Help with a critical drop in temperature. Stage I - decrease in body temperature. The patient's complaints during this period

I period- heat production predominates over heat transfer. Cooling of the surface layer of the skin reflexively causes trembling, and the sensation of cold is explained by irritation of the nerve endings of the skin, due to a decrease in its temperature caused by spasm of the superficial vessels. The period lasts from several hours to several days.

Fig.9

II period- the heat transfer process increases and is almost equal to the heat generation process. Body temperature is set at constant high numbers. Skin blood vessels dilate and sweating increases. Duration from several hours to several days.

Fig.10

III period- heat transfer processes prevail over heat generation processes. Body temperature decreases. The decrease in body temperature can be gradual (lytic) or rapid (critical). A critical drop in body temperature is accompanied by profuse sweating, general weakness, pale skin, and collapse (acute vascular insufficiency) may develop.
Fig.11

Table 8

Complications that occur when the temperature drops critically:

Collapse- acute vascular insufficiency with a sharp decrease in blood pressure.

Symptoms, allowing the nurse to suspect collapse:

Pale skin, cyanosis of the nasolabial triangle, cold sticky sweat, dilated pupils, low blood pressure, thready pulse.

Nurse tactics

1. Tell your doctor.

2. Create rest and a horizontal position in bed, with the leg end raised by about 30-40 0 C.

The temperature can drop critically, that is, very quickly - from high numbers to low ones, for example from 40 to 36 ° C within an hour. This is accompanied by a sharp drop in vascular tone, a decrease in blood pressure, and the appearance of a thread-like pulse. The patient is pale, covered with cold, sticky sweat (profuse sweating); cyanosis of the lips and severe weakness are observed. The crisis is dangerous due to the development of collapse.

At critical decrease in body temperature patient, the nurse should:

1. Call a doctor.
2. Raise the foot end of the bed and remove the pillow from under your head.
3. Monitor blood pressure and pulse.
4. Prepare for subcutaneous administration a 10% solution of caffeine-sodium benzoate, cordiamine, 0.1% solution of adrenaline, 1% solution of mesatone.
5. Give strong sweet tea.
6. Cover the patient with blankets and apply heating pads to the patient's arms and legs.

Monitor the condition of his underwear and bed linen (linen needs to be changed as necessary, sometimes often).

A lytic (gradual) decrease in body temperature over several days is not dangerous for the patient and does not require special measures.

When there is a lytic decrease in the patient's body temperature, the nurse should:

1. Create peace for the patient.

2. Control of t°, blood pressure, respiratory rate, PS.

3. Change underwear and bed linen.

4. Carry out skin care.

5. Transfer to diet No. 15.

6. Gradual expansion of the physical activity regime.

End of work -

This topic belongs to the section:

Assistant nurse for patient care

Secondary vocational education of the Republic of Tatarstan.. Kazan Medical College.. specialties..

If you need additional material on this topic, or you did not find what you were looking for, we recommend using the search in our database of works:

What will we do with the received material:

If this material was useful to you, you can save it to your page on social networks:

All topics in this section:

Filling out an emergency notice
An emergency notification is drawn up by doctors and paramedical staff of the healthcare unit in the event that a patient is diagnosed with head lice, an infectious disease (suspected), a foodborne illness, or an acute occupational disease.

Filling out documentation upon discharge from hospital
Target. Document the outcome of the disease. Indications. End of the patient's hospital stay. Material resources: 1. Medical card

Determining the patient's body weight
Weighing patients regularly is a reliable method of controlling edema. Body weight is of great importance for clinical practice, in particular for the diagnosis of certain diseases: obesity,

Algorithm for measuring patient body weight
Preparation for the procedure: 1. Check the serviceability and accuracy of the medical scales in accordance with the instructions for their use. 2. Place a napkin on the scale platform. 3. B

Determining the patient's height
Upon admission, if the patient’s condition allows, it is customary to determine height using a special wooden stadiometer in a standing or sitting position. If the patient has hearing impairment, use

Height measurement algorithm
Preparation for the procedure 1. Explain to the patient the purpose and course of the upcoming procedure and obtain his consent 2. Wash and dry your hands (using soap or antiseptic) 3.

Execution algorithm
Preparing for the procedure. 1. Wear an additional robe, apron, and gloves. 2. Explain to the patient the need and sequence of the upcoming procedure and obtain consent for the procedure.

Execution algorithm
Preparation for the procedure 1. Explain the washing procedure to the patient and obtain his consent. 2. Fill the bathtub, measure the water temperature (35-37 °C). 3. Warn the patient about the possibility

Execution algorithm
Preparation for the procedure 1. Explain the upcoming procedure and obtain consent (if possible). 2. Lower the head of the bed to a horizontal level (or to the maximum

Patient transport
The method of transporting the patient from the emergency room to the specialized department is determined by the doctor depending on the severity of the patient’s condition: on a stretcher or on a gurney, on a wheelchair, in arms, on foot.

