buy hong kong bestellen flovent 125mcg best online pharmacy generic relafen purchasing zyrtec online propranolol dosage for high blood pressure fertomid 50 mg tablet indocin dosage acute gout cozaar sales 2011 rumalaya order clindamycin phosphate vet-vipps online pet pharmacy augmentin shopping usa buy pariet without prescription mestinon timespan rxlist all types suprax pills do i need a prescription for combivent can you order diakof prescription drugs their mexico buy metoclopramide lipitor $4 participating pharmacies brand vytorin buy cheapest lopressor to buy indian generics online etodolac metoprolol tartrate uses buy nitrofurantoin online overnight is cipro an over the counter drug non prescription florinef pharmacy what is azithromycin what is haldol for drug rhinathiol cold orrspray diovan for daily use canada grifulvin v overseas asthma uk cymru viagara super active overnight shipping lasix canada companies only med cab pulmicort domperidone dosage children aciclovir tablets pregnancy nexium prices us vente de suhagra au quebec low cost isoniazid rogaine 2 india side effects of erythromycin tablets how much does evista cost purchase ethionamide pills order non generic eldepryl order zofran canada v-gel in croatia is generic acivir pills effective nexium generic without prescription allopurinol alternatives natural taking zoloft overseas lexapro 10 mg cold turkey canadian drug store alli sales gsk actonel medication guide how to get brand levitra cardizem online can you get high off citalopram 40 mg buy pamelor pills clozaril starting dose benzac mail order what does paxil do to you generic uk paypal aygestin citalopram ships from india put the intermolecular forces in order from strongest to weakest risperdal doctors online buy zithromax online australia no prescription free or low cost sinemet diflucan no prrescription purchase generic premarin what does allegra hives used to treat is plavix generic drug compare prices endep try to numb the pain with alcohol and pills wellbutrin rx list side effects hydrochlorothiazide suppliers overseas eurax how to buy prescription medicine for cold sores on lips side effects of viagra on healthy men no perscription hydrocodine starting dose of synthroid for hypothyroidism onde comprar xenical barato serpina italiano alli overnight shipping cheap my tadalis sx coupons where was the exelon patch commercial filmed discount proventil fluconazole side effects anxiety buy cheap astelin nasal spray canadian pharmacy diovan lawsuit rhinocort in the uk styplon tablets what does compazine contain india pharmacies online that sell femara what is cleocin t used for how to use diamox to prevent altitude sickness generic viagra low dose 25 mg dilantin shortage pfizer para que sirve glucofage xr 750 mg viagra non prescription purchasing motrin online uk nike air max 1 leopard pack vermox pharmacy prices list viagra super active online in us metoclopramide dose pediatric online pharmacy uk zaditor i pill antabuse website stomach pain from mobic order viagra professional overnight medication for anxiety and depression without weight gain canadian drug laws wiki viagra order online prescription buy monmycin online without a prescription health canada erexin-v does etodolac cause weight gain acheter singulair buy isoniazid with e check what percentage of illegal drugs come from mexico canada phenergan tablets online generic equivalent for imitrex generic benzaclin pump buy aceon lowest price where to buy albuterol tablets order tinidazole no rx canadian pharmacy citalopram 20 mg how long does it take to work lamictal online buy trimox online buy tamoxifen citrate in australia can i make keflex no prescription dutasteride alli canadian renagel shortage 2012 compounding pharmacies british columbia buy generic luvox tadacip tablets uk bupropion side effects forum amoxil purchase in canada no prescription mail order viagra soft cialis super active overnight delivery cheapest online pill store where can you buy baby aspirin sale dramamine flovent on line for sale no script canada pharmacies online that sell biaxin brahmi precio mexico finax tablets purchase on line generic vpxl for sale on line yagara generic wikipedia drugs sinemet shipping overseas diclofenac 5mg tablets can i make minomycin what type of medication is solu medrol what is the correct dosage of danazol valacyclovir dosage buy clozaril pills in the canada lexapro for dogs buy buy cyklokapron pills online aristocort online pay paypal discount code for zyrtec anything better than celebrex why is alli so expensive can you buy canadian discount avapro pariet without a prescription generic viagra with paypal wellbutrin sr and birth control pills buy celexa overseas price for cialis 5 mg fluoxetine generic health cialis online bestellen erfahrungen buy viagra with no prescription uk purchase hyzaar 50 12.5 mg xeloda 500mg tablets buy bactrim online pharmacy what is ponstel medicine for cymbalta price without insurance comprar cialis 5mg online propecia 1 mg film tablet buy unisom new zealand online atorlip-10 usa sale how to take nolvadex liquid medication for anxiety disorder metoclopramide dose hiccups can i get high on vytorin acheter lasix france order biaxin without prescription penegra tablet of 100 mg dog anxiety medication xanax what is the generic for elavil where to buy nizoral shampoo in hong kong fluconazole 200 mg directions evista weight gain side effects voltaren how many to take canadian alliance of british pensioners bc brand benicar for sale aspirin sales data how much does lamisil cost without insurance dutas best price how to order malegra dxt triamterene pill shortage what does bayer aspirin look like wellbutrin sr generic name what is trazodone 100mg used for online pharmacy uk ginette-35 lasix injection side effects pill identifier wizard drugs.com glucophage 500 costo who makes generic desyrel adalat sony tv watch online 19 june what are all the pills that can get you high hydrochlorothiazide prices cvs lowest priced aristocort what is triamcinolone acetonide cream .1 azithromycin dosage for adults sinusitis doxycycline online overnight top 10 online tinidazole sites cost of suprax zovirax cream available over counter worldwide pharmacy clozaril buy coreg 40 buy motilium in singapore non prescription valtrex pharmacy does metformin er come in 1000 mg can you buy lotrisone pharmacy online canadian minocin 100mg price glyset coupon code body choice hoodia nopal cactus reviews nexium online pill store big discounts can i get lipothin is aciclovir available over the counter aricept tablets online sony xperia sl zestoretic no prescription reviews where can i buy propecia in uk coreg 40 mg dose post cycle therapy hyzaar medicine glucophage 500 mg zoloft compulsive shopping albenza visa actonel prices at costco best place buy amantadine pct procardia over the couter buy clomid 5 what color is allegra pills januvia customer reviews how to take risperdal mg what is lotensin pills used for original casodex online amoxil shelf life indian altace online lortab side effects itching mobic drug store online sertraline hcl 50 mg high atorlip-5 tablets from buy order lasix dogs xenical for sale cost car hire vigra airport cordarone drug schedule olanzapine user reviews prescription drugs without prescriotion indian pharmacy association membership orlistat 120mg capsulas what is topamax made of compazine canada drug store tamoxifen citrate uk buy nolvadex buy online kamagra oral jelly does the pill alesse make you gain weight domperidone 10mg what is it used for compazine dosage im allegra d canadian pharmacy lisinopril pharmacy mail order can diltiazem cause weight gain can you buy viagra over the counter brand world war 1 battles buy uroxatral bulk to buy wellbutrin in uk what is naprosyn tablets acheter mobicarte orange par internet pyridium medicine children fml forte canada prescription 1 man 1 jar actual video pronovias benicarlo cheap lithium class action lawsuits comprar trental pela internet lukol order by phone discount keftab risperdal indications and usage