Kudyisa Tubhu uye IV paMugumo weHupenyu
Zvakajairika uye zvakajairika kuvarwere vanotarisana nechirwere chisingaperi kuti vawane kurasikirwa kwechido nekuderera kwechidyo mune zvekudya kana kunwa uye kuora kurasikirwa. Sezvo urwere huri kufambira mberi, varwere vangave vasingakwanisi kutora zvokudya kana mvura inenge iri mumuromo kana kuti havadi kudya kana kunwa. Zvinogona kunge kuti murwere ave achirwara kwechinguva uye ave achigamuchira chikafu chekuita asi kwete kuwana chero zviri nani.
Chero mamiriro ose ezvinhu, mubvunzo kana kuti kusarega kana kubvisa chikafu chekuvaka chingasimuka. Izvi zvinogona kuva chikonzero chekushamisika kukuru uye kushushikana kwevanoda varwere uye vanochengeta.
Zvokudya zvinovaka muviri ndezvokuburitsa rubatsiro rwemuviri wehutano mune fashoni isingadi murwere kuti adye uye amedze. Izvi zvinogona kupiwa nehuwandu hwemarenteral nutrition (TPN) kana kuti kuburikidza nemugodhi wepasi (NG tube) kana gastrostomy tube (G-tube kana PEG tube).
Kune zvinhu zvakawanda zvinogona kukonzera kurasikirwa kwekudya uye kuderedza kunwa kwemuromo kwezvokudya uye mvura inoswedera pedyo nechokuguma kwehupenyu. Zvimwe zvinokonzera zvinodzokororwa, zvakadai sekudzivirira, kusuruvara , uye kurwadziwa . Zvimwe zvinokonzera zvingasaiti kurapwa zvakanaka, zvakadai semamwe makondombera, kushandurwa kwenyika yekuziva, uye kushaya simba kwemisumbu inofanirwa kudya. Zvimwe zvinokonzerwa zvinokonzerwa zvinofanira kuonekwa nechiremba werairo uye kutaurirwa. Kana mhaka yacho isingazivikanwi kana isingatauriki, chisarudzo chekuti hachiregi kana kubvisa rubatsiro chingada kuitwa.
Kuita sarudzo yekurega kana kubvisa chikafu chekuvaka uye hydration inomutsa pfungwa, mafirosofi uye manzwiro evanhu vakawanda. Inowanzobatsira vanhu vanotarisana nechisarudzo ichocho chakaoma chekunzwisisa izvo sayenzi nemishonga zvakawana pamusoro pezvokudya zvekuvaka uye hydration pakuguma kwehupenyu.
Makomborero uye Ngozi dzeKudya Kwekuvaka uye Hydration
Munharaunda yedu uye tsika, zvokudya uye mvura inonyoreswa inoonekwa seinokosha kuti urarame hupenyu uye kukurumidzira kuporesa nekudzoka kubva kurwere. Icho chinopesana nevanhu vakawanda maitiro ekurega kuchengeta zvokudya nemvura kubva kune chirwere chinorwara kana kufa . Asi isu tose tinoziva kuti ruzivo simba. Sezvo nechisarudzo chipi nechipi chezvokurapa iwe unotarisana nawo, zvinokosha kuti unzwisise zvibatsiro zvezvipingamupinyi. Chirongwa chekugadzirira chinobatsira kune murwere anorwara zvachose here? Ngatitorei kuti tsvakurudzo yezvokurapa inogona kutiudza chii:
- Kwose Parenteral Nutrition - TPN isiri yekusagadzikana kwechikafu chinoshandiswa chete kwenguva pfupi. Inopihwa kuburikidza nemutsara wepamusoro, uyo unowanzoiswa mumutsipa kana kuti armpit uye kushandiswa kuburikidza nemhangura apo inopera pedyo nemwoyo. Yakambofungidzirwa kuti varwere vane kenza vangabatsirwa neTPN. Tariro yacho ndeyekuti inogona kugadzirisa kurasikirwa kwechido uye kurasikirwa kwakanyanya kwehutano varwere vanorwara nekenza nekuvandudza kusarura kwavo. Zvisinei, zvidzidzo zvakasiyana-siyana zvakawana kuti hazvina kubatsira kenza varwere kuwedzera kuwedzera kana kuvandudza hupenyu hwavo. Pane kudaro, zvakanyanya kuwedzera njodzi yezvipembenene nezvinetso nechepamusoro mutsara waiva nengozi kuvarwere.
- Nasogastric (NG) Tubhu - Kune varwere vasingakwanisi kumedza, zvingave zvakakonzerwa nemavhutu asina kuvhiringidzika, kushaya simba, kana kusagadzikana kwepfungwa, kudyisa kuburikidza nehutachiva kwave kuri kushandiswa kwakakwana kwezvokudya. Iyo nasogastric tube ndiyo nzira iri nyore kwazvo yekuita izvi. Bhuku rinoiswa mumumhino uye pasi pasi nehuro mukati mudumbu. Chirongwa chekudya chemvura chinowanikwa kuburikidza nehuputi zvichienderera mberi pfupi rinononoka kana kazhinji pazuva nehana yakakura. Kufanana neTPN, zvisinei, zvidzidzo zvakawanda zvezvehutano zvakaratidza kuti kuwedzera kwehuwandu hwevarwere vanorwara vanoparara havakwanisi kana vakagadzirwa nemafuro pane kwete. Zvakare, njodzi dzinotyisa. Varwere vane NG tubes vane ngozi yakanyanya yepneumonia inogona kuderedza zvakanyanya kuponesa kwavo. NG tubes inogonawo kutorwa nyore nyore, zvichikonzera kutambudzika kune vose murwere uye vadiwa vavo.
- Gastrostomy (G) Tubhu - Gastrostomy tube ndiyo inopinza zvakananga mudumbu nekugadzira chirwere. Rimwe gastrostomy rinopedzisira riripo, kana peG tube, rinopedzisira risati rapera uye harisi nyore. Neimwe yeipi idzi, pane ngozi shomanana yemurwere inokwevera tu tube kunze. Icho chiri chichiri chiitiko chepineumonia, zvisinei. Kungofanana nehutambo hwemasogastric, pane uchapupu hushoma hwokuti kudyidzana negastrostomy tube kuchawedzera hutano kana tarisiro yehupenyu yevanorwara vanorwara.
- Kunyengedza (IV) Kuwedzerwa - Kana murwere asingakwanisi kunwa mvura kana kusanwa izvo vatarisiri vake vanofunga kuti zvakakwana mvura, mutarisiri angave akaedzwa kuti akumbire IV fluid. Zvirwere zvinogona kuponeswa kuburikidza nediki tsono inowanikwa mumhino uye yakasungirirwa kusvika kune tubing. Zvidzidzo zvakaratidza kuti kutungamirira mvura kumurwere anouraya pamagumo eupenyu anopa zvishomanana, kana zvikasadaro, zvinobatsira. Ngozi dzinosanganisira kutapurika pachinzvimbo chekuisa mukati kana muropa, uye kusvibiswa kwehuwandu kunokonzerwa nokuputika kana kuti kunyange kufema zvinetso mumatambudziko akaoma.
Zvimwe pamusoro peHara neTatu paMugumo weHupenyu
Sources:
20 Zvinetso Zvakajairika Kuguma kweHupenyu Kuchengetedza. B. Kinzbrunner, N.Weinreb, J. Policzer
HPNA Policy Statement Artificial Nutrition uye Hydration Mukuguma kweHupenyu Care