106 cases of patients with congestive heart failure Clinical Nursing

        [Keywords:] congestive heart failure; bisoprolol; Care
        A clinical data to choose the third national conference to develop congestive heart failure congestive heart failure on diagnostic criteria [1]
        106 hospitalized patients with congestive heart failure (male 70, female 36) patients, age 25 to 69 (mean 47 ± 18) years of age. According to NYHA classification criteria [2] for the cardiac function in 76 cases at the III level, IV grade 30 cases; Etiology of 33 cases classified as coronary heart disease, 15 cases of rheumatic heart disease, hypertension and heart disease in 21 cases, 37 cases of dilated cardiomyopathy. in the conventional therapy of heart failure drugs (vasodilators, diuretics and positive inotropic drugs) on the basis, po Bosu (bisoprolol, Beijing Fourth Ring Pharmaceutical Factory), starting dose of 01625 ~ 1125 mg, 1 sub-d - 1, observe the heart rate, blood pressure changes, according to the patients tolerated the situation, a ~ 3 wk to increase 01625 ~ 1125 mg, 1 sub-d - 1, maximum dose of 5 mg, 1 sub-d - 1, combined strong diuretic blood volume when you pay attention to correct deficiencies and electrolyte balance. the results of clinical remission in 93 cases, invalid 13 cases. to ease maintenance therapy after discharge in patients followed up for 6 mo with no death.
        2 Discussion
        2.1 Bisoprolol observed after drug
        Changes in heart rate and blood pressure is the application efficacy of bisoprolol in treatment of heart failure is an important indicator. Bisoprolol inhibited the heart of the β 1 receptors to decrease heart rate, there is the risk of bradyarrhythmia occurred, such as Ⅱ ~ Ⅲ degree atrioventricular conduction block, sinus syndrome. Clinical Nursing observation should be noted that heart rate changes, control ≥ 60 times in min - 1. through the kidney juxtaglomerular apparatus cell β -adrenergic receptor blocking, inhibit vascular renin 2 angiotensin system, thereby lowering diastolic blood pressure. such as blood pressure is too low (8 / 6 kPa) should consider the reduction or withdrawal at the same time with other positive inotropic drug use, and make an adjustment accordingly. this group of patients found no medication this results in a clear heart rate and blood pressure reduction. In addition, the use of drug should be to observe the signs and symptoms of heart failure, such as difficulty breathing, edema, pulmonary rales and so on. this group 1 patient after the drug overdose breathing difficulties in the timely detection of clinical care of the above, giving oxygen and intravenous infusion of aminophylline spasm after treatment the symptoms improved significantly.
        2.2 Care
  
        The quality of life in patients with congestive heart failure is low, often feel fear, anxiety or irritability, lack of faith in treatment. Care through patience, understanding and compassion for patients that, as far as possible to explain the patient's condition to produce a sense of trust and security to maintain a good mood and cheerful mood, which actively cooperate with the treatment. in the daily diet should be kept low-salt diet and avoid a large number of drinking water, to reduce the cardiac stress. eat more protein, vitamin-rich diet, it is best to take Shaoshiduocan of meal approach. peacetime activity levels should be proper control of the doctor's advice to avoid strenuous exercise, getting enough rest. Regular consumption of honey or eating bananas and so on, to maintain smooth stool. keep warm, avoid upper respiratory tract infection or further aggravate heart failure induced by . β -blockers in patients with congestive heart failure is a long-term drug treatment, need to constantly adjust the dose of disease development. the effects of treatment often to patients with drug use in order to realize a few weeks, so I should be prepared to discharge guidance and the corresponding health education, require patients to adhere to medication and regularly review hospital electrocardiogram, liver and kidney function, electrolytes, cardiac ultrasound and left ventricular function assessment and, based on inspection results and make adjustments accordingly.
        [References]
  
        [1] ZHOU Yong-chang, GUO Wan-school. Ultrasound Medicine [M]. 3rd ed. Beijing: Science and Technology Literature Publishing House, 1998: 549.
        [2] Murphy J G. Mayo clinic cardiology review [M]. 2nd ed. Philadelphia: Lippincott Williams

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