costco pharmacy zyrtec price what is the drug lithium carbonate used for punar vivah desi tashan 8th january 2013 ditropan where to purchase to buy mestinon in uk olmesartan price yasmin lowest price torsemide supplier in uk average cost of valtrex drugs like zyprexa acai berry trees for sale where can i get kamagra in london ephedraxin online pay paypal antabuse for sale australia can you only get doxycycline on prescription cheap kamagra sales uk how to take alphagan mg paxil buy uk cialis online without prescription mexico neurontin 800 mg tablet kytril discount medications lisinopril for men in usa ordering aldactone mexico can etodolac be abused generic from diovan flonase lawsuit canada donde puedo comprar isoptin carafate cheap price cheap imitrex uk can you buy atorlip-10 over the counter in germany avodart cost uk can you buy atarax over the counter kamagra soft australia pharmacy low price epivir-hbv uk apo omeprazole alcohol atorlip-5 without insurance online generic evecare indian generics online singulair ranitidine suppliers overseas cheap kamagra suppliers uk online serpina buy online ireland is casodex a prescription drug sildenafil oral jelly uk what is metoprolol succ er allopurinol no prescription pricelist quiero comprar cytotec en lima buying reglan for dogs famvir for men sale in uk cheap diarex approved best cozaar prices purchase allopurinol in us augmentin mg order chloramphenicol 100 review is there a generic for xeloda liposafe uk next day delivery buy sinemet online in usa how to by pariet online medrol no prescription canada bentyl shop net free protonix coupons kamagra gold generic 2013 drugs amantadina clorfenamina paracetamol suspension buy tadacip pills in the canada deltasone pas cher italie imuran online buy glucophage tablets online free coupon for mobic buy viagra with american express neurontin limited india levitra for men sale in uk augmentin antibiotico bambini dosi buy tetracycline no prescription prices can you buy lotrisone discount online compare allegra d 24 hour prices generic depakote available us purchase alcohol antabuse from per pill low price viagra online augmentin medication side effects buy advair diskus in ireland overnight pharmacy cleocin gel where to buy online uk order clomid rosuvastatin pills sweat generic brand amoxil switzerland best herbal viagra reviews luvox drug in germany pharmacy tofranil shoppers drug mart indian allegra red sea order phexin canada celexa 20mg tab accutane 5mg tablets donde puedo comprar asacol proscar medication guide cheap actos uk online delivery buy what is nizoral used for methotrexate pills look like avodart direct pharmacy using clomid and nolvadex for pct what does generic zoloft cost bentyl 10 mg uses generic elimite for sale on line tinidazole prices at costco buy flexeril singulair purchase in canada no prescription phenergan 5mg tablets where can i buy testosterone gel buy prescription drugs mexico cialis tablets buy erexin-v mexican pharmacies cancun mexico alligators is generic danazol effective levlen online legally where can i buy shuddha guggulu get protonix toronto haldol reviews buy imuran paypal cardura comprare how to buy benzac in london ranitidine best price where can i order alphagan albendazole next day shipping canada cipro drugs generic viagra online pharmacy american express online pharmacy vipps certified what does confidor do compare prices xenical order 3 aciphex mg enalapril safe during breastfeeding can you get high off of etodolac 500 mg eli lilly cialis canada generic advair diskus 1000 50 phone in order for benemid crestor cheap betapace canada prescription aricept generic date is mail order nexium safe can you get paxil zyprexa tablets 2.5 mg does generic lipitor have more side effects feldene purchase viagra soft 50mg tablets evecare reviews for men yasmin tablets 150 mg colospa online usa canadian mall pharmacy what is adderall for what does generic plavix cost order ralista online elocom krem srbija buy motilium 10mg abilify visado top indian pharmaceutical companies 2011 buy erythromycin antibiotic macrolide entocort express canada buying antibiotics from canada purchase paroxetine in australia clomid without trigger shot canadian association of chain drug stores nadine saby lasuna mail order best price for ciplox non prescription quibron-t bupropion online overnight shipping dutas for men sale in uk natural therapy for low testosterone can fucidin h be used for impetigo where to buy cytoxan in canada safely united pharmacies finpecia legit generic for augmentin 500mg gout medication colchicine where can i get carafate pills betapace online forum buy anti anxiety medication dogs buy seroflo inhaler canada how long to take colchicine for gout attack pletal shop net where to buy colchicine online canada over counter bactroban indian generics online aygestin nosh aspirin for sale low amitriptyline hee is soma better than robaxin zetia drug class action suit pharmacy mexico serophene cheapest way get finasteride Purchase tamoxifen 10 mg buy diflucan 200mg is generic wellbutrin sr effective novolog peak time order tamoxifen tablets orlistat buy online us buy probalan singapore stromectol online meds buy cheap tretinoin 0 05 clopidogrel and aspirin capsules evista tablets 150 mg uk buy actos online pioglitazone ventolin inhalers without prescription propecia canada head office seroquel xr 300 mg tablet buy fml forte online cheap zyban quit smoking reviews what is hoodia extract over counter acticin can i fill a prescription without insurance seroquel quetiapine fumarate generic mail order viagra buy speman online in usa best diet for increasing fertility zestoretic on line purchase canada drugs tofranil with prescription triamterene over the counter how much will actonel cost levothyroxine weight loss reviews hytrin echeck buy cipro paypal accepted pharm support group canada buy tetracycline with no script benicar on line for sale no script best place to buy cephalexin to buy astelin azelastine fosamax order brand levitra daily use reviews estrofem 2mg mtf pulmicort for men in usa aldactone reviews acne.org buy diarex online us no prescription does generic viagra work uk paypal brafix over counter where to buy viagra in uk shops what is piroxicam 20 mg used for cost of diovan 320 mg generic neurontin switzerland what works best viagra levitra or cialis accutane discounts coupon what does ranitidine do where do i valtrex in uk pharmacy mexico sominex aciphex 20 mg tab azithromycin alcohol consumption orlistat roche precio argentina buy cialis by phone best weight loss pills 2012 for men precose no prescription canada ventolin hfa vs albuterol otc cefixime best price pariet how much does health cost when i reach 62 metronidazole 500mg tablets used for hydrochlorothiazide canada drug store canada drug service of sheboygan maxalt discount coupons fast sinequan delivery can you buy aristocort synthroid 75 mg price pharmacy mexico lexapro gpchealth stromectol mexico female viagra no prescription compare prices how much is betnovate tablets the evolution of a viagra salesman tengo omifin para hombres ordering mestinon order parlodel online uk propecia before and after photo results amoxil for daily use canada met rx buy where to buy azulfidine claritin costco brand ordering low dose betnovate maximum dosage of paxil very cheap etodolac clomid for men success lopressor dosage range strattera generic wikipedia drugs dulcolax next day viagra japan tokyo how long to take suprax for uti amlodipine besylate side effects tingling antabuse on line in the mexico dapoxetine remeron 30 mg 28 tablet fiyatФБ where to buy tinidozole blue oblong pill av v15 celebrex cheapest nizagara without a prescription from india ceftin pharmacy cost of lynoral without insurance can motilium make you gain weight female cialis online pharmacy oder mg tablets of bactrim where can i buy prednisone tablets without prescription in the netherlands acquistare vasotec in italia side effects of mirtazapine in men no prescription blopress sale diclofenac 100 mg zerit pharmacy order buy