Devices for determining blood pressure
The auscultatory method of measuring blood pressure was proposed in 1905 by N.S. Korotkov. There are manual (tonometer), semi-automatic and automatic types of devices that measure blood pressure. Tonometer

Blood pressure measurement (order of the Ministry of Health of Russia dated January 24, 2003 No. 4), registration of indicators. Patient information
To measure blood pressure correctly, a number of conditions must be met. 1. Conditions for measuring blood pressure. The measurement should be carried out in a calm, comfortable environment

Algorithm for studying blood pressure on the brachial artery
Preparation for the procedure: 1. Introduce yourself to the patient, explain the purpose and course of the procedure. 2. Wash and dry your hands (using soap or antiseptic). 3. Give the patient

Errors in blood pressure measurement. Teaching the patient self-monitoring of blood pressure
In order to avoid mistakes when changing blood pressure, you must strictly adhere to certain rules. These universal rules should be followed regardless of the type of device: - 30 minutes before

Execution algorithm
Preparation for the procedure 1. Tell the patient that you will teach him how to measure blood pressure. 2. Determine the patient's motivation and ability to learn. 3. Check with the patient whether he agrees

Determination of NPV, registration
The combination of inhalation and subsequent exhalation is considered one breathing movement. The number of breaths in 1 minute is called the respiratory rate (RR) or simply the respiratory rate. Normal breathing

Glossary
Acrocyanosis is a bluish discoloration of the distal parts of the body caused by an increase in the amount of reduced hemoglobin in the blood from the subcutaneous

Pulse detection, pulse location, registration
Pulse studies can be carried out not only on the radial artery, but also on the carotid, temporal, femoral arteries, as well as arteries of the foot, etc. Pulse studies should be carried out on both limbs

Pulse research algorithm
Preparation for the procedure 1. Introduce yourself to the patient, explain the process and purpose of the pulse examination procedure. Obtain patient consent for the procedure. 2. Treat your hands with hygiene

Algorithm for measuring body temperature in the armpit
Preparation for the procedure: 1. Wash and dry your hands (using soap or antiseptic). 2. Prepare a thermometer (glass mercury): check its integrity, if necessary

Preparation for the procedure: 1. Wash and dry your hands (using soap or antiseptic). 2. Prepare the thermometer: check its integrity and, if necessary, wipe it dry

Algorithm for measuring temperature in the rectum
Preparation for the procedure: 1. Wash and dry your hands (using soap or antiseptic), put on gloves. 2. Prepare a thermometer: check its integrity, if necessary -

Recording temperature on a temperature sheet
To graphically display daily temperature fluctuations, temperature sheets are drawn up, in which the patient’s name is indicated, and the results of measuring body temperature are recorded. They take him to the reception

Nursing care for the patient during each period of fever
An increase in body temperature above 37 °C is called fever. Body temperature rises in infectious diseases and some conditions accompanied by disruption of thermoregulatory activity

The second period is stabilization of high body temperature
May last from several hours to several days. Skin vessels dilate, heat transfer increases in accordance with heat production, so further increase in body temperature stops

Drawing up portion requirements
Medical nutrition - diet therapy - is the most important element of complex therapy. Prescribed in combination with other types of therapy (pharmacological drugs, physiotherapeutic procedures). Medical pit

Characteristics of diets
Diet No. 0. Prescribed: after surgery on the digestive organs, with traumatic brain injury, cerebrovascular accident. Purpose: to provide food intake when

Food distribution
Immediately before serving food, tables must be prepared, covered with clean tablecloths, and oilcloth tablecloths must be thoroughly washed. It should be emphasized that it is very important for patients

Feeding a seriously ill patient with a spoon
Purpose: feeding the patient. Indications: inability to eat independently. Preparation for the procedure: 1. Check with

Feeding a seriously ill patient using a sippy cup
Purpose: feeding the patient. Indications: inability to independently eat solid and soft food. Equipment: sippy cup; napkin

Glossary
Portion chart is a sheet containing information about the number of different dietary tables, types of fasting and individual diets.

Executing the procedure
4.Wash and dry your hands. Wear gloves. 5. Liberally treat the blind end of the probe with glycerin (or other water-soluble lubricant). 6.Ask the patient to tilt his back slightly

Algorithm for feeding a seriously ill patient through a nasogastric tube
I. Preparation for the procedure. 1. Introduce yourself to the patient (if the patient is conscious), inform about the upcoming feeding, the composition and volume of food, and the method of feeding. 2. Wash and dry

Drinking regime; Helping the patient get enough fluids
Drinking regimen is the most rational order for drinking water during the day. At the same time, the drinking regime is directly tied to proper nutrition, since in addition to eating food for human health

Determination of water balance
Purpose: diagnosis of hidden edema. Equipment: medical scales, graduated glass container for collecting urine, water balance sheet.

