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03~休息与活动.ppt
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    Rest

    &

    Activity

    Rest

    Condition of rest

    > Adequate Sleep

    > Mental Relaxation

    > Physical Comfort

    Sleep

    * Stages of sleep

    NREM (non-REM):

    Stage Ⅰ, Ⅱ，Ⅲ，Ⅳ

    REM (rapid eye movement)

    * Sleep cycle

    Sleep Cycle

    Assessment of sleep

    > Factors Affecting Sleep

    > Sleep Disorders

    > Sleep Characteristics of Hospitalized Clients

    > Collection of Data About Sleep

    Sleep characteristics of hospitalized clients

    > Desynchronization

    昼夜性节律去同步化

    > sleep deprivation睡眠减少

    > sleep fragmentation睡眠中断

    > vulnerability to rebounds

    诱发补偿

    Collection of Data About Sleep

    > Usual sleep pattern

    > Bedtime rituals performed t help fall asleep

    > Use of sleep medications and other drugs

    > Sleep environment

    > Recent changes in sleep patterns or difficulties in sleeping

    Usual Sleep Pattern

    * hours of undisturbed sleep

    * time of going to bed

    * time of waking up in the morning

    * time and duration of naps

    * time of trying to fall asleep

    * frequency and reason of waking up at night ,duration of these periods

    * whether easily aroused and snore

    * sleep disorders：insomnia, sleepwalking，sleep talking

    * quality of sleep or satisfaction with sleep

    Nursing Intervention to Promote Sleep

    > 创建良好的物理环境

    > 满足病人的睡眠习惯，做好就寝前的准备工作

    > 合理安排护理措施

    > 加强心理护理

    > 健康教育

    > 指导合理使用药物

    Activity

    Factors Affecting Activity

    * 生长发育

    * 生理因素

    * 精神心理因素

    * 个体的态度和价值

    * 外界因素

    * 医疗性制动

    生 理 因 素

    * 先天或后天的身体畸形

    * 骨骼或肌肉生长问题

    * 影响关节活动性的因素

    * 中枢神经系统的损伤

    * 骨骼肌肉系统的损伤

    * 其他系统的问题

    Effects of Immobility

    > Musculoskeletal system

    Disuse atrophy 废用性肌萎缩

    Osteoporosis 骨质疏松

    Contracture挛缩

    Stiffness and pain in the joint 关节僵硬、疼痛

    > Cardiovascular System

    Orthostatic (postural)hypotension

    体位性低血压

    Thrombus formation of deep vein

    深静脉血栓形成

    Effects of Immobility

    > Respiratory system

    Decreased respiratory movement

    Retention of carbon dioxide

    二氧化碳滞留

    Hypostatic pneumonia坠积性肺炎

    > Metabolic System

    Decreased metabolic rate

    Negative nitrogen balance

    Effects of Immobility

    > urinary system

    Urinary retention尿潴留

    Urinary calculi泌尿道结石

    Urinary infection泌尿道感染

    > Gastrointestinal system

    Constipation便秘

    > Integumentary System

    Pressure ulcer

    > Psychosocial Effects

    Activity

    &

    Nursing Process

    Assessing

    > general information一般资料

    > cardiorespiratory function status 心肺功能状态

    > Musculoskeletal status骨骼肌肉状态

    > Joint function status 关节功能情况

    > body activity level 机体活动能力

    > current state of illness目前的患病情况

    > social and psychological status社会心理状况

    Implementing

    > 选择合适的卧位

    > 保持脊柱的正常生理弯曲和各关节的功能位置

    > 预防活动受限导致的损害

    > 维持关节的活动性

    > 肌肉的等长练习和等张练习

    肌 力 分 级

    * 0级完全瘫痪、肌力完全丧失

    * 1级 可见肌肉轻微收缩但无肢体运动

    * 2级 肢体可移动位置便不能抬起

    * 3级 肢体能抬离床面但不能对抗阻力

    * 4级 能作对抗阻力的运动，但肌力减弱

    * 5级 肌力正常