Encyclopedia of Family Medicine

Chapter 39 Nursing of Special Populations

Women's Five-Phase Health Care

Menstruation, pregnancy, childbirth and puerperium, lactation, and menopause are called the five periods of women.In these five phases, if care is not taken, it is easy to suffer from diseases.In order to improve women's physical fitness, five-stage protection is very necessary.

Menstrual period: The body's ability to resist infection decreases, pelvic congestion, which can cause some symptoms.There are also changes in systemic neurohumoral aspects.Mood swings, fatigue, etc.Therefore, during the menstrual period, strenuous activities should be avoided, water should be avoided, and sexual life should be forbidden.It is necessary to explain the knowledge of physiological hygiene to adolescent girls, so that they can understand why menstruation occurs and maintain menstrual hygiene correctly.

Pregnancy: In order to conceive the development of the fetus in the mother's body, the mother's reproductive system, cardiovascular system, endocrine system, digestive system and other systems undergo great changes.In order to protect the health of pregnant women, ensure the normal development of the fetus, and prevent obstetric complications, prenatal examinations must be carefully done for early detection and early treatment.Healthy pregnant women can do daily work. After 32 weeks of pregnancy, they should avoid night shifts to ensure adequate rest and sleep. They should take in various nutrients in terms of diet, and do not smoke or drink alcohol.Dress loosely, pay attention to cleanliness, take a bath frequently but no tub bath.Sexual life is forbidden within 12 weeks and after 32 weeks of pregnancy.

Intrapartum and puerperium health care: During the delivery process, the labor process must be closely observed, and abnormalities can be detected in time and properly handled.Keep the area clean after childbirth.Before each breastfeeding, wash the nipples with soapy water and water, eat digestible and nutritious food, and ensure adequate sleep.Maternal sweating can take a bath and change underwear frequently.In summer, pay attention to indoor ventilation, prohibit sex life, and avoid infection. During the puerperium, appropriate activities are also required to facilitate the recovery of the body.

Lactation period: Postpartum mothers breastfeed their babies for about ten months. In order to ensure that the mother has enough milk, she should give guarantees in terms of diet, emotion, sleep, and rest.

Menopause: Menopause is a transition period when ovarian function gradually declines to disappear, and most women can adapt to this change.When a series of symptoms appear beyond the physiological limit, you must go to the hospital for treatment.Menopausal women should be taught health knowledge, have a correct understanding of menopause, eliminate worries, maintain a happy spirit, have regular gynecological examinations, and early detection and treatment of diseases.

Prevention and treatment of postmenopausal osteoporosis

Postmenopausal ovarian function declines and estrogen levels drop significantly, which will cause a series of systemic changes, including accelerated bone loss leading to osteoporosis, and 50% of women with osteoporosis suffer spontaneous fractures in their later years, endangering women's physical and mental health.With the advancement of science and technology, the average life expectancy of women in my country has been extended from 1965 years old in 59 to 70 years old, while the average age of menopause is still around 50 years old, and now there are also a few women who have premature menopause at the age of 40 years. Prevention and treatment of osteoporosis is an urgent problem.

Women begin to lose bone mass from the age of 30, firstly cancellous bone mass, then cortical bone mass, and the annual loss rate is about 0.25~1%.From the beginning of menopause to the first few years of menopause, the bone loss accelerates, with an annual loss rate of about 1-3%, which lasts for 5-10 years.Back pain appears first, and vertebral body compression can also be accompanied by spinal deformity. It is common for people to hunchback and become shorter as they get older.

Prevention and treatment of postmenopausal osteoporosis is mainly prevention. It should start from the growth period, so that the maximum bone mass can be obtained when the bone is mature, and the bone loss should be minimized when the bone is mature.It has been recognized that the following four prevention and treatment measures: estrogen supplementation, adequate calcium intake, adequate vitamin D intake and weight-bearing exercise can effectively prevent and treat postmenopausal osteoporosis.

Some domestic hospitals try a long-acting estrogen (Nylestriol), only take 1-2 times a week, 1-2 mg each time, and take 4 days of progesterone in the middle of each month, 10 mg per day.Supplement 1 grams of calcium (can take active calcium or Longmu Zhuanggu Granules), 5 units of vitamin D per day, and often participate in sports.In short, under the guidance of a doctor, timely use of hormones for prevention and treatment is a simple, cheap and effective method.