Preparing and changing bed linen for a seriously ill patient
The functional purpose of a simple medical service: prevention of bedsores, ensuring personal hygiene of the patient. Material resources: a set of pure white

Preparation and change of underwear and clothing for a seriously ill patient
Functional purpose of a simple medical service: prevention of bedsores, ensuring personal hygiene of the patient. Material resources: non-sterile gloves

Preparation for the procedure
1. Introduce yourself to the patient, explain the purpose and course of the procedure (if the patient is conscious). Ensure that the patient has informed consent for the upcoming procedure. 2.Process ru

Caring for the oral cavity of a seriously ill patient
The functional purpose of a simple medical service is to ensure the patient’s personal hygiene. Material resources: tray, forceps, tweezers, vacuum electrician

Removing crusts from the nasal cavity of a seriously ill patient
The functional purpose of a simple medical service is to prevent nasal breathing problems and ensure the patient’s personal hygiene. Material resources:

Caring for the eyes of a seriously ill patient
The functional purpose of a simple medical service is to ensure the patient’s personal hygiene. Material resources: sterile tray, tweezers, gauze balls,

Completing the procedure
13.Remove the towel. Place the patient in a comfortable position. 14. Collect care supplies and deliver to a special room for further processing. 15. Snya

Diaper rash symptoms
Diaper rash manifests itself in the form of erythema (redness) of the skin folds. In the future, if treatment is not started, superficial cracks appear deep in the fold, and in advanced cases bleeding occurs

Providing a vessel to a seriously ill patient
The functional purpose of a simple medical service is to ensure personal hygiene. Material resources: bedpan, oilcloth, toilet paper, linen

Giving a urine bag to a seriously ill patient
The functional purpose of a simple medical service is to ensure personal hygiene. Material resources: bedpan (for women) or urine bag (for

Changing a diaper
The functional purpose of a simple medical service: prevention of bedsores, ensuring the patient’s personal hygiene. Material resources:non-sterile pepper

Algorithm for performing the manipulation
I. Preparation for the procedure. 1. Introduce yourself to the patient, explain the process and purpose of the procedure. 2. Separate the patient with a screen (if necessary). 3. Treat your hands hygienically

Caring for hair, nails, shaving a seriously ill patient
The functional purpose of a simple medical service is to ensure the patient’s personal hygiene. Material resources: water thermometer, liquid soap, shampoo. cr

Application of mustard plasters
Indications: 1. Inflammatory diseases of the respiratory tract. 2. Angina. 3. Hypertensive crisis. 4. Myositis. 5. Neuralgia. 6. Osteochondrosis.

Executing the procedure
6. Immerse the mustard plaster in water, temperature – 40-45°C. 7. Apply the mustard plaster firmly to the skin with the side covered with mustard. 8. Repeat paragraphs. 6-7, placing the required amount of mustard plaster

Cupping
Indications: 1. Inflammatory diseases of the respiratory tract. 2. Intercostal neuralgia. 3. Radiculitis. 4. Myositis. 5. Increased blood pressure. Contraindications

Executing the procedure
8. Apply a thin layer of Vaseline to the skin. 9. Moisten the wick in alcohol and squeeze it out. Close the bottle with a lid and set aside. Wipe your hands. 10. Light the wick. 11. Weight

Using a heating pad
Indications: 1. Pain caused by spasm of smooth muscles. 2. Intestinal colic. 3. Pain due to chronic gastritis. 4. Hepatic and renal colic

III.End of the procedure.
11. Remove the heating pad. 12. Examine the patient’s skin, help the patient take a comfortable position, cover. 13. Wash, dry your hands, put on gloves. 14. Open the cap on the heating pad

III. End of the procedure.
9. Remove the compress after the prescribed time. 10. Dry the patient's skin. 11.Wash your hands. 12.Make a record of the procedure performed and the patient’s reaction in the medical documentation

III.Complete procedure.
12.Remove the compress after the prescribed time. 13.Wipe the skin and apply a dry bandage. 14.Wash your hands. 15.Make a record of the procedure performed and the patient’s reaction in medicine

III. End of the procedure.
13. Remove the compress after the prescribed time. 14. Dry the skin and apply a dry bandage. 15. Wash your hands. 16. Make a record of the procedure performed and the reaction.

III. End of the procedure.
18. At the end of the procedure, remove the catheter and place it in a disinfectant solution. 19. Remove gloves, wash hands. 20. Make a record of the medical service performed.

Glossary.
Spasm vasoconstriction Necrosis necrosis Infiltrate tissue compaction inflammatory

Installation of the gas outlet pipe. Observation and care of the patient after the procedure
Increased gas formation in the intestines when its motor function is impaired is called flatulence. If the release of gases from the intestines using a cleansing enema is undesirable, but

Algorithm of actions
Preparation for the procedure: 1. Introduce yourself to the patient, explain the purpose and course of the upcoming procedure. 2. Separate the patient with a screen (if the procedure is performed in many ways)

Enemas
An enema is a therapeutic and diagnostic medical service that involves the introduction of various liquids into the lower segment of the colon. Therapeutic enemas are used for the following purposes:

Preparing the patient and administering a cleansing enema
Goal: to empty the intestines. The procedure is carried out in a separate room (enema room). The depth of insertion of the tip into the rectum depends on age and varies from 2-3 cm in a newborn

Algorithm of actions

Algorithm of actions
Preparation for the procedure: 1. Introduce yourself to the patient, explain the purpose and course of the procedure. 2. Separate the patient with a screen, ensuring his isolation. 3. Put on headlights

Algorithm of actions

Algorithm of actions
Preparation for the procedure: 1. Introduce yourself to the patient, explain the purpose and course of the upcoming procedure. 2. Prepare all necessary equipment to perform this service

Preparing the patient and administering a medicinal enema. Observation and care of the patient after the procedure
Medicinal enemas - therapeutic enemas with the introduction of various medicinal substances. Most often they are microenemas, their volume is 50-100 ml. Indications:

Algorithm of actions
Preparation for the procedure: 1. Introduce yourself to the patient, explain the purpose and course of the upcoming procedure. 2. Prepare all necessary equipment to perform this service

Types of catheters, sizes
To catheterize the bladder, a urethral catheter (a tube that is passed through the urethra into the bladder) is used. Catheters can be: 1) rubber (soft

Catheterization of the bladder with a soft catheter in women and men (on a phantom)
Equipment: sterile catheter, 1 pair of sterile gloves, sterile wipes, sterile glycerin, antiseptic solution, urine collection container, sterile trays.

