(1) Pain
Pain is the most serious symptom in patients with advanced stage, especially in patients with advanced cancer. The pain of other advanced patients is not too serious. In the last few days of life, more than half of people will have new pain. Pain control should be timely and effective, and "three steps" should be used correctly. Analgesics should be regularly collected online by the applied medicine www.med 126.com, instead of being used when necessary. It is more difficult to control than to prevent pain when it occurs. For anxiety and pain caused by the inability to take painkillers orally, painkillers can be given through skin patches, sublingual administration, intravenous or intramuscular injection and other ways. In addition to drug analgesia, other methods can be used to relieve pain, such as relaxation, hypnosis, acupuncture, neurosurgery and so on. In addition, if the pain is uncontrollable and there is no appetite, don't force the patient to eat, so as not to increase the burden and pain of the patient.
(2) Dyspnea
Phlegm obstruction and dyspnea are common symptoms of terminal patients. Sputum and oral secretions should be sucked out in time. When breathing becomes shallow, rapid, difficult or tidal, immediately deliver oxygen. If conditions permit, you can take a semi-recumbent position or raise your head and shoulders appropriately. Some patients have wheezing due to shortness of breath and anxiety, so they can use anti-anxiety drugs according to the doctor's advice, and use morphine to reduce the breathing frequency when necessary; At the same time, opening the window or using a fan for ventilation, nurses' calm behavior, touching the patient gently with their hands and whispering will all help the patient to stay calm. In addition, the patient has a so-called "dying throat sound", which can be atomized by wet and cold aerosol to make the secretion dilute and easy to cough up. Put an aspirator beside the bed. For those who breathe with their mouths open, wet their mouths with wet wipes or cotton swabs, or wet their lips with lip balm, and cover their mouths with wet gauze after the patient falls asleep.
(3) Delirium
Some patients will have mental changes such as delirium before dying, and factors such as cancer brain metastasis, metabolic brain lesions, electrolyte imbalance, abnormal nutrition or sepsis should be considered. Symptoms will be more serious in the afternoon or evening. Collecting and sorting out patients' restlessness on medical network requires close observation, finding out the treatable causes, such as pain, brain hypoxia, asthma, bladder or rectal dilatation, and giving symptomatic treatment.
(4) massive hemorrhage
Severe acute hematemesis, bloody stool, vaginal bleeding, etc. The amount of bleeding exceeding 800ml can cause shock, and it can directly lead to death for dying patients, which needs to be controlled quickly. Sedatives, hemostatic drugs and morphine should be prepared for standby, so as to calm, stop bleeding and relieve pain at any time according to the doctor's advice; Cooperate with the doctor for other hemostasis treatment. Eliminating patients' mental stress and emotional fluctuation is collected online at www.med 126.com, accompanying patients and holding their hands. Gastrointestinal bleeding should generally be fasted for 24 ~ 48h, and cold compress should be applied to the stomach. Patients with hematemesis should adopt a position that is easy to vomit to prevent aspiration; Wipe the blood with a dark towel; If blood in the stool is frequent, you can put a paper pad around the anus of the patient, and the patient should wipe it clean after defecation every time to keep the buttocks clean.
In a word, nursing staff should closely observe the changes of illness, strengthen patrol, and make good prognosis estimation and rescue preparations; At the same time, let the family members make ideological and material preparations and arrange the aftermath.