Breast milk is the best food for babies
Breastfeeding is the ideal food and drink for infancy because breastfed children are less likely to get sick and malnourished.

The protein and fat contained in breast milk are essential amino acids and fatty acids for infants, and are easily digested in the stomach; breast milk contains substances and various antibodies that can resist diseases, and the lactose contained in breast milk can inhibit the growth of E. Infants rarely have diarrhea, breast milk is rich in vitamins and minerals, and the ratio of phosphorus and calcium is appropriate; the temperature of breast milk is suitable, fresh, clean and convenient, which is incomparable with milk and milk powder.

Children should be breastfed as early as possible after birth. When breastfeeding begins, the milk is yellow and viscous, called colostrum. Colostrum contains more antibodies, which is very beneficial to newborns.

Since the various nutrients needed by the baby come from breast milk, the mother's diet also needs to be varied to ensure that it is nutritious. ①In addition to the staple food, eat more fresh vegetables, soy products, eggs, and drink more chicken, fish, and broth; It must be correct; ④Adopt the bilateral position method, and then switch to the other side after eating on one side; ⑤Feed the baby irregularly, as long as the child wants to eat, and frequently stimulate the nipples to increase the formation of breast milk.

In terms of feeding time, generally 15-20 minutes is appropriate.

Keep the nipples clean when feeding, and clean them before each feeding.If the nipple has small cracks, it is best not to breastfeed directly, use a breast pump to suck out the milk, and then feed it with a bottle.

For the healthy growth of children, we must vigorously promote breastfeeding.

How to take calcium tablets in infancy
Calcium plays a very important role in infant health.Because infancy is in constant growth and development, it needs the supply of various nutrients.But the minerals most likely to be deficient are calcium and iron.Because calcium is easily affected by many factors in the process of human absorption.Factors that mainly affect the absorption of calcium in the human body, such as oxalic acid in food, are easily combined with calcium to form calcium oxalate that cannot be absorbed.Therefore, when the food contains more oxalic acid, the absorption rate of calcium will naturally be greatly reduced.Foods containing more oxalic acid are spinach, celery, onion, amaranth and so on.If calcium absorption is affected and the calcium concentration in the body decreases, neuromuscular excitability will increase, and early symptoms such as crying, restless sleep, startle, tetany, etc. will occur.When symptoms develop further, osteomalacia can also be caused in the skeletal system, such as square skull, pectus excavatum, and beading.Limb deformities present "O"-shaped, "X"-shaped legs and so on.

Milk and vegetables contain more calcium, and human milk is the most easily absorbed calcium, so breastfed babies generally do not need to take calcium tablets.

For artificially fed babies, they should take calcium supplements while taking vitamin D every day since they are 3 months old, but the amount should not be too much, it is better not to exceed 0.3 grams to 0 grams a day.

Of course, in the absence of calcium deficiency and vitamin D deficiency (without signs of rickets), blindly taking calcium tablets is not beneficial to the baby.If the amount is too large, it can also hinder the absorption of other minerals such as zinc.

toddler eating arrangements

Children's deciduous teeth are gradually erupted, and their chewing ability has been enhanced.But the capacity of the stomach is much smaller than that of an adult, so you can't eat a lot in one meal like an adult.Compared with his (her) body, the energy needed by young children every day is much greater.How to let children get enough food supply to meet the energy needed for rapid growth and development is an important issue.

Toddlers aged 1-3 need to eat 5-6 meals a day.That is, in addition to the normal 3 meals a day, children can be given some food or fast snacks in the middle of the two meals.Such as fruit, bread, biscuits, pies, milk, etc.At the same time, attention should be paid to the regulation of color, aroma and taste in the diet of young children.In addition, guide children to eat vegetables.Chop the vegetables and add some animal and vegetable oil to the porridge to make mashed porridge. You can also make the vegetables into stuffing and wrap them in the children's favorite buns, dumplings, and wontons.

Also pay attention to the diversification of food types to increase the child's appetite and make him (she) interested in food.Often change the types of food and preparation methods, such as noodles, risotto, wontons, dumplings, steamed buns, steamed buns, flower rolls, pancakes, vegetable puree porridge, eggs can be boiled, steamed, fried, and you can give your children some fish, meat, Soy products and animal offal.Don't let your child develop the habit of partial eclipse, even if the child likes to eat food, don't eat and eat more.Otherwise, young children will quickly become bored with this kind of food that they like to eat.As long as the diversification of food types is ensured, the intake of various nutrients required for the growth and development of young children is also guaranteed.