Wear sterile gloves
6. Wrap the penis with sterile wipes. 7. Pull back the foreskin (if any), grab the penis from the side with your left hand and pull it to its maximum length perpendicularly

Wear sterile gloves
8. Cover the vaginal opening with sterile napkins. 9. Spread the labia minora to the sides with your left hand. With your right hand, take a sterile napkin moistened with an antiseptic solution and apply

Caring for the perineum of a patient with a urinary catheter
Equipment: terry cloth mittens, towel, gloves, absorbent diaper (oilcloth and regular diaper), water container, cotton balls. Preparation in

Types and use of removable urinals. Care of catheters and urine bags
Urine collection systems are removable urinals, made of rubber, polymer material (nylon, nylon). The urinal consists of a catheter and a drainage bag. Applicable for violations of the EU

Types of gastric tubes
Type of probe Characteristics Purpose Thin gastric Diameter 5-9 mm Fractional studied

Algorithm of actions
Flushing using a gastric tube (the patient is conscious) Preparation for the procedure: 1. Introduce yourself to the patient, explain the process and purpose of the procedure. 2. Usa

Material resources
1. Thick sterile gastric tube with a diameter of 10-15 mm, length - 100-120 cm with marks at a distance of 45, 55, 65 cm from the blind end - 1 pc. 2. 70cm long rubber tube (to extend

Algorithm of actions
Preparation for the procedure: 1. Measure blood pressure and count pulse. 2. Remove the patient’s dentures (if any). 3. Medical worker

Algorithm of actions
Preparation for the procedure: 1. Inform the doctor. 2. Put on gloves. 3. If the patient has dentures, they should be removed. 4. Sit the patient down

Algorithm of actions

Algorithm of actions
Preparation for the procedure: 1. Call a doctor immediately. 2. Put on gloves. 3. If the patient has dentures, they should be removed. 4. Remove pillows

Disinfection, pre-sterilization cleaning and sterilization of probes
1. Carry out pre-disinfection in a 3% chloramine solution. Pour the rinsing water into the sewer. 2. Place the probes in a 3% chloramine solution for 1 hour. 3. Rinse under running water.

Doctor's prescription sheet
Name of the hospital Name of the department Full name of the patient ___Sidorov A.P._______ Case history no.__1256_______________ DIAGNOSIS:___________________________________Admitted____16.0

Filling out requirements for medicines and the procedure for obtaining them from a pharmacy
In accordance with the needs of the department, the head nurse prescribes and receives medications from the pharmacy. There are special instructions for prescribing medications from a pharmacy.

With senior nurses, at the post, in treatment rooms
Name of the medicinal product________________________________________________________________________________ Concentration, dosage, unit of measurement _______________________

Distribution of medicines to patients of the medical department
Goal: Ensure that patients take medications on time. Equipment: medications, prescription sheets, sterile pipettes, spoons, beakers, container with boiled water

Sublingual route of administration (sublinqua)
With sublingual and subbucal administration (a form of oral administration), the drug is not exposed to digestive and microbial enzymes and is quickly absorbed

Rectal route of administration (per rectum)
The administration of drugs through the rectum (rectal) refers to the enteral route of administration. Liquid dosage forms are administered through the rectum: decoctions, solutions, mucus in the form of microenemas and

Possible patient problems and nursing interventions for them
When carrying out drug therapy, problems may arise that are associated with the patient’s refusal to take prescribed medications. Typically, patients can motivate their

External route of administration
The external route of administration is the use of medicinal substances on the skin and mucous membranes of the eyes, nose, vagina, and ears. This route of administration is designed primarily for local action.

Application of powder
Powders or dusting with powdered medicinal substances (talc) are used to dry the skin during diaper rash and sweating. The surface on which the powder is applied must be clean

Inhalation route
The introduction of drugs into the body by inhalation is called inhalation. The drug is in the bottle in the form of an aerosol. Using inhalation medicinal products

Education
4. Give the patient and take an empty can for yourself. Do not spray the medicine into the air. This is dangerous for your health. 5. Invite the patient to sit down during training,

Education
4. Give the patient and take an empty can for yourself. 5. Invite the patient to sit down during the training. 6. Demonstrate the procedure to the patient using an inhalation device

Types of syringes and needles, their structure. Preparing a single-use syringe for use
Injection (translated from Latin as “injection”) is the parenteral administration of drugs (the entry of drugs into the body, bypassing the digestive tract). To perform

The choice of needle depends on the type of injection
Type of injection Needle length, mm Needle diameter, mm Intradermal 0.4 Subcutaneous

Set of medicine from an ampoule and a bottle
Material resources: manipulation table, syringe (of the required volume for a certain type of injection), tray, tweezers, antiseptic or ethyl alcohol 70°, medicines

Calculation and dilution of antibiotics
Antibiotics are administered intramuscularly or intravenously. There are 2 ways to dilute antibiotics: 1:1 and 1:2. When diluted 1:1, 1 ml of solution should contain 100,000 units of antibiotic.