tadapox 20 comprar viagra en argentina contrareembolso online sale of vpxl can we trust estrace online how to use dulcolax suppository for infants vytorin delivery uk buying alligator tags fucidin fast usa can you take mentat ds syrup daily januvia side effects lawsuit serevent generico italiano memory medicine aricept viagra online echeck payment bactrim from canada best place to buy pilex cheap kamagra tablets probalan delivery uk triamcinolone acetonide injection knee alli pas cher pharmacie toprol xl for daily use canada what is viagra professional pills used for drug market order bupropion micardis generic prices buy viagra professional 50 how to take singulair oral granules compare prices ephedraxin eulexin order purchase zithromax on line in australia zoloft india pharmacy diltiazem and simvastatin 2011 buy diovan 160 mg tesco pharmacy jobs search avapro medication used can you buy propecia in japan canada drugs combivent with prescription asacol discontinued dbp buy celebrex online comprar viagra contrareembolso valencia buy diabecon online usa cheap hoodia sale uk best generic hyzaar sites where can i buy diazepam cheap online realiable cialis orders safe place to purchase sildenafil buy no prescription levitra cabana pharmacies approved where to buy lamictal drugs online pulmicort canada pharmacy very cheap rocaltrol paroxetine india paxil diclofenac generic wikipedia drugs silagra tablets benemid to buy from europe generic elavil medication prazosin reviews and dosage Purchase crestor 10 mg exelon prescription prices trazodone insomnia tolerance canadian medicine now buy z pack online canada where to purchase flonase eulexin online legally comprar vasodilan original en madrid online hydrea purchase post cycle therapy skelaxin comprar levitra 20 mg antabuse over the counter usa albenza order on web where does actos work side effects of premarin cream in toddlers levitra online usa can you order prevacid can you take serevent daily cialis vs viagra vs levitra which is better canadian online pharmacy for grifulvin v seroquel sales 2009 disfuncion erectil en jovenes yahoo medicine acticin yagara without prescription online generic olanzapine can you only get citalopram on prescription discount viagra soft paroxetine drugs femcare order online aldactone drug in uk pharmacy what does augmentin treat for infections femara for fertility dose where to get mevacor pct cystone reviews for men long time side effects provera emsam on line purchase gasex active ingredients bupron sr discontinued viagra mg india tetracycline drugstore best site to buy cafergot why has casodex been discontinued purchase abilify medication malegra dxt maximum dosage online chloroquine purchase zentel 200 mg 10 tabletas how to by sinemet online betnovate cream in canada regaine vs rogaine what is clonidine hcl 0.2mg pomegranate juice recipe urdu cheap zerit no prescription male performance enhancement pills voltaren buy online ireland antabuse reviews for men use of trihexyphenidyl in children with cerebral palsy what medicine is comparable to singulair erythromycin no prescription canada pony express drugs what are the side effects of reglan in dogs canada pharmacy drugstores fosamax spc viagra pills sale uk craigslist manchester nh cars cipro 750 mg 14 tablet motilium buy mexico arava desert israel map zyvox sales canadian alliance of physiotherapy regulators recognition over the counter drugs similar to crestor generic zoloft in usa cvs employee discount on prescriptions american lipitor how to stop asthma cough brand viagra no prescription overnight delivery minocin mail order recommended zoloft dosage during pregnancy ramipril side effects anxiety feldene side effects weight gain cheapest rumalaya albenza 10 mg cost retino-a cream 0,025 dose what does alliteration mean kids eulexin shipping overseas inhouse pharmacy biz coupon code zyrtec costco generic low blood pressure medication over the counter comprar nolvadex sin receta espaУБa buy maxaman mg purchase hoodia australia doxycycline gen rx increasing testosterone effects bactrim compuesto para que sirve cipla pharmaceuticals pune buy myambutol paypal cardura online aspirin delayed release tablets 50 mg during pregnancy buy nizoral cream online alesse prices usa allegra over the counter cost become available best online discount pharmacy glyset canada prescription topamax with paypal payment maximum daily dose of rabeprazole sodium accutane picture results accutane journal side effects of arjunarishta all types cefadroxil pills glucophage sale evista 50mg tablets aciphex coupon discount olanzapine best price order haridra best pharmacy to order avodart best prices for alli medicine atrovent cheap terramycin refill pack brahmi online shipping can you buy diclofenac over counter england better than uroxatral buy aciphex for daily use ephedraxin precio mexico motilium melts retin-a ge medication buy strattera have no prescription periactin 40mg allegra pills kamagra direct from india motrin online uk wellbutrin sr express canada blopress 40 mg dose suhagra for purchase positive synthroid reviews can buy colospa online prednisone dose bell;s palsy pharmacy support technologies inc zyban prescription nhs yagara online prometrium 100 mg for pregnancy ventolin side effects long term use best generic aleve sites eulexin online sales premarin without prescriptions online mircette india acheter pas cher zyrtec grifulvin v for men in usa singulair bonus pills generic bactroban ointment canada 15 off drugstore buy keftab 200 precio de redustat en farmacias guadalajara buyers of cordarone canada buy flonase hong kong prescription cost 4 corners pharmacy legit what is lioresal used to treat prescription cheap estrace online without order estrace online with visa viagra free sample australia research grade female cialis sominex drug oversea reglan spain is prednisone for pets the same as humans buying duetact using paypal aciclovir dosis pediatrica iv accutane singapore cost maxalt melt over the counter cardizem side effects long term use rosuvastatin discounts codes lisinopril manufacturer in usa buy medications without prescriptions what is clorfenamina maleato where to buy cheap generic arjuna ciplox on line no script lisinopril dosage chf can you buy haldol over the counter in germany revatio buy usa buy nizoral 40 prometrium where to buy in canada tenormin for sale online prazosin online in usa tricor singapore contact zyvox pfizer fda approved arimidex to buy in england phentermine side effects pregnancy how to get venlor on line cheap florinef usa what is tricor medicine used for erythromycin side effects in pregnancy net direct pharmacy reviews buy inderal online uk glyset order canada stieva-a gel acne retino-a cream 0,05 pas cher differin sale buying hoodia from canada no prescription can meloxicam get you high if you snort it brafix weight gain alphagan 5mg tablets viagra delivery next day generic cozaar uk paypal yagara generic for purchase artane combivent drugstore.com lotensin 40 mg dose km-pcmpharmacy.com valtrex buy online canada long term side effects of forzest can you order beclomethasone beconase aq nasal spray buy propranolol perth australia what types of zofran are there serophene 20mg tab protonix side effects webmd quiero comprar voveran sr cost of viagra professional what does l-tryptophan do can you buy bystolic over the counter where to buy yagara drugs online how much is generic accutane atorlip-5 shelf life doxycycline dogs dose kennel cough can i order lozol no prescription in the usa buy benemid next day does codeine cough syrup get you high costco brand zantac chewable children;s motrin oder mg tablets of cafergot awc pharmacy online viagra scams buy generic lamisil can you get high off bystolic free diovan hct coupons cialis brand name sale discount how long after accutane can i do microdermabrasion order alligator skins ostrich coumadin sale brafix brand positioning caverta drug oversea rx pharmacy discount card buy periactin hong kong pharmacy 4mg where can i get finast ranitidine iv dose in children research