Kuvhara muviri kunoderera muhuwandu hwekufamba kwezvigaro zvakagadzirirwa zvakanaka uye hunoratidzwa nezvigaro zvakakosha uye zviduku uye zvakaoma kudzinga. Icho chinotenderwa, chakasiyana nemunhu mumwechete zvichienderana nehuwandu hwemhando yehutachiona hwekudzivirira uye zviratidzo zvekusagadzikana. Inogona kukonzerwa nechinhu chipi zvacho chinopedzisira chichideredza maratidziro emvura kana kuvhiringidza utumbo.
Kunyanya kunowanzoitika kune varwere pedyo nekuguma kwehupenyu. Vanorwara nekenza vangave vane huwandu hunopararira, pamwe nehuwandu huwandu makumi manomwe kubva kuzana kubva muzana kusvika kuzana muzana yevarwere vanoona kuvhiringidzika pane imwe nguva panguva yezvirwere zvavo. Izvi zvinobata hutano hwehutano hwehutano zvikuru. Inokonzera kushaya muviri, hutano, uye mupfungwa kunetseka kune varwere, izvo zvinogona kukanganisa vatarisi vavo.
Zviratidzo
Chiratidzo chekutanga chekumbirwa kwemazuva nekuderera kunowedzera muhuwandu uye huwandu hwekufamba kwemvere. Varwere uye avo vane hanya navo dzimwe nguva vanoti izvi zvinoderera kusvika kudyiwa kudyiwa kwezvokudya kana mvura. Nokuti kuvhiringidzika kune chiremera, zvinorevei kune mumwe murwere angave akasiyana kune umwe. Semuenzaniso, kana murwere achiwanzoita kufamba kwemafuro zuva nezuva uye kamwe kamwe anotanga kuva navo katatu pavhiki, kuvimbiswa kunofanira kuonekwa. Kana, kunyange zvakadaro, murwere anowanzove nekufamba kwemazuva ose zuva rimwe nerimwe, kuenda kwemazuva maviri kana matatu pasina imwe kungasava dambudziko.
Zvimwe zviratidzo zvekuvharwa zvinosanganisira kubvongodza , kusungwa kwepamuviri , kushandiswa kwehuwandu hwemhepo inopfuuridza, inokonzera chigadziko chemvura, marwadzo emakumbo kana kushungurudzika, kurwadziwa kwepakadzika nemakumbo, uye kusakwanisa kupfutidza. Kana kuvhiringidzika kusina kutorwa kwenguva yakati, kusuruvara uye kurutsa kunogonawo kuitika.
Zvinokonzera
Kuvharwa kunogona kukonzerwa nehosha. Kunyanya kunobatwa nekenza kunogona kukonzerwa nemavhuna mukati kana pedyo nhengo dzekudya, musana wemvura, kana nzvimbo inonzi pelvic. Maviri acho anogona kumanikidza kana kuvhiringidza hutachiona kana kuderedza motility mumatumbo.
Zvirwere zvepfungwa-zvakadai saPasinson's , MS , uye ALS-dzimwe nguva zvinopesana negastric motility. Chirwere cheshuga chinogona kukonzera neuropathy inotungamirira kuderera kwechikwata mumakoloni. Mamwe mamiriro ezvinhu, akadai se hypothyroidism, anogonawo kukonzera kuvhiringidzika.
Maitiro ehupenyu hunoita sokuti kuderera kwechido uye kudyiwa kwemvura kunogona kutungamirira ku hypercalcemia , kana kuwedzera kwe calcium muropa, iyo inogonawo kuita kuti kuderedzwa kwemvura mumuviri, zvichiita kuvhiringidzika. Kushayiwa simba uye kuderera kwebasa kunobatsira kukwanisa kushandisa masimba emadziro emadziro uye kuponesa mitsipa yepasi pepelvic, izvo zvinokosha pakugadzirisa zvakakodzera.
Mishonga inogonawo kunge inokonzera kubatwa. Opioid analgesics, yakadai se morphine uye oxycodone, inononoka pasi motility yemvura kuburikidza nekudzvinyirira mberi peristalsis uye kuwedzera inzwi real anal sphincter. Opioids inowedzerawo kunwa kwemvura uye electrolytes mumakumbo makuru uye maduku, zvichiita kuti zviome, dzakaoma zvigaro.
Mimwe mishonga inogona kuwedzera pakuvimbiswa inosanganisira:
- Vinka alkaloid chemotherapy yakadai seVelban (vinblastine)
- Anticholinergic zvinodhaka sePhenergan (promethazine)
- Tricyclic zvinodzvinyirira zvakadai saPaulil (paroxetine)
- Antiparkinsonian zvinodhaka kusanganisira levodopa
- Iron inowedzera
- Antihypertensives (high blood pressure medication)
- Antihistamines seBenadryl (diphenhydramine)
- Antacids
- Diuretics inosanganisira Lasix (furosemide)
Ndingaita Sei Kuti Ndidzivirire kana Kuti Ndibate Kuvharirwa?
Kubudirira kwekudzivirira kudzivirira kunobva pakuwana kwakakwana kwemvura, kudya kwakakodzera, nekuita basa (kushingaira kunokurudzira matumbo).
Sources:
Kinzbrunner, BM; Weinreb, NJ; Policzer, JS; 20 Matambudziko Anowanzo: End of Life Care, McGraw-Hill Publishing, 2002.
Ferrell, BR, naCoyle, N; Bhuku reWorld Palliative Nursing, Oxford University Press, 2006.