Technique of intradermal, subcutaneous and intramuscular injections
Plan: 1. Anatomical areas and intradermal injection technique. 2. Anatomical areas and subcutaneous injection technique. 3. Anatomical areas and technique

Algorithm for intradermal administration of drugs

Anatomical areas and subcutaneous injection technique
Due to the fact that the subcutaneous fat layer is well supplied with blood vessels, subcutaneous injections are used for faster action of the drug. Anatomical areas:

Algorithm for subcutaneous administration of drugs
I. Preparation for the procedure. 1. Make sure that the patient has informed consent for the upcoming procedure of administering the drug. If there is none, specify yes

Anatomical areas and intramuscular injection technique
Muscle tissue has an extensive network of blood and lymphatic vessels, which creates conditions for rapid and complete absorption of drugs. To perform an intramuscular injection, choose

Algorithm for intramuscular drug administration
I. Preparation for the procedure. 1. Make sure that the patient has informed consent for the upcoming procedure of administering the drug. If there is none, specify yes

Calculation and rules for administering insulin
Insulin and heparin injections are given subcutaneously. Insulin is available in 5 ml bottles, 1 ml contains 40 units or 100 units. Insulin is administered with a special disposable syringe, taking into account that

Calculation and rules for administering heparin
Vials with heparin solution are available in 5 ml, 1 ml can contain 5000 IU, 10000 IU, 20000 IU. Equipment: bottle with heparin, syringe and 2 needles, tweezers, alcohol, sterile cotton ball

Intravenous injection technique. Filling the IV fluid system
Plan: 1. Anatomical areas and intravenous injection technique. 2. Filling the system for intravenous drip administration of liquids. 3. Technique inside

Anatomical areas and intravenous injection technique
Anatomical areas: intravenous administration of drugs is performed in peripheral veins (veins of the elbow, dorsum of the hand, wrists, feet), as well as in central veins. Int.

Algorithm for intravenous administration of drugs (boost)
I. Preparation for the procedure. 1. Make sure that the patient has informed consent for the upcoming procedure of administering the drug. In the absence of such

Filling the IV fluid system
Material resources: couch, manipulation table, sterile kidney-shaped tray, non-sterile tray, venous tourniquet, sterile anatomical tweezers, nested anatomical tweezers

Algorithm for intravenous drug administration
(drip using a system for infusion of infusion solutions) I. Preparation for the procedure. 1. Make sure the patient has informed consent for the upcoming

Algorithm for taking blood from a peripheral vein
I. Preparation for the procedure. 1. Make sure that the patient has informed consent for the upcoming procedure. If this is not the case, check with your doctor for further steps.

Compliance with universal precautions when performing injections and handling used instruments and materials
1. Carry out hand hygiene before and after the procedure. 2. Use gloves, goggles, a mask, an apron, a robe, and a cap during the procedure. 3. Use unheated

Universal precautions when collecting and transporting biological material to the laboratory
Medical personnel who have undergone special training in work techniques and safety measures are allowed to work on collecting and transporting biological material. When taking biological

Technique for taking the contents of the pharynx, nose and nasopharynx for bacteriological examination
A swab from the throat and nose allows you to inoculate it on a nutrient medium, identify the pathogen, and also determine its sensitivity to antibiotics. Functional purpose of simple honey

Collection of material from the nose
STEPS NOTE PREPARATION FOR THE PROCEDURE 1. Explain to the patient the meaning and necessity of the upcoming study

Collection of urine for general analysis
Purpose - diagnosis of diseases and monitoring the course of the disease process Indications - diseases of the kidneys, urinary tract, cardiovascular system, metabolic diseases, pregnancy

Urine collection according to Zimnitsky
The goal is to study the functional state of the kidneys (daytime, nighttime, and daily diuresis are determined, as well as the amount and relative density of urine in each of 8 servings). Normal daily diuresis is

Collecting urine for sugar
The goal is to detect glucose in urine (in normal urine, glucose is present in traces and does not exceed 0.02%). The appearance of sugar in the urine - glucosuria can be physiologically caused by eating with

Collection of urine for bacteriological examination
Bacteriological and bacterioscopic examination of urine makes it possible to determine the pathogen in an infectious disease of the urinary system and to produce a quantitative and qualitative composition of the microflora

Rules for storing received material. Preparation of the accompanying document
Urine should be delivered to the laboratory no later than 1 hour after it is collected, otherwise contamination from the environment can lead to alkaline fermentation. For research

Collection of stool for scatological examination, for occult blood, for the presence of helminths, protozoa, for research for enterobiasis
Collect feces in a clean, dry glass container. It should not contain any impurities of urine or other substances. It is known that feces contain a huge number of microorganisms (billions!). And although big