grade ayurslim florinef medication order ceftin order in the us better than celebrex ventolin inhaler over-the-counter uk zithromax suspension storage comprar trileptal pela internet viagra soft phone orders lisinopril hctz picture of pill order furosemide from australia without prescription the online drugstore periactin buyers of zyrtec canada aciclovir dosis adulto varicela how long to use exelon patch is there a drug comparative to doxycycline generic drug names accutane can buy dipyridamole online viagra super active over the couter kamagra soft legal in england how can i get antibiotics without a doctor;s prescription buy renagel tablets generic viagra thailand buy cafergot online from uk terramycin delivery where to buy combivent online canada over counter quibron-t cipla ltd patalganga midc aciclovir tablets nhs cheap voveran 100 mg canadian alliance for community service learning website cacsl flovent spain over counter abilify coupons printable preciso de receita para comprar tamoxifeno comprar revia online low dose trazodone for sleep buy generic cialis in usa m and s credit card clozaril on line in the india erythromycin 500 mg filmtab side effects pramipexole tren gyno can you overdose on robaxin buy lithium batteries ev where to buy cheap generic elavil buy naltrexone no prescription uk avandamet buy canada coreg prices usa purchase yasmin online what does claritin clear do mail order generic mentat minipress drug store online cheapest place to buy haldol atarax medication dosage nolvadex gyno dosage colchicine price india list of non prescription drugs in canada nymphomax online cheap amantadine dogs arthritis levaquin dosage sinusitis speman without script buy premarin online india to buy deltasone guaranteed discount swiss legend trimix diver prevacid side effects in babies very cheap duphalac can order diabecon canada how much does ventolin inhaler cost finpecia cheapest ephedraxin roche precio argentina arimidex for daily use canada bactrim ds for uncomplicated uti ophthacare online pharmacy uk buy suprax cheap buy generic pariet online no prescription benzac on line for sale no script is viagra safe for teenagers buy betnovate online overnight abana generico italiano ethionamide no prescription compare prices medrol and alcohol non proscription tablets for cancer how to take feldene flash where can i purchase inderal zestril tablets 40mg clozapine for dogs no rx dosage is ranitidine legal in uk lexapro reviews men best site get dapoxetine advair diskus sales lasix brands india elavil prescription pill how much does lisinopril hctz cost glucophage generico italiano crestor 5 mg india trandate brand order buy antabuse bulk saw palmetto pills at walmart pyridium tablets purchase on line baclofen now himplasia perth australia buy actos online no prescription farmacie online bucuresti what is the correct dosage of malegra fxt lexapro generic name escitalopram oxalate accutane hair loss regrowth why has hoodia been discontinued buy seraquil online echeck overnight delivery generic amitriptyline online clindamycin generic cleocin how to take tadacip mg cheap acivir pills free delivery canada flagyl tablets online alli cost uk can you buy ventolin without a script cost of finasteride in australia erection pills available in india generic for lamisil 250mg getting dilantin in australia arimidex prices uk cheapest propranolol to buy are alligators endangered or threatened mountainwest apothecary lopressor in the uk now what is zofran medicine used for capoten order canada buy differin online india genuine viagra online how much does digoxin cost artane 5 mg tablet cheaper alternative to seroquel augmentin side effects tiredness cialis buy online us research grade ditropan what type of inhaler is flovent eye drops xalatan side effects chloroquine 100 cost of zyban in australia omnicef dose for pediatrics purchase midamor online why aren asthma inhalers free do you need prescription buy viagra canada bystolic and lisinopril combination cost of lisinopril without insurance abilify delivery safe use betnovate pregnancy lloyds pharmacy discount code 2011 effexor without prescriptions pyridium 200mg preУЇo can you buy lamisil online drugstore save german pharmacies online order flagyl 500mg estrofem india us online pharmacy no prescription needed hydrocodone actos canada drug store order lopressor 50mg vente orlistat a la reunion most common side effects of pamelor how to use metformin for pregnancy mail order voltaren online paroxetine prescription craiglist caverta online order what is olmesartan medicine what is precose tablets pregnancy symptoms with clomid early pharmacy online no prescription xanax eurax online meds ayurslim buy canada buy cheap doxazosin cheapest avapro to buy tamoxifen side effects nhs what does viagra cost in mexico can you buy evecare over the counter onde comprar viagra online how long to get bactrim out of your system pilex prescription only purchase ampicillin on line in mexico where is zyrtec on sale what are the uses of parlodel order flovent 120 mg discount aciclovir online pharmacy genuine seroquel best price what types of eulexin are there blount discount pharmacy west maryville tn amantadine delivery london fertomid prescription only hydrocodone promethazine cough syrup buy aciclovir online from mexico what is ginseng royal jelly used for viagra women's viagra what's the best online pharmacy atlantic drugs legitimate order levitra leading prevacid dosage baby stopping depo provera symptoms cefixime brands available in india prazosin online coupon code comprar nitroglycerin online to buy premarin in uk cipla south africa jobs free or low cost kytril where to get antibiotics for std lamisil drugstore nolvadex without prescriptions birth control pills flagyl er bactrim 80-400 mg tablets advair diskus without perscription drug market order female viagra vigra shipping to singapore us pharmacies buy cialis is torsemide legal in uk flomax delivery uk levitra 20 mg best price what is an example of alliteration in romeo and juliet prilosec tablets otc online cialis sublingual purchase lithium 100 mg alli india sale buy viagra online forum drugs prednisone tablets lot p1i300 buy terramycin without a script cheap cialis super active buy online safe to buy generic ditropan from uk viagra vs cialis reviews costco pharmacy doxycycline price too much synthroid weight gain acquisto levitra lotensin mg buy i took my birth control pills out of order alli online buy iv nexium dose free coupon for pravachol ajanta pharma skin products is generic cleocin gel available in usa buy proscar with no prescription cheapest endep what is a good dose for zoloft bystolic anxiety disorder buy alli 84 pack celerity stand buy lexapro online buy aricept cheap prescription needed lov cost zyloprim purchase viagra super active pills aristocort delivery london hydrocortisone boots uk fluoxetine manufacturer usa retin a micro online no prescription tofranil in croatia generic prandin available buy alli australia elocom krema-upotreba discount zerit purchase xalatan permethrin spray boots order cialis professional 20 mg cheap atacand pills non prescription atacand what is the generic name for prilosec buy cialis in australia online generic drugs today brand names is there a drug comparative to isoptin finpecia pas cher italie how much does medrol dose pack cost lozol pharmacy tramadol cod overnight delivery non prescription epivir-hbv pharmacy seroquel cheapest aricept rx keppra xr generic name viagra en ligne canada tegaserod uk licence flagyl er shortage is allegra d 24 hour over the counter where can i get some skelaxin tesco viagra cost what is aspirin good for jocuri onlain 3d nexium medication assistance program robaxin buy australia Purchase 10 adalat 10mg letrozole pills for sale buy reglan with paypal acheter pas cher lipothin ginseng no prescription reviews nymphomax ships from india how do i get viagra samples glycomet prix en pharmacie en france calcium carbonate next day delivery prilosec on the internet healtyman canadian online pharmacy for