Abstract:

On February 22, 2021, a 38 year old male patient with severe tuberculous meningitis was treated in the First Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University. The patient was complicated by cerebral infarction, renal insufficiency, severe malnutrition, pulmonary infection, and diabetic ketoacidosis. During hospitalization, through the nursing and management mode of cooperation of nursing professional team, with the help of various nursing record sheets, evaluation sheets and monitoring sheets, condition observation content was established to closely monitor patients, risk events were reported and monitored, and standardized communication mode was implemented for the shift handover of critically ill patients. Special management on blood glucose was implemented to achieve individualized blood glucose control objectives, and improve the nutritional status of patients through whole process nutritional management. First-aid procedures were formulated for serious potentially fatal complications especially such as cerebral hernia, asphyxia and respiratory failure, blood coagulation and other indicators were closely monitored, and physical therapy such as lower limb massage and wearing compression elastic socks were used to prevent the occurrence of deep venous thrombosis. At the same time, the implementation of safety protection measures was strengthened to avoid the occurrence of security events such as falling into the bed and unexpectedly drawn tubes. Strict drug treatment management was carried out, the dual route drug infusion of external jugular central venous catheter and upper limb superficial venous catheter were implemented and a daily drug input plan was formulated to ensure that the drugs could be input on time, in quantity, safely and in time to achieve the treatment effect. After careful nursing, no complications occurred during hospitalization, and 22 days after hospitalization, the patient was transferred to the local tuberculosis specialist hospital for further treatment.

Key words: Tuberculosis, meningeal, Diabetic ketoacidosis, Nursing care