Intlungu yokuphulukana (BTP) yintlungu eyenzeka phakathi kwamanyathelo ahleliweyo amachiza enhlungu. Yimpawu ezixinzezelayo ezifuna unyango olukhawulezileyo.
Uninzi lwezigulane ezineentlungu ezingapheliyo, eziquka ukunakekelwa kwezilwanyana kunye nezigulane zezibhedlele , zinikezwa imishanguzo ukuze zisebenzise njengoko zifunekayo ukuphatha intlungu. Amachiza kwi-BTP ngokukhawuleza asebenza ngokukhawuleza kwexesha lokuthatha isenzo (ngokuqhelekileyo ukubonelela ukuphucula iiyure ezimbini ukuya kwezine).
Ngelishwa, uphando luboniswe ukuba nangona intlungu ixhaphake kwizigulane ezinezifo eziphambili ekhaya, amayeza okuyikhupha ayenjalo, kwaye izigulane zintlungu azihlali zisebenzisa amayeza amaninzi ukuphatha intlungu yazo njengoko ivunyelwe.
Xa BTP ivela nini?
Izigulane ezinobandezeleka obungapheliyo zidla ngokubhekiselele kwii-clock (ATC) zee- opioid . Intlungu yokuphulukana ibonisa phakathi kwezi zilingo zamachiza kwaye ngokuqhelekileyo ibangela isigulane esikhulu. Kubalulekile ukuba ukwazi ukuqonda i-BTP kwaye ugcine irekhodi elichanekileyo yalo ukuze umniki-nkonzo wakho wezempilo, okanye owomthandayo onokunyamekela, angayiphatha kakuhle.
Intlungu yokuphulukana ineentlobo ezintathu zentlupheko: intlungu yesiganeko, intlungu, kunye nokuphelelwa kwonyango lokuphela kwemithi. Kubalulekile ukuba umboneleli wakho onakekelo lwempilo aqaphele uhlobo luni lwe-BTP ojongene nayo kuba unyango ngamnye luyahluka.
UkuPhatha I-Pain Incident Pain
Intlungu yesiganeko intlungu enokuqikelelwa kwaye eyenzeka ngemisebenzi ethile. Umzekelo walesi sigulane esineentlungu xa ephendukile ukusuka ecaleni ukuya kwelinye icala lokunyamekela.
Iintlungu zesiganeko zihlala ziphathwa ngokuthe ngqo. Ngenxa yokuba intlungu iqikelelwa, izigulane ezineentlungu zesiganeko zingadluliswa ngaphambili, zisebenza ngokukhawuleza, imithi yentlungu engapheliyo phambi kwezinto ezibangelwa intlungu.
I dose ingatshintshwa ngokusekelwe kumgangatho kunye nobude bomsebenzi obulindelekile ukuba kubangele intlungu.
UkuPhatha Ubuhlungu Bokuzenzekelayo
Intlungu engeyonto ayifanelekanga kwaye ayihambelani nayiphi na imisebenzi ethile. Ngenxa yokungaqiniseki, kudla kunzima ukunyanga.
Iintlungu zintlungu zihlala ziphathwa ngokusebenza ngokukhawuleza, imilenze emfutshane yentsuku ehlala inokukhawuleza xa intlungu ifika. Amachiza adjuvant angabuye azame ukunikela ukulawula ubuhlungu obungcono. Amachiza adjuvant aquka ukuchaswa, ukuxhatshazwa , kunye nezinye iyeza eziphucula ubuhlungu bezinye izigulane.
Ukunyangwa kweMithi yokuPhelelwa kweMithi ekupheleni
Le nto yinto efana ngayo: intlungu eyenzeka ekupheleni kwexesha apho i-dose yeyeza ejoliswe ukuba isebenze. Ngokomzekelo, kwisigulane esithatha i- morphine ekukhululwe rhoqo emva kweeyure eziyi-12, intlungu eyenzeka phakathi kweyure lesibhozo neye-10 ithathwa njengokungaphumeleli kokuphela kwesosi.
Unyango lwe-failure-end-dose failure ungabandakanya ukunciphisa ithuba phakathi kwamanani okanye ukwandisa umthamo weyeza. Ngokomzekelo, isigulane esineentlungu emva kweeyure ezisibhozo ngelixa isilwanyana esilindele ukunikezela ukuphucula iiyure ezili-12 sinokuthi ixesha eliphakathi kwamanani liye linciphela ukuya kwiiyure ezisibhozo, okanye i-dose yayo inganyuswa ngama-25 ukuya kuma-50 ekhulwini.
Kuzo zonke iimeko, amayeza aqhelekileyo asetyenziswa rhoqo kwisimo sokubhedlele ukuphatha i-BTP isisombululo somlomo (i-OMS). I-OMS ifom ye-morphine eqala ukusetyenziswa ngokukhawuleza kwaye ngokubanzi ibonelela ngeeyure ezimbini ukuya kwezine.
Ukugcina Ingxelo Yobunzima bobuhlungu
Indlela efanelekileyo yokuqinisekisa ukuba intlungu ihamba ngokufanelekileyo iyalondolozwa ngokwaneleyo kukuba kugcinwe i-log ecacileyo nechanekileyo. Ukugcina irekhodi echanekileyo yamanqanaba entlungu, amayeza asetyenziswa ukuyiphatha, kunye nokuphendula kumachiza kuya kunceda umboneleli wezempilo unqume unyango olungcono. Igalelo lakho lonyango linokubonakala lifana nelinye ngaphantsi.
Umzekelo Ukuphuluka kweMpawu zoMnxeba
| Umhla / Ixesha / iNqanaba lePhulo | Ngo-8, 9: 00a, intlungu 5/10 | Ngo-8, 5: 00p, intlungu 6/10 | NgoDishumi 11, 11: 00a, intlungu 4/10 | NgoDishumi 12, 2: 00a, intlungu 6/10 |
| Amachiza / i-Dose / impendulo | i-morphine 5mg, intlungu engapheliyo, enye i-5mg inikezwe ngoncedo | morphine 10mg, intlungu ikhululiwe | morphine 10mg, intlungu ikhululiwe | morphine 10mg, intlungu ikhululiwe |
Imithombo:
Ferrell, BR kunye noCoyle, N; Incwadi ye-Nursing Palliative, i-Oxford University Press, ngo-2006.
UFerrell BR, uMcGuire DB, kunye no-Yarbro CH; Management Management Pain, uJones noBartlett Publishers, ngo-1995.
Mercadante, C, kunye. al .; Ukugqithisa Intlungu kwi-Advanced Cancer Patients Elandelwayo ekhaya: I-Longitudinal Study, Journal of Pain and Symptom Management, Volume 38, Issue 4, iphepha 554-560 (Oktobha 2009).