外科英語:手術(shù)前宣教

PREOPERATIVE TEACHING

術(shù)前宣教

Assessment

評(píng)估

1. Ask about client's previous experiences with surgery and anesthesia.

1、詢問病人以前的手術(shù)和麻醉經(jīng)歷。

2. Determine client's and family's understanding of surgery.

2、確定病人和家屬是否了解手術(shù)情況。

3. Identify client's cognitive level, language, and culture.

3、評(píng)價(jià)的認(rèn)識(shí)水平、語言和文化背景。

4. Assess client's anxiety related to surgery.

4、評(píng)估病人是否對(duì)手術(shù)感到焦慮。

Implementation

實(shí)施

1. Use Standard Protocol.

1、按標(biāo)準(zhǔn)程序開始操作。

2. Inform client and family of date, time, location of surgery, and where to wait.

2、告知病人及家屬手術(shù)日期、時(shí)間和、位置及等待區(qū)。

3. Inform client and family about the anticipated length of time of surgery.

3、告知病人及家屬預(yù)計(jì)手術(shù)時(shí)間。

4. Answer questions client and family ask.

4、回答病人及家屬所提問題。

5. Describe perioperative routines.

5、說明圍手術(shù)期常規(guī)。

6. Describe preoperative medications.

6、說明圍手術(shù)期用藥情況。

7. Review which routine medications are to be discontinued before surgery.

7、檢查術(shù)前應(yīng)停用何種藥物。

8. Describe perioperative sensations to expect (sights, sounds, touch).

8、說明手術(shù)期間可能有的感覺(視覺、聽覺、觸覺)。

9. Describe pain-control methods. Many clients have a patient-controlled analgesia (PCA) pump.

9、說明止痛方法。很多病人有病人自控鎮(zhèn)痛泵。

10. Describe what client will experience postoperatively.

10、說明病人可能的術(shù)后感覺。

11. Have client practice splinting. Hold pillow to abdomen for support while sitting up or coughing.

11、病人練習(xí)夾板療法，以起坐或咳嗽時(shí)用枕頭支撐腹部。

12. Have client practice turning and sitting up.

12、病人練習(xí)翻身和起坐。

Flex knees.

Splint incision with left arm and pillow.

Push on the mattress with right arm and swing feet over the edge of the bed.

屈膝。

用左臂和枕頭夾住切口。

右臂按床墊，擺動(dòng)兩腿至床沿。

13. Have client practice deep breathing and coughing.

13、病人練習(xí)深呼吸和咳嗽。

• Assist client to sitting position.
• Instruct client to place palms of hands over the lower border of the rib cage with third fingers touching.
• Have client take slow, deep breaths and feel fingers separate.
• Have client hold the breath for 3 seconds and exhale through the mouth slowly, as if blowing out a candle.
• Instruct client to cough forcefully.
• Have client practice several times.
• Have client perform turn, cough, and deep breathing every 2 hours.

• 協(xié)助病人起坐。
• 指導(dǎo)病人將兩手手掌置于肋下緣，中指相接。
• 病人慢、深呼吸，感覺手指分開。
• 病人屏氣3秒鐘，慢慢用口呼氣，如吹蠟燭。
• 指導(dǎo)病人用力咳嗽。
• 病人反復(fù)練習(xí)上述動(dòng)作。
• 病人每2小時(shí)練習(xí)翻身、咳嗽和深呼吸一次。

14. Have client practice use of an incentive spirometer

14、病人練習(xí)使用誘導(dǎo)性肺量器。

• Position in a sitting or reclining position.
• Instruct client to exhale completely, then place mouthpiece so that lips completely cover it and inhale slowly, maintaining constant flow.
• After maximum inspiration, client should hold breath for 2 to 3 seconds, then exhale slowly.
• Instruct client to breathe normally for a short period, then repeat process.

• 病人處坐位或拱垂位。
• 指導(dǎo)病人呼氣，放置銜嘴，嘴唇完全封閉，慢慢吸氣，速度均勻。
• 至無法吸氣時(shí)屏氣2-3秒鐘，然后慢慢呼氣。
• 指導(dǎo)病人正常呼吸，然后重復(fù)上述動(dòng)作。

15. Have client practice leg exercises.

15、病人進(jìn)行腿部練習(xí)。

• Rotate each ankle in a complete circle. Draw imaginary circles with the big toe five times.
• Alternate dorsiflexion and plantar flexion while instructing client to feel calf muscles tighten and relax. Repeat five times.
• Instruct client to alternate flexing and extending knees one leg at a time. Repeat five times.
• Instruct client to alternate straight leg raises. Repeat five times.
• Instruct client to perform these leg exercises every 2 hours while awake.www.gydjdsj.org.cn

• 全方位旋轉(zhuǎn)腳踝，想象用大拇指畫圈五次。
• 交替屈、伸足部，指導(dǎo)病人體會(huì)小腿肌肉緊張和放松的感覺，重復(fù)五次。
• 指導(dǎo)病人分別交替屈、伸兩腿膝部。重復(fù)五次。
• 指導(dǎo)病人交替練習(xí)直腿抬起，重復(fù)五次。
• 指導(dǎo)病人在醒時(shí)每2小時(shí)做腿部練習(xí)一次。

16. Verify that client's expectations of surgery are realistic. Correct expectations as needed.

16、確認(rèn)病人對(duì)手術(shù)有較為現(xiàn)實(shí)的預(yù)期。必要時(shí)應(yīng)糾正其想法。

17. Reinforce therapeutic coping strategies. If ineffective, encourage alternatives.

17、強(qiáng)化治療應(yīng)對(duì)方法，如方法無效，可鼓勵(lì)采用其他方法。

18. Use Completion Protocol.

18、按標(biāo)準(zhǔn)程序完成操作。

Evaluation

評(píng)價(jià)

1. Evaluate client's understanding of and ability to participate in preoperative teaching.

1、評(píng)價(jià)病人對(duì)術(shù)前教育的理解程度及參與能力。

2. Ask family where they will be waiting.

2、詢問病人家屬在何處等候病人。

3. Determine readiness to care for client after discharge.

3、確定是否已經(jīng)作好病人出院護(hù)理準(zhǔn)備。

4. Observe emotional support provided and coping strategies.

4、遵守情感護(hù)理要求和應(yīng)對(duì)策略。

5. Identify Unexpected Outcomes and Nursing Interventions

5、確認(rèn)意外結(jié)果和護(hù)理措施。

Record and Report

記錄與報(bào)告

1. Record on preoperative instruction flow sheet.

1、在術(shù)前指導(dǎo)流程表上作好記錄。

2. Report any concerns about follow-up care to appropriate personnel.

2、向適當(dāng)人員報(bào)告有關(guān)隨訪護(hù)理的問題。

Revised