betnovate buy emsam next day adalat online pharmacy uk buy dostinex tablets uk how to import ceftin free or low cost atrovent cialis under the tongue dp fgr 100 pill cozaar generic drug worldwide pharmacy keflex buy yasmin online uk children;s benadryl dose 2 year old order lisinopril online without rx prescription shipping available buy nitroglycerin detrol side effects glaucoma buy zanaflex online overnight delivery to buy albenza triamcinolone injection for scars buy cefixime tablets online diltiazem in the uk now cytotec order online how long does it take for toradol to work erection packs 2 in usa prednisolone donde puedo comprar cialis en ecuador buy asics online usa to australia dramamine meclizine pregnancy renagel drug information renova cream coupon pariet to purchase without a prescription buy indocin mexican pharmacies advair inhaler wiki buy tegretol without rx flagyl antibiotico foglietto illustrativo buy antabuse no prescription online accutane lawsuit statute of limitations new york elocon on line in the uk trileptal mg no prescription buy trazodone online from india buying amoxil in manchester is dexilant better than prilosec glucophage uk brand name actos online pharmacy viagra soft in croatia pravachol to buy from europe liv bonus pills smoking cessation medications zyban can buy clonidine over counter prescription orlistat 120mg uk fast metformin delivery information apcalis jelly prednisone in usa ondansetron odt no prescription toradol 20 mg gocce orali generic propranolol hcl levitra 10 mg bucodispersable vademecum best site get saw palmetto class action lawsuit against celexa buy speman capsules discount nolvadex mg zithromax z-pak 250 mg dosage how to get off depakote flovent cost canadian how to use korean red ginseng root weight gain after acai berry kroger pharmacy rx coupons best online pharmacy without prescription reviews mycelex-g medication side effects cordarone usa sale side effects of chemo drug xeloda overdose of elavil side effects side effects of lamisil generic famvir over counter australia motilium online meds purchasing relafen online uk what is keftab used for propecia before and after results lotrel order online no prescription buy ventolin asda side effects lipitor 80mg tablets vente de zyvox au quebec levothroid online pharmacy no prescription cheap genuine nymphomax online genuine voveran sr best price maxaman tablets online beat way to order viagra plus comprar himcocid original en madrid can you buy without generic lotensin use suhagra tablets order brand cialis without rx augmentin generic side effects what does zofran treat propУƒТЉcia avodart jalyn stromectol comprar is aggrenox better than plavix biaxin on line purchase nexium 40 mg capsule generic alesse cost what is the generic drug for prevacid what is the drug xeloda used for health canada clonidine azelastine generic astelin buy precose mexican pharmacies all types sustiva pills reglan india ranitidine generic cheap costs can order voveran online buy ethionamide uk medrol dose pack online duphalac pills best site to buy antabuse lamisil tablets 150 mg amitriptyline for sale where to buy tinidazole online uk alli weight loss at walmart combivent mg canada bristol-myers squibb pharmaceuticals ireland propranolol over counter uk tegretol medicine children buy glyset usa canadian life health insurance companies lisinopril hctz doses available buy flagyl er 750 mg can claritin cause weight gain tadalis sx 20 mg aristocort by mail order uk buy clonidine no prescription purchase doxycycline oral compound feline buy abilify 3 mg top 10 online femcare sites purchase plavix online lamisil at flagyl er mail order deltacortril ent 5mg tabs used omnipod insulin pump what does calcium hydroxide react with to make calcium carbonate nitroglycerin order by phone best cheap drugstore powder foundation cleocin no prescription what do paxil pills look like imitrex coupons discounts evista 10 mg cost depakote now co uk generic for lamictal revatio from mexico formula 1 tickets buy iv zyvox online compare antivert prices sale motrin zetia side effects leg pain generic nimotop switzerland order buy allopurinol overnight purchase citalopram lowest price genuine imuran best price kamagra chewable discount voucher costco pharmacy promethazine price where can i buy levaquin what is quibron-t used for stilnox cr side effects bactrim dose buy cytotec abortion pill buy premarin tablets online buy fml forte uk terramycin 100 injection is mail order lozol safe nexium 40 mg capsule price acivir pills 20mg tab serophene online coupon code cephalexin medication penicillin meridia uk canadian medrol flomax weight gain what is carafate pills used for can you buy toprol xl over the counter in germany buy aldactone boots cheap citalopram free delivery warfarin prescriptions in china best price finax inderal 40 mg pharmacy is there a drug comparative to cialis sublingual prometrium pill shop discount code beat way to order nolvadex long term side effects of mobic viagra ohne rezept kaufen paypal duration of doxycycline for acne vitamin shoppe coupon 20 periactin order online kamagra chewable online forum coreg drug oversea buy methotrexate online uk acticin drug oversea is strattera available in canada can you order myambutol tal funciona viagra generico buy furosemide in singapore augmentin prospect brand name synthroid online atorlip-5 mg tablet promethazine codeine cough syrup for sale buy vasodilan in ireland recommended dose of citalopram for anxiety what is remeron made of what does enteric coated aspirin look like cialis sublingual refill pack is evecare legal in uk cheapest place to buy alavert voltaren dosage too high brand amoxil online order buy mentat online reviews buy alli america most reliable place to buy chloramphenicol online indocin suppository ingredients costco alli orlistat 60mg refill pack zyprexa looking for what are promethazine pills where entocort neurontin pills look like the chepest lexapro haldol 40mg what does zantac cure imuran 100 mg tablet buy cheap levitra china aricept overnight cod buy cheap neurontin online buy robaxin no prescription estrace for sale philippines what does neurontin do to you anafranil 100 mg isoptin express canada flovent india kamagra chewable tablets from buy what is elavil tablets mexican pharmacy no prescription methotrexate maxalt rpd medication diclofenac generic brand buy furosemide fast shipping como comprar actonel provera 10 mg tabletta birth control pills vermox norvasc medication generic viagra on line order buy vytorin online usa clonidine online coupon code side effects of augmentin 625 cane you buy viagra over the counter in canada thalidomide enantiomers uses how to order retino-a cream 0,025 pilex cost comparison what does visceral and parietal mean bactrim ds dosage for children prednisolone tablets dosage asthma ordering doxycycline 500mg what is betnovate pills used for tenormin tab. 50 mg purchase lisinopril in usa morning after pill over the counter atacand without prescription cystone tablets himalaya drugs withdrawal from prednisone after 5 days canadian-pharmacy-24h.com coupon states where alligators are found buy anafranil 10mg protonix australia price what does serevent renagel drug classification buy online nolvadex without precription cialis 36 hour online online forum buy claritin prescription yellow extacy pill identifier vermox where to get can you buy mentat ds syrup pravastatin online, no prescription testosterone therapy for women australia does relafen cause weight gain cefixime mg tablet can you buy cialis soft in ireland prescription levitra lipothin coupons stop smoking medication zyban prednisona 50 mg precio cheap antabuse buy online dapoxetine tablets india flonase cause weight gain actavis promethazine uk erythromycin buy australia canadian differin propecia from canada buy viagra canada using paypal eldepryl india ordering wellbutrin xl online canadian pharmacy delivery prescription generic albendazole purchase nootropil worldwide pharmacy zovirax dilantin 100mg capsule buy propecia generic online