease is a heart disease caused by chronic lesions of lung tissue, pulmonary artery vessels or thorax causing abnormalities in the structure and function of lung tissue, producing increased pulmonary vascular resistance and increased pulmonary artery pressure, causing dilatation and hypertrophy of the right heart, with or without right heart failure.
It can occur in the elderly, but most of them develop from middle age. Most pulmonary heart disease in the elderly develops from chronic obstructive pulmonary disease. It has a high incidence, especially in the smoking population, and is increasing year by year.
1.Dietary guidance
Diet therapy plays an important role in the development of chronic pulmonary heart disease, prognosis. Eat less and more meals, rinse your mouth before and after meals to keep your mouth clean and help promote diet. It is advisable to eat high fiber easy to digest light diet to avoid aggravating respiratory difficulty due to constipation and abdominal distension. Reduce the consumption of food containing high sugar to avoid causing sticky sputum. If the patient has edema, ascites or low urine, sodium and water intake should be limited to less than 3 grams of sodium per day and less than 1500 ml of water per day.
2. Rest and activity guidance
In the period of cardiopulmonary function loss, patients should absolutely rest in bed, and can be assisted to adopt a comfortable lying position, such as semi-recumbent or sitting position, which can reduce the oxygen consumption of the body, help to promote the recovery of cardiopulmonary function, slow down the heart rate and reduce respiratory distress, and for patients who are bedridden, they should turn over regularly, change their posture and maintain a comfortable position to avoid the occurrence of pressure sores. During the compensatory period, according to the principle of gradual progress and according to the ability, patients should be encouraged to move appropriately, and the amount of activity should be such that the patient does not feel fatigue and the symptoms do not worsen. Encourage patients to carry out respiratory function exercises to improve their activity endurance.
3.Guidance on daily life
Instruct the patient and family members to understand the process of disease occurrence and development and the importance of preventing acute attacks, and to reduce the number of recurrent attacks. Avoid and prevent various triggers that may lead to acute exacerbation of the disease.
Insist on reasonable oxygen therapy at home, continuous low-flow, low-concentration oxygen intake, oxygen flow rate 1-2L/min, concentration at 25%-29%, time of oxygen intake at 15 hours or more. Avoid turning up the oxygen flow rate straight away, which may aggravate carbon dioxide retention and lead to lung brain. Insist on continuous oxygen, especially at night, to help improve the patient’s quality of life.
Encourage the patient to quit smoking, which can lead to weakened airway evolution and susceptibility to infection.
Instruct the patient to eat a high-protein, high-calorie, high-vitamin, low-sugar diet and avoid gas-producing and constipation-inducing foods. During the period of abdominal distension, a liquid or semi-liquid diet with small and frequent meals, appropriate amount of water, and a clean mouth can be maintained.
During the remission period, appropriate physical exercise and respiratory exercise can be carried out according to the pulmonary and cardiac function, such as walking, Tai Chi, abdominal breathing, lip-reducing breathing, etc.