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1、2019/8/18,1,白 内 障 病 人 护 理 (Nursing for Cataract Patients),Taian Health School 纪 建 光,2019/8/18,2,晶状体在眼球内的位置 (Position of Lens in the Eye),2019/8/18,3,2019/8/18,4,Egg,Pullet,2019/8/18,5,Egg White,EggYolk,2019/8/18,6,EggShell,2019/8/18,7,2019/8/18,8,晶状体的特性 (Properties of Lens),1.Transparent(透明的) Body 2
2、. Protein pruti:n 3.Convex knveks （Degree： 1000-1200）,2019/8/18,9,Definition： 广义上讲，任何因素导致晶体(lens)出现浑浊(turbidness)t:bidnis 都可称为(cataract),Disease Description,2019/8/18,10,白内障国情 (National Conditions） 1.6000 万( sixty million)白内障患者 2.100万(one million)白内障患者应施行手术 3.每年新增患者40万(four hundred thousand) 4.人口老龄化
3、，患者逐年增加，白内障治疗、 护理任务项繁重 (A burdensome task),2019/8/18,11,白内障临床分类 (Classification of Clinic),2019/8/18,12,一：Senile Cataract si:nail 年龄相关性白内障(age-related cataract）,2019/8/18,13,二： Traumatic Cataract tr:mtik 外伤性白内障:眼球穿孔伤、钝挫伤,2019/8/18,14,三： Metabolic Cataract ,metblik 代谢性白内障：糖尿病，甲状腺疾病,2019/8/18,15,四：Con
4、genital Cataract kndenitl 先天性白内障,2019/8/18,16,五： Medicamentous Cataract 药物性中毒性白内障：长期使用“类固醇”药物 六：Radiated Cataract reidieitid 辐射性白内障：因放射线所致,2019/8/18,17,老年性白内障 Senile Cataract,2019/8/18,18,1.年龄增长，晶状体逐渐混浊，即为老年性白内障。一般起于4045以后 2.主要病因:氧化损害(Oxidative Damage) ksideitiv 3. 临床表现:眼前阴影和渐进性、无痛性视力减退(Visual Deter
5、ioration) di,tirirein,2019/8/18,19,Nursing Assessment,(一)Health History 1. 年龄(Age) 2. 外伤(Trauma) 3. 营养(Nutrition) 4. 遗传 (Heredity) hirediti 5. 代谢(Metabolize) mtblaiz 6. 全身病(General Disease),2019/8/18,20,身体状况 (Physical Condition),1.症状(Symptom),渐进性视力下降 (Gradual Visual Deterioration ） di,tirirein,2019/
6、8/18,21,Clinical Stages,一期(Initial Stage) 1、无视力下降（对视力无影响） 2、皮质内出现空泡，水裂和板层分离， 从周边逐渐向中央扩大，呈“羽毛状”或 楔形浑浊 3、此期发展缓慢，可经数年,2019/8/18,22,2019/8/18,23,二期：膨胀期 (Dilatational Stage) 1.视力下降 2.晶体呈不均匀浑浊 3.晶体体积变大，将虹膜向前推移 4.前房变浅 5.诱发急性闭角型青光眼 AACG: （ Acute Angle Closure Glaucoma),2019/8/18,24,2019/8/18,25,三期：成熟期 (Matu
7、rity Stage) mtjuriti 1.视力下降至眼前手动/光感 2.晶体灰白色均匀浑浊 3.虹膜投影消失 4.眼底不能窥入,2019/8/18,26,2019/8/18,27,四期：过熟期(Overripe Stage) uvraip 1.视力突然提高(晶体皮质液化外溢 核下沉） 2.前房加深 3.虹膜震颤 4.浑浊晶体纤维分解液化，呈乳白色 5.棕黄色晶体核下沉于囊袋下方 6.诱发晶体溶解性青光眼,2019/8/18,28,2019/8/18,29,Physical Sign 白瞳症(White Pupil) 是最明显的体征,2019/8/18,30,Nursing Diagnosi
8、s,1.感知改变(Perceptual Alteration) 2.自理缺陷(Self Care Deficit) 3.受伤危险(Risk for Injury) 4.知识缺乏 (Knowledge Deficit) 5. 潜在并发症(Potential Complications),2019/8/18,31,Nursing Goals,1.病人视力提高 2.自理恢复 3.避免受伤 4.熟悉相关知识 5.避免并发症,2019/8/18,32,Nursing Interventions,一般护理(Ordinary Providence) 1.病房介绍(Ward Introduction) 2.饮
9、食指导(Diet Guidance),2019/8/18,33,治疗配合 ( Therapeutic Alliance ) erpju:tik lains,一：Nursing of Drug (1)维生素类 VitC, VitB2 (2)滴眼液:白内停,谷胱甘肽,卡他灵 二：Surgical Care,2019/8/18,34,2019/8/18,35,Preoperative Care,1.抗生素(Antibiotic) ,ntibaitik眼液 术前3天 2.镇静剂 3.冲洗结膜囊 4.冲洗泪道 5.降眼压Intraocular Pressure ,intrkjul 6.散瞳孔,2019/
10、8/18,36,2019/8/18,37,2019/8/18,38,2019/8/18,39,2019/8/18,40,Postoperative Care,一：“四位” 一体 (Four Positions) 1.体位(Body) 2.头位(Head) 3.口位(Mouth) 4.手位(Hand) 二：预防感染(Infection Prevention) 氧氟沙星滴眼液 三：定期复查(Regularl Countercheck) one week, one month， six months,2019/8/18,41,Health Education,1.Cause of Cataract 2.Symptoms of Cataract 3.Diagnosis of Cataract 4.Theropy and Nursing Knowledge 5.Prevention of Cataract,2019/8/18,42,Thanks a Lot !,