diclofenaco sodico 75mg buy levothroid 15mg online pilex suppositories buy lopid medicine children is it safe to order capoten apcalis buy 100mg cheap kamagra can you buy viagra in las vegas order buspar canada buy ophthacare pills online caverta canada prescription what is extendaquin used for nyc cialis no prescription jelly sale cheapest cialis prescription order femara 2.5 mg diltiazem on line no script amantadine online forum buy anafranil quick karen scott candian meds rumalaya generic wikipedia drugs lipitor dosage instructions fast cafergot deleviery bristol-myers squibb canada wiki trazodone reviews for depression delivery without cheap abilify acyclovir dose in renal failure kytril canada overnight delivery prednisone 10 mg tablet uses albenza side effects nitroglycerin for dogs buy acheter desyrel pas cher bupropion xl costco what is silagra used for prilosec lawsuit 2011 order fucidin cream 2 brafix shoppers drug mart there generic available cozaar terbinafine hydrochloride cream 30g buy vigara sydney zantac 150 mg usa methotrexate tablets dosage atrovent drugs online purchases blue pill m on one side 100 on other tadapox tablets side effects where can i purchase suhagra coreg 12.5 mg tablet orlistat sold over counter nitroglycerin pills cost kamagra discounts codes uroxatral prices usa buy cardura discount prednisone dosage dogs lupus buy mestinon next day ezetimibe 10 mg simvastatin 40 mg aarp prescription solutions prior authorization form how to get cephalexin on line generic for actonel 150 mg phone in order for actoplus met how to purchase nymphomax online generic viagra paypal casodex side effects depression lioresal shop net when will nexium have a generic zentel 400 mg bula ciprofloxacina clorhidrato monohidrato hoodia next day shipping looking for viagra pills buy ampicillin low cheap price uk version of paxil cholesterol lowering and ezetimibe buy tamoxifen australia purchase aciphex 6 canadian pharmacy flomax on the internet buy relafen in ireland do you need rx mobic zoloft uk name allopurinol side effects liver function aircept for free mexico what does ampicillin do for acne revatio shop aldactone tablets 25 mg 100 25 for sale hyzaar online there generic zyvox maxalt for uninsured is tamoxifen available over the counter flonase online forum delivery buy phenergan topic ceftin dosage for children cardura without prescription medrol bonus pills order elimite reviews pictures of generic prozac pills sildenafil indian brands compra de cialis online mebendazole dosage for children all types atarax pills exelon prescription prednisone 20mg for dogs side effects viagra suppositories buy can low dose prednisone cause weight gain grifulvin v usa sale my purinethol coupons average dosage of accutane what is co-azithromycin for lipitor recall november 2012 what does generic propecia look like can you get addicted to imitrex colchicine medication used aricept uk brand name cheap fedex buy astelin online no prescription prozac generic name fluoxetine viagra sublingual overnight pharmacy what is the classification for ditropan what is famciclovir used for in cats generic abilify (aripiprazole) meclizine pregnancy safe clindamycin hydrochloride and alcohol inderal anxiety medication allergy medication astelin donde puedo comprar robaxin canadian online pharmacy for torsemide prometh with codeine cough syrup where can i get previcid buy alesse uk discount prescription to buy provera fast astelin deleviery hoodia order filling prescriptions fast buy fucidin 50 anafranil on line in the canada can you buy silagra over the counter in germany to buy mevacor levitra plus sale prescription 10mg online cyklokapron india tadapox weight gain zebeta drug canadian pharmacy how long do lansoprazole take to work viagra uk over the counter where to buy norvasc online where to buy sumycin vente de brand advair diskus au quebec buy trial erection packs 1 paypal metoclopramide class of drugs buy levothyroxine in uk buy suprax 400 mg no prescription where to purchase zenegra bupron sr online forum purchase wellbutrin sr in mexico evecare medication side effects buy beconase aq paypal betapace without rx azathioprine side effects nhs diclofenac drug oversea online lipothin purchase arimidex pct side effects buy periactin with e check viagra super active online in usa best price for real robaxin levetiracetam keppra generic best pharmacy to order metformin order non generic metformin where can i get lexapro cheap zentel tablets 400mg glyset sale purchase kamagra in australia maxalt precio mexico fastest isoptin uk delivery comprar dilantin en argentina is it illegal to order generic urispas buy cystone capsules buy finpecia online with mastercard discount code for sarafem buy cheap buspar top drugstore lipsticks can you order flonase spray prescription eve mentat self cost kamagra pill shortage rhinocort prescription coupons where to buy proscar online mexico adalat retard nifedipine hydrea shoppers drug mart nizoral mg buy do you need rx aristocort reminyl for men sale in uk avodart rx what is micardis side effects rosuvastatin for sale australia crestor 40 mg 28 film tablet prospektУМs what is parlodel used to treat how does viagra work wikipedia keppra suppositories buy generic for synthroid levothyroxine generic name colospa what is the medicine valtrex prescribed for prednisone dosage asthma attack can order antibiotics online canada can you buy rumalaya in ireland what does tetracycline inhibit glucophage on line no script pfizer viagra supreme court canada what is the correct dosage of acticin womens viagra gel uk version of ditropan gabapentin without prescription what does a generic phenergan pill look like calcium carbonate chewable tablets formulation water pills joint pain colchicine uk online order accutane online no prescription where to buy cheap viagra in australia what is valtrex proscar prescription free lowest price haridra capoten pills drugstore hydrochlorothiazide best price levitra 10 mg schmelztabletten vardenafil buy cyproheptadine use brafix coupon online urispas order online splitting prilosec pills pharmacy express online scam fake viagra how to tell get atacand toronto original doxazosin online aristocort shop net 1 guy 1 jar original video lasuna capsules ortho tri cyclen acne treatment is generic mestinon available in usa low price bupron sr uk fucidin cream 2 w/w order cymbalta 60 mg online biaxin without a prescription from india order colospa pill most common side effects of protonix bystolic brand order tamoxifen side effects steroids generic levaquin uk clonidine pill shortage cialis soft online no prescription where to purchase retin a online dapoxetine cheap price cephalexin capsules bp 500mg minocycline discount card generic cipro uk leading biotech and pharmaceutical companies in india what drug category is avandamet generic rogaine 5 buy canada ordering prescription drugs online canada celadrin max dose nizagara discount zyrtec d shelf life genesis acai 100 canada roxithromycin online bestellen maxalt medication dosage order flagyl from pyridium where to get zestoretic ordering online pharmacy nexium sales 2012 canadianhealthcaremall.net abilify 5 mg tab prescription mobic 150 mg trental canada prescription red panax ginseng extract reviews online pharmacy uk viagra sublingual purchase meclizine online no prescription aleve uk brand name sesxy sciop viagra rogaine 5 for men sale in uk Purchase abilify 4mg canada cabana without a script pharmacy zerit generic reviews russian pharmacy brooklyn ny buy depakote mg online feldene 40 mg piroxicam mentax no prescription canada antivert online coupon code yagara with paypal payment sinemet 25 mg / 100 mg canadian mexican online pharmacies overnight delivery of lipitor generic geriforte usa pharmacy cytotec mg usa ditropan from canada hoodia pills for sale abilify dosage instructions air max 1 leopard pack 2012 acheter pyridium sominex tablets purchase on line retino-a cream 0,05 not generic
You are here: صفحه اصلي آموزش بیماران مراقبتهای ویژه (ICU) مراقبت های پس از ترخیص تغذیه بیمار 2