Collection of stool for occult blood
The goal is to identify hidden bleeding from the digestive tract. Indications: peptic ulcer of the stomach and duodenum, stomach cancer, gastritis, etc. Result

Taking stool for examination for helminth eggs and enterobiasis
In the feces there are eggs of helminths: trematodes, or flukes (liver fluke, lancet fluke), cestodes, or tapeworms, nematodes, or roundworms (roundworms, pinworms, whipworms,

Preparation of accompanying document. Rules for storing received material
Before examination in the laboratory, sputum can be stored for no more than 1-2 hours in the refrigerator at a temperature of 40C, so you need to deliver the material to the laboratory as quickly as possible, providing it with

Gastric intubation
Functional purpose of a simple medical service: study of the secretory and motor functions of the stomach. Gastric contents are obtained on an empty stomach and after a “trial

Duodenal sounding
The functional purpose of a simple medical service: taking bile for diagnosing diseases of the gallbladder, biliary tract and for therapeutic purposes - to stimulate the outflow

An X-ray examination of the colon (irrigoscopy) is usually performed after the introduction of a barium suspension into the colon using an enema. To do this, the patient must fulfill certain requirements

Preparing for an X-ray examination
X-ray examination methods determine the shape, size and mobility of the stomach, detect ulcers, tumors and other pathological changes. The nurse should prepare the patient

Preparation for endoscopic examination
Endoscopic examination of the esophagus, stomach and duodenum is currently one of the most important diagnostic methods that allows visually determining the localization with great accuracy

Preparation for x-ray examination of the liver and biliary tract
This study is based on the ability of the liver to secrete iodine-containing drugs with bile, which makes it possible to obtain an image of the biliary tract (intravenous and infusion cholangiocholecystography

Preparation for x-ray examination of the kidneys and urinary tract
When performing an X-ray examination of the kidneys, survey radiography of the kidneys and urinary tract and intravenous (excretory) urography, in which a contrast agent is used, are most often used.

Preparation for examination of the kidneys, bladder, pelvic organs and prostate gland
Ultrasound examination of the kidneys does not require special preparation. However, ultrasound examination of the uterus, ovaries (if transvaginal examination is not possible), bladder, prostate gland, etc.

Algorithm of actions.
1. Call an ambulance through a third party. 2. Stand behind the victim and place your arms around the chest. 3. Squeeze the fingers of one hand

Algorithm of actions.

Algorithm of actions.
1. Call an ambulance through a third party. 2. Lay the patient on a hard base, unbutton tight clothing, and place a cushion under the victim’s shoulders at the level of the shoulder blades.

Algorithm of actions.
Option 1 1. Make one hand into a fist and place it in the epigastric region under the sternum.

C. Indirect cardiac massage (CCM)
9. Palpate the lower ribs towards the sternum.

Cardiopulmonary resuscitation by two rescuers
One rescuer performs artificial ventilation of the lungs, the other performs indirect cardiac massage, their movements are coordinated, clear, and energetic. Required condition -

Action algorithm
1. Remove clothes from the body and lay on your back without a pillow. 2. Remove existing valuables from the deceased in the department in the presence of the attending or duty doctor, about which a report must be drawn up together with the doctor and

The questions of why to measure temperature, where to measure it, with what and how, will be answered by Doctor of Medical Sciences, Head. Department of General Practice of Family Medicine KhMAPO, Chairman of the Kharkov Association of Family Physicians Korzh A.N.

Body temperature is one of the parameters that is tightly controlled by the body and maintained within a narrow range to allow life to function. In fact, usually in a normal healthy person the body temperature in the armpit ranges from 36.4°C to 36.9°C. A temperature of less than 27°C or more than 42°C is, as a rule, incompatible with life. Thus, an increase in body temperature by 5°C or a decrease in it by 9°C leads to irreversible changes in tissues, which entails the death of the body. The above temperature parameters of vital activity are average for the majority of humanity. True, history knows individual facts when living people recorded temperatures of both 46.5°C and 14°C.

Temperature is most often measured in the armpit; in some cases, it is advisable to measure the temperature on the skin of the forehead and other parts of the body.

Body temperature is usually measured with a medical thermometer. The most widely used thermometer consists of a glass tube with a capillary lumen, at the end of which there is a reservoir filled with mercury.

The duration of temperature measurement should be at least 10 minutes. There should be no linen between the thermometer and the body. Body temperature is measured twice a day: between 6 and 8 a.m. and at 4-6 p.m. In this case, you need to lie down or sit. At these hours, you can judge the maximum and minimum temperatures, respectively.

Normal body temperature values ​​when measured in the armpit range from 36°C to 37°C. During the day it fluctuates: the maximum value is observed between 17 and 21 hours, and the minimum, as a rule, between 3 and 6 hours, while the temperature difference is normally less than 1 ° C (no more than 0.6 ° C). After great physical or emotional stress, in a hot room, body temperature may rise. In children, body temperature is 0.3-0.4°C higher than in adults; in old age it may be slightly lower.

In women, the concept of “basal temperature” is used to assess the menstrual cycle.

With its help, you can determine days favorable for conception; find out if ovulation is occurring; assess the production of hormones in different phases of the menstrual cycle. Basal temperature is measured by health workers.