Prevention and treatment of hand, foot and mouth diseases
In places where young children are concentrated in spring, a disease called "hand, foot and mouth disease" is easy to spread.The main manifestations are children's hands, feet, mouth and other parts, and there are also small blister-like rashes on the buttocks. After the blisters rupture, they form small ulcerated surfaces and cause pain.At this time, the child is very painful, drooling, and hinders normal drinking and eating due to painful swallowing. "Hand, foot and mouth disease" is a worldwide epidemic, which is caused by a new enterovirus.This virus can be transmitted through air droplet breathing, and can also be transmitted through the digestive tract by taking food with virus-contaminated hands.The disease is easy to cause epidemics in nurseries and kindergartens where young children are concentrated.However, the course of this disease is short and the prognosis is good. Generally, it can recover in about a week. Except for those with severe damage to the central nervous system, there will be no serious consequences and no sequelae.

In the treatment, antiviral and symptomatic treatment methods are used. Oral Viraling or Banlangen Granules can be applied to local ulcers such as oral mucosa. Ulcer cream and gentian violet can be applied. At the same time, some drugs such as vitamin B and C should be taken orally.If you have fever, you can give some antipyretics or physical cooling.

Sick children need to be isolated to prevent the spread of epidemics to varying degrees.

The elderly should do a good job in gastrointestinal health
(1) Pay attention to protecting your teeth, eat less sweets, brush your teeth in the morning and evening, and repair your teeth if they are found to be bad.

(2) Eat a reasonable diet, eat more fiber-rich foods and fruits, one can strengthen the chewing ability of the teeth, and the other can reduce the occurrence of constipation.

(3) Food cooking should be as complete as possible in color, flavor and taste, and a certain amount of water should be kept.Avoid eating alone. If possible, eat with your children or relatives and friends, which can increase your appetite.

(4) Eat meals on time, and don't overeat for dinner.

(5) Pay attention to exercise, which can increase the blood supply of the whole body and increase appetite.

(6) Once gastrointestinal dysfunction occurs, especially when the symptoms last for more than two weeks, such as constipation or diarrhea, pain, vomiting, melena or blood in the stool, weight loss, etc., you should seek medical treatment in time.

(7) Develop the habit of defecating regularly.Pay attention to observe the color of the stool when defecating. If any abnormality (black or whitish) is found, you should go to the hospital to find out the cause in time.

(8) Do not smoke, do not drink excessively.

(9) Do not abuse laxatives.

(10) Do regular physical examinations as much as possible, at least once a year.

older people's sex life

When women reach the age of 45 to 50, their ovaries begin to shrink and stop ovulating, and menopause occurs, which means the loss of fertility.Because the ovaries have the ability to produce sex hormones, there is a need to increase sexual desire, but because the secretion of sex hormones is greatly reduced with the arrival of menopause, this reduces the sexual desire on the one hand, and on the other hand, it can shrink and narrow the vagina , the secretions decrease and become dry, often accompanied by vaginal itching and pain during sexual intercourse, and it is difficult to achieve sexual pleasure. Some people are not interested in sexual desire because of this.But this by no means means that older women have no sexual desire. It is important to use lubricants during sexual intercourse to overcome pain during intercourse and still satisfy sexual desire.

Male testes produce testosterone and sperm, which govern fertility.The role of its hormones is the same as the hormones produced by the ovaries, and it has the requirement to increase libido. As the production of sex hormones decreases, libido also decreases, but it does not stop the production of sperm.Male fertility can be maintained until the last day of life. According to literature reports, 81-year-olds have children in their later years.

Sex life is the instinct of human beings, and it is also one of the great pleasures of life. Although the elderly grow with age, their sex hormones decrease and their physical strength is poor, and their requirements for sex are not as good as those of young people, but it does not mean that the elderly have lost their sexual function. , The key is to eliminate ideological concerns and psychological obstacles, and realize that the sex life of the elderly is a normal physiological requirement.Pay attention to the use of lubricants during sex, so that the sex life of the elderly can also reach an ideal situation, do not be left out!
(End of this chapter)