قطب علمی آموزش الکترونیکی دانشگاه علوم پزشکی شیراز

تغذیه بیمار 2

چاپ
Untitled document
Picture1
   لوله های تغذیه ای که به طور مستقیم در دیواره معده کار گذاشته می‌شوند انواع مختلفی دارند اما روش استفاده و مراقبت از آن‌ها مشابه می‌باشد از انواع آن می‌توان گاستروستومی –ژئوژنستومی،... نام برد. کار گذاری این لوله‌های تغذیه ای از طریق یک روش ساده جراحی انجام می‌گردد به این صورت که لوله مخصوص تغذیه در دیواره معده تعبیه می‌شود. این روش برای بیمارانی استفاده می‌گردد که به علت بیماری خاص امکان تغذیه از راه دهان را ندارند.

 

 

 

 

 

در این مبحث به این سؤالات شما پاسخ داده می‌شود:

  1. چگونه لوله های تغذیه ای به طور مستقیم در دیواره معده کار گذاشته می‌شوند؟
  2. تغذیه با لوله های که مستقیم در دیواره معده کار گذاشته می‌شوند چگونه انجام می‌شود؟
  3. مراقبت‌های لازم برای بیماران با لوله‌های مستقیم در معده چیست؟
  4. اقدامات لازم در صورت بروز تهوع و استفراغ چیست؟
  5. در صورت بروز اسهال چه اقداماتی انجام شود؟
  6. اقدامات لازم در هنگام بروز بی اشتهایی چیست؟

     

     1.چگونه لوله های تغذیه ای به طور مستقیم در دیواره معده کار گذاشته می‌شوند؟

این نوع لوله ها انواع مختلفی دارند اما روش استفاده و مراقبت از آن‌ها مشابه می‌باشد از انواع آن می‌توان به گاستروستومی –ژئوژنستومی،... نام برد.

تصویر 1: لوله مستقیماً در دیواره معده یا روده قرار می‌گیرد

کار گذاری این لوله‌های تغذیه ای از طریق یک روش ساده جراحی انجام می‌گردد به این صورت که لوله مخصوص تغذیه در دیواره معده تعبیه می‌شود. این روش برای بیمارانی استفاده می‌گردد که به علت بیماری خاص امکان تغذیه از راه دهان را ندارند.

 

    

2.    تغذیه با لوله های که مستقیم در دیواره معده کار گذاشته می‌شوند چگونه انجام می‌شود؟

وسایل لازم: آب، سرنگ مخصوص غذا، غذای آماده شده

بیمار را در وضعیت نشسته یا روی پهلوی راست قرار دهید.

ابتدا دست‌ها را بشویید سپس با سرنگ غذا محتویات داخل معده را بکشید اگر بیشتر از 100 سی سی بود غذا دهی را به 1 تا 2 ساعت بعد موکول کنید. در غیر این صورت غذایی که قبلاً آماده کرده و از صافی گذرانده‌اید (درجه حرارت مطلوب برای غذا و آب مورد استفاده درجه حرارت اتاق است) را نزدیک بیمار بگذارید پیستون سرنگ غذا را خارج کنید و بعد سرنگ را به سر لوله ای که در دیواره معده کار گذاشته شده است وصل کنید دست خود را بالا نگه دارید بعد حدود 30 تا 50 سی سی به بیمار آب بدهید تا مسیر شسته شود بعد غذا را در سرنگ بریزید و بگذارید آرام آرام وارد معده شود. سعی کنید همیشه سرنگ پر از غذا باشد تا هوا وارد معده نشود و بیمار دچار نفخ شکم نشود. بعد از اتمام تغذیه حدود 30 تا 50 سی سی مجدداً آب وارد معده کنید تا مسیر کاملاً شسته و باز شود بعد از اتمام کار تغذیه سرنگ و وسایل مورد استفاده را با آب و مایع ظرف‌شویی بشویید دقت داشته باشید در هر وعده غذایی بیش از 300 تا 500 سی سی غذا نباید به بیمار داده شود بعد گیره لوله را بسته و لوله را در جای خود ثابت کنید در صورت لزوم می توانید از پانسمان نیز استفاده کنید.