It is known that many diseases are accompanied by changes in the temperature of the affected areas of the body. The cessation of blood flow, for example, when a vessel is blocked by a blood clot or an air bubble, is accompanied by a decrease in temperature. In the zone of inflammation, where, on the contrary, metabolism and blood flow are more intense, the temperature is higher.

In particular, malignant neoplasms in the stomach have a temperature 0.5-0.8°C higher than the surrounding tissues, and with liver diseases such as hepatitis or cholecystitis, its temperature rises by 0.8-2.0°C. It is also known that hemorrhages lower the temperature of the brain, and tumors, on the contrary, increase it.

An increase in body temperature above 37°C is a protective-adaptive reaction and is called fever. Depending on the cause of occurrence, infectious and non-infectious fevers are distinguished. The latter is observed in cases of poisoning, allergic reactions, malignant tumors, etc. The following types of fever (according to the degree of temperature increase) are distinguished: subfebrile (from 37 to 38 ° C), moderate (from 38 to 39 ° C), high (from 39 to 41 °C) and excessive or hyperpyretic fever (above 41°C).

Treatment is aimed primarily at the underlying disease. Low-grade and moderate fevers are protective in nature, so the temperature should not be lowered. For high and excessive fever, the doctor prescribes antipyretics. It is necessary to monitor the state of consciousness, breathing, pulse rate and its rhythm: if breathing or heart rhythm is disturbed, emergency assistance should be called immediately.

Reduced body temperature can be observed with pathology of the endocrine system, as well as with general hypothermia. In the latter case, you should know how to increase body temperature without causing harm to the patient. Under no circumstances should a person with hypothermia be placed in a hot bath.

The patient must be warmed slowly in a dry, warm room.

A child's temperature rises faster than an adult's and can reach higher values. Before deciding how to “bring down” the temperature, you need to ask yourself: is it worth doing? The immune system, which resists infection, is activated at high temperatures and works more efficiently. Therefore, at the moment, pediatricians do not recommend prescribing antipyretic drugs if the temperature does not exceed 38.5°C. A higher temperature is dangerous in itself; the child may experience convulsions, so this temperature must be lowered.

Monitor the baby's pulse and breathing. With an increase in body temperature of 1°C, the heart rate accelerates by 20 beats per minute. Breathing also increases during fever.

Nurses from the patronage service of the Red Cross Society have extensive experience in caring for patients with fever. Here are some tips. Please note that depending on the stage of fever, the caregiver's actions will vary.

Caring for patients in the stage of body temperature rising to 38.5°C

The patient complains of chills, weakness, headache, aching pain throughout the body; the skin is pale and has the appearance of “goose bumps”. Such a patient must be put to bed, covered with a blanket, warm heating pads applied to his feet, drafts avoided, and hot tea with raspberries, viburnum, and linden blossoms given in large quantities. Be sure to monitor your pulse, blood pressure, and breathing rate.

Caring for a patient in the stage of maintaining body temperature at a high level (39°C - 41°C)

This stage lasts from several hours to several days. The patient experiences dry mouth, thirst, headache, and rapid heartbeat. Very high body temperature can cause loss of consciousness, delirium, hallucinations, cardiac dysfunction, bowel function and urination. Such a patient should not undergo any thermal procedures (heating pads, compresses, mustard plasters, etc.). It is necessary to cover the patient with a sheet, put an ice pack wrapped in a towel on the forehead, or apply water-vinegar lotions to the forehead and temples, wipe the patient’s body with water at room temperature with the addition of vinegar, ensure constant access of fresh air to the room, but avoid drafts. Be sure to monitor your oral cavity: rinse your mouth with a 2% solution of baking soda, and lubricate your lips with petroleum jelly. It is very important to replenish the body’s need for fluid, give cool drinks: juices, rosehip decoction, alkaline mineral water up to three liters per day to reduce the concentration and remove toxic substances from the body. Feed such patients in small portions 6-7 times a day. Be sure to change your underwear and bed linen, especially after sweating.

Caring for patients in the stage of decreasing body temperature

A decrease in body temperature can occur in two ways: lytic (within 2-3 days) and critical (within several hours). Lytic reduction is safe for the patient. A critical decrease in body temperature is accompanied by sudden, profuse sweating, a drop in vascular tone (collapse), depression of cardiac activity, a drop in blood pressure, a decrease in the amount of urine excreted, and general weakness. The patient's limbs become cold and frozen, and blueness appears on the cheeks, lips, fingertips, nose, and earlobes. It is necessary to call a doctor immediately, because... If qualified medical care is not provided on time, the patient may die. A person should not be left alone; it is necessary to give him strong sweet tea or coffee, remove the pillow from under his head, raise the foot end of the bed by 30-40 cm, using blankets and other available means. Apply heating pads wrapped in towels to your arms and legs, change your underwear, and create a calm environment for deep sleep.

In conclusion, one more important tip

If the thermometer breaks, under no circumstances should you collect mercury with a vacuum cleaner, with your hands, or throw it down the toilet or garbage disposal. It is necessary to wear rubber gloves, collect in a glass container with a lid, and call the rescue service.

The second period is the period of temperature preservation

The first period is the period of temperature increase

Periods of fever

During the course of fever, there are 3 main periods that the nurse needs to know, because. The tactics of her behavior have their own characteristics. During the period of fever, it is necessary to especially carefully monitor the condition of the patient’s skin and take all measures to prevent bedsores. Such patients need to be fed to bed. You should also not allow visitors to the sick person, because he should not get tired. It is necessary to frequently change underwear and monitor the general condition of the patient.

During this period, heat generation prevails over heat transfer; heat generation increases by 20-30%, and sometimes by 50% or more.

The increase in heat production is due to increased oxidative processes, primarily in the muscles - muscle tone increases, sometimes turning into trembling. Metabolism is activated, basal metabolism increases, spasm of skin blood vessels occurs, which leads to a decrease in its temperature and a decrease in heat transfer: this is also facilitated by a decrease in sweating. A decrease in skin temperature due to vascular spasm is subjectively perceived as a feeling of cold and the patient tries to warm up, despite the increase in body temperature. With a rapid increase in body temperature (influenza, lobar pneumonia), chills occur; with a slow development of fever (bronchopneumonia, typhoid fever), this does not happen.

The maximum temperature rise does not exceed 42 degrees. C., when measured in the rectum and rarely exceeds 41.1 g. WITH.

The patient has fever, accompanied by severe chills, blue lips, cyanosis of the extremities, headache and general poor health.

When the body temperature reaches a level corresponding to the displacement of the “set point”, a further rise in body temperature does not occur, because heat production again occurs in equilibrium with heat transfer.

Heat production remains somewhat increased, but at the same time heat transfer also increases, and excess heat is “discharged”. This is accomplished by hyperemic, hot skin, and the chills stop.

This period is characterized by increased toxicity, headache, feeling of heat, dry mouth, severe weakness, and aches throughout the body. At the height of fever, delirium and hallucinations are possible.

As a result of dilation of the blood vessels of the skin and increased sweating, heat production decreases and heat transfer increases.

This period proceeds in different ways. Body temperature can drop critically - quickly from high to low numbers (from 40 to 36 ° C) - This is often accompanied by a sharp decrease in vascular tone, a drop in blood pressure, and a thready pulse. Such a sharp drop in temperature is accompanied by weakness and profuse sweating. The limbs become cold to the touch, the lips are cyanotic. This condition is called a crisis and requires urgent action. A critical drop in temperature can be observed with lobar pneumonia, as well as with some infectious diseases.

A gradual decrease in body temperature is called lysis or lytic. Lysis is accompanied by the appearance of slight sweat on the skin and weakness. Usually, after the temperature drops, the patient falls asleep. You can't wake him up, because... Sound sleep is the best way to recuperate.

a) crisis b) lysis

Features of caring for febrile patients

The principles of caring for febrile patients, depending on the stage (period) of fever, can be briefly formulated as follows:

– in the first period of fever it is necessary to “warm” the patient,

– during the second period of fever, the patient should be “cooled”,

– in the third period, it is necessary to prevent a drop in blood pressure and cardiovascular complications.

Help in the first period of fever

The nurse should:

1. Provide bed rest,

2. Cover the patient warmly,

3. Place a heating pad at your feet;

4. Provide plenty of hot drinks (tea, rosehip infusion, etc.),

5. Control physiological functions,

6. Ensure constant monitoring of the patient.

Help in the second stage of fever

The nurse should:

1. Ensure that the patient strictly adheres to bed rest.

2. Ensure constant monitoring of a febrile patient (monitoring blood pressure, pulse, body temperature, and general condition).

3. Replace the warm blanket with a light sheet.

4. Give the patient (as often as possible!) a fortified cool drink (fruit juice, rosehip infusion).

5. Place an ice pack or a cold compress soaked in a vinegar solution (2 tablespoons per 0.5 liter of water) on the patient’s forehead - for severe headaches and to prevent impairment of consciousness.

6. In case of hyperpyretic fever, a cool rubdown should be done, you can use lotions (a towel folded in four or a canvas napkin, soaked in a solution of vinegar half and half with water and wrung out, applied for 5-10 minutes, changing them regularly).

7. Periodically wipe your mouth with a weak soda solution and lubricate your lips with petroleum jelly.

8. Meals should be carried out according to diet No. 13.

9. Monitor physiological functions, place a bedpan or urinal.

10. Prevent bedsores.

Help in the third period of fever

At critical decrease in body temperature

1. Call a doctor.

2. Raise the foot end of the bed and remove the pillow from under your head.

3. Monitor blood pressure and pulse.

4. Prepare for subcutaneous administration a 10% solution of caffeine-sodium benzoate, cordiamine, 0.1% solution of adrenaline, 1% solution of mesatone.

5. Give strong sweet tea.

6. Cover the patient with blankets and apply heating pads to the patient’s arms and legs.

7. Monitor the condition of his underwear and bed linen (linen needs to be changed as necessary, sometimes often).

At lytic decrease in body temperature patient, the nurse should:

1. Create peace for the patient.

2. Control of T°, blood pressure, respiratory rate, PS.

3. Change underwear and bed linen.

4. Carry out skin care.

5. Transfer to diet No. 15.

6. Gradual expansion of the physical activity regime.

Standard care plan for febrile illness