dangerous moments of high blood pressure

Core clew: patients with high blood pressure because long-term blood pressure is bigger, the blood vessels in the spasticity, so that blood vessel elasticity decreased, and the brittleness increases, if at this time due to some reason contributing to increased blood pressure suddenly, is easy to cerebral hemorrhage, cerebral vascular rupture and causing this for patients with high blood pressure, is undoubtedly the most fatal blow. Therefore, patients with hypertension should try to avoid a sudden rise in blood pressure, especially under the following circumstances, should be more cautious. Due to the long-term pressure on blood vessels, blood vessels are in a spasm state in patients with hypertension, resulting in decreased vascular elasticity and increased brittleness. If blood pressure rises suddenly due to some reason at this time, it is easy to cause cerebral vascular rupture and cerebral hemorrhage, which is undoubtedly the most fatal blow for patients with hypertension. Therefor

The related nursing of intracranial hypertension

1. General care:

Raise the head of a bed 15~30 degrees, in order to facilitate intracranial venous reflux, reduce cerebral edema.

Oxygen supply: Intermittent or continuous oxygen intake.

Maintain normal body temperature and prevent infection.

Controlled inflow and outflow: the adult's daily fluid infusion volume shall not exceed 2000ml and the daily urine volume shall not be less than 600ml.

2. Prevent sudden increase of intracranial pressure

Rest: Avoid increased intracranial pressure caused by emotional excitement.

Maintain an open airway.

Avoid severe coughing and constipation.

Timely control of seizures.

3. Drug treatment and nursing

Nursing of dehydration treatment: transfusion speed is fast, otherwise, increases the burden of the circulatory system. Dehydrating drugs should be used to prevent the phenomenon of intracranial pressure bounce alternately.

Nursing care of hormone therapy: observe the adverse reactions such as stress ulcer bleeding and infection induced by hormone without cause.

4. Hibernation treatment and nursing

Apply medicaments and physical method to reduce body temperature, make the patient is in inferior hypothermia state, the purpose is to reduce cerebral oxygen consumption and cerebral metabolization rate, reduce cerebral blood flow, increase cerebral to ischemia hypoxia tolerance, reduce cerebral edema.

If did not enter hibernation state begins to cool down, the patient's cold response will appear chill, make the body the metabolic rate increased, oxygen consumption increased, but increased intracranial pressure.

The cooling rate should be 1 per hour, and the temperature should be 32 ~ 34. Hypothermia can trigger arrhythmias.

The time of hibernation hypothermia therapy is generally 2 ~ 3 days. When the treatment is stopped, physical cooling is stopped first, and then the hibernation drugs are gradually stopped. The temperature is allowed to return spontaneously.

5. Nursing care of ventricular drainage:

The location of the drainage tube: sterile drainage bag, proper fixation of the drainage tube and drainage bag, the opening of the drainage tube should be 10-15cm higher than the lateral ventricle plane to maintain normal intracranial pressure, the drainage tube should be temporarily clipped when the patient is moved to prevent cerebrospinal fluid reflux.

Drainage speed and volume: daily drainage volume should not exceed 500ml.

Keep drainage clear.

Observe and record the color, quantity, and character of CSF.

Nursing care after cerebrospinal fluid shunt: strictly observe the condition and judge the effect of the shunt.

6. Respiratory care

Keep respiratory tract unobstructed after craniocerebral injury patients by fully to oxygen, the patient's breathing difficulties, hypoxia symptoms not to improve or expectoration drainage is difficult, should cooperate with the doctor early tracheotomy, keep clear of respiratory secretions, relieve airway obstruction, make the intrathoracic pressure and intracranial pressure drop, and reduce respiratory dead space, increase the effective gas exchange, improve breathing and lack, relieve cerebral edema and lower intracranial pressure. If the patient's breathing is weakened and tidal volume is insufficient, use a ventilator to assist breathing.

Oral care to prevent respiratory tract infection 2 times a day, atomization inhalation 2 ~ 3 times a day, turn over, pat back 2 ~ 3h once, turn over action should be light and steady. The dressings at tracheotomy were changed daily to keep the dressings dry and clean, the endotracheal cannula was disinfected every 4h, the endotracheal drops were added with 20ml normal saline and mucosolvan 15mg, 2ml per hour, and the outer opening of the tracheotomy was covered with a single layer of sterile normal saline gauze. Aseptic operation should be strictly observed when sputum aspiration is carried out, the internal secretions should be inhaled first, and then the nasal and mouth secretions should be inhaled. Each suction should not exceed 15s, and the patient should not cough too much and increase the intracranial pressure.


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