   

  3.  مراقبت‌های لازم برای بیماران با لوله‌های مستقیم در معده چیست؟

1. هر روز اطراف لوله را با آب و صابون بشویید و به آرامی آن‌را خشک نمایید. گاز یا دستمال کاغذی را روی پوست بیمار نکشید بلکه آهسته با گذاشتن و برداشتن دستمال پوست اطراف لوله را خشک نمایید.

2. اطراف لوله را از نظر زخم، رنگ، ترشحات و خونریزی بررسی کنید و در صورت مشکل به پزشک مراجعه نمایید.

3. قبل از غذا دادن حتماً مقدار غذای باقی مانده در معده را اندازه گیری کنید.

4. لوله را تا جایی که وارد معده شده است علامت‌گذاری کنید تا در صورت کوتاه یا بلند شدن لوله متوجه شوید و سریعاً به پزشک اطلاع دهید.

5. در صورتی که بیمار دوست داشت می‌تواند غذا را بو کند، بچشد یا بجود و دور بریزد این کار از لحاظ روحی و جسمی به بیمار بسیار کمک می‌کند.

6. مقدار غذایی که در هر وعده به بیمار می‌دهید را به دقت ثبت کنید.

 

4.      اقدامات لازم در صورت بروز تهوع و استفراغ چیست؟

اگر بیمارتان دچار تهوع و استفراغ می‌باشد ابتدا باید سعی کنید علت اصلی آنرا پیدا کنید ممکن است از عوارض جانبی داروها باشد یا غذای تهیه شده آلوده باشد.

زمانی که بیمار تهوع دارد بهتر است حجم کمی غذا را با فاصله های مکرر به بیمار بدهید. مراقب باشید بیمار به علت تهوع و استفراغ دچار کم آبی نشود.

تذکر: از خوراندن حجم زیادی غذا دریک وعده غذایی به بیمار خودداری نمایید.

اگر بیمار استفراغ می‌کند سر بیمار را بالا بیاورید و به یک سمت خم کنید و ظرفی در اختیار وی قرار دهید تا محتویات دهان را در آن بریزد.

در این بیماران سعی کنید مرتب دهان بیمار را بشویید اگر بیمار نمی‌تواند مسواک را تحمل کند از محلول آب نمک یا آب ساده و یا دهان‌شویه برای شستن دهان استفاده کنید.

در صورت ادامه تهوع و استفراغ حتماً با پزشک مشاوره کنید ممکن است بیمار نیاز به استفاده از داروهای ضد تهوع داشته باشد؛ و بیمار دچار کم آبی شود پس در این مورد دقت لازم را داشته باشید و از پزشک یا پرستار کمک بخواهید.

   

5.       در صورت بروز اسهال چه اقداماتی انجام شود؟    

اگر بیمار مبتلا به اسهال شده است. اول سعی کنید علت آنرا پیدا کنید ممکن است غذای بیمار آلوده بوده باشد.                                                        

برنامه رژیم غذایی بیمار را از موادی ساده مانند پنیر – موز – ماست – برنج کته ای تهیه کنید. از دادن میوه و سبزی – مایعات داغ – قهوه و غذای چرب به بیمار خودداری کنید.       

بعد از هر بار اجابت مزاج ناحیه تناسلی را از مدفوع پاک کنید و ناحیه تناسلی را با آب و صابون بچه بشویید و خشک نمایید. در صورت ملتهب شدن ناحیه تناسلی با مشورت پزشک می‌توانید از پماد زینک اکساید و پودر بچه استفاده نمایید.

نکته مهم: جهت ایمنی خود حتماً از دستکش یک‌بار مصرف استفاده کنید.

در صورت تکرار اسهال با پزشک و پرستار مشاوره کنید. زیرا در اثر ادامه اسهال بیمار دچار کم آبی می‌شود.

   

6.  اقدامات لازم در هنگام بروز بی اشتهایی چیست؟

افراد بیمار ممکن است به علت مسائل روحی یا جسمی دچار بی اشتهایی شوند. در این افراد سعی کنید غذای بیمار را تزیین کرده و شکل زیبایی به غذا بدهید تا اشتهای بیمار تحریک شود.

دهان‌شویه دادن بیمار می‌تواند اشتهای او را تحریک کند.

این بیماران باید از موادی استفاده کنند که معده سریع خالی شود مانند غذاهایی که شیرین هستند یا انواع ژله، بستنی و ...

مکمل‌های غذایی مانند پروتئین‌ها، ویتامین‌ها و شیر خشک به مواد غذایی بیمار اضافه کنید تا بیمار مقدار انرژی لازم را دریافت کند.

 

خلاصه

 

لوله‌هایی که به طور مستقیم در دیواره معده کار گذاشته می‌شوند، انواع مختلفی دارند. اما روش استفاده و مراقبت از آن‌ها مشابه می باشد از انواع آن می‌توان به گاستروستومی –ژئوژنستومی، ... نام برد. البته در ارتباط با این لوله‌ها می‌بایست مراقبت‌های زیر انجام شود:

1. هر روز اطراف لوله را با آب و صابون بشویید و به آرامی آنرا خشک نمایید. گاز یا دستمال کاغذی را روی پوست بیمار نکشید بلکه آهسته با گذاشتن و برداشتن دستمال پوست اطراف لوله را خشک نمایید.

2. اطراف لوله را از نظر زخم، رنگ، ترشحات و خونریزی بررسی کنید و در صورت مشکل به پزشک مراجعه نمایید.

3. قبل از غذا دادن حتماً مقدار غذای باقی مانده در معده را اندازه گیری کنید.

4. لوله را تا جایی که وارد معده شده است علامت‌گذاری کنید تا در صورت کوتاه یا بلند شدن لوله متوجه شوید و سریعاً به پزشک اطلاع دهید.

5. در صورتی که بیمار دوست داشت می‌تواند غذا را بو کند، بچشد یا بجود و دور بریزد این کار از لحاظ روحی و جسمی به بیمار بسیار کمک می‌کند.

6. مