herve leger skirts 32 cases of thymoma with myasth

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32 cases of thymoma with myasthenia gravis Perioperative Nursing

. 2.2.2.2 During the mechanical ventilation and monitoring of care: to maintain airway patency, suction once every 20 ~ 30min, and good airway humidification, effective suction, suction time, every time less than 15min, smoking to pure oxygen before and after sputum 10min, to keep the oxygen concentration. Ventilator breathing pattern to use more simv (synchronized intermittent assisted ventilation), tidal volume of 8 ~ 12ml/kg, Frequency 12 ~ 20 times / min, oxygen concentration of 40% to 60%, respiratory ratio was 1:1.5, the daily Monitoring ventilator parameters,[link widoczny dla zalogowanych], arterial blood gas monitoring 3 times a day, according to paO2 and SPO2, skin color, breathing, etc. to adjust oxygen concentration. From the ventilator should be gradually reduced oxygen concentration, respiratory rate, and then break down, as the patient is breathing on his own ability to have a breathing machine and then leave. 2.2.2.3 promptly anticholinergic activity of drugs and hormones: MG occurred, given pyridostigmine clear 60mg crush tube after injection, dexamethasone 1020mg plus intravenous liquid, if cholinergic Neural crisis should be reduced pyridostigmine out of the drug increased the amount of adrenal cortex hormones. 2.2.2.4 Note again crisis: myasthenic crisis patients after tracheotomy, mechanical ventilation and application of anti-cholinesterase drugs and hormones, the basic condition under control, but the myasthenic crisis can be more second relapse,[link widoczny dla zalogowanych], discontinuation of the respirator, the patient should always pay attention to changes in breathing, with or without hypoxia, cyanosis,[link widoczny dla zalogowanych], respiratory difficulty to detect signs of weakness to give emergency treatment, the group 1 patients after discontinuation of ventilator dead 3d in myasthenia gravis crisis once again, a profound lesson. 2.3 to enhance nutritional support, maintaining water and electrolyte acid-base balance 【2】: the majority of patients before serious condition, unable to chew, swallowing difficulties can not eat, poor health, should be on those who can not eat nasal feeding, to the high protein, high calorie , high-vitamin diet, such as fish, pork ribs soup, vegetable soup, fruit juice, etc., the daily 500 ~ 1000ml, intravenous fat emulsion, protein, plasma, energy mixture, water and electrolyte liquid, often in patients with poor eating certain degree of hyponatremia, hypokalemia, or acidosis, pay attention to laboratory samples taken,[link widoczny dla zalogowanych], receive test results. Better nutrition, increased resistance of patients to correct acid-base balance and electrolyte disturbance, but also the lack of perioperative nursing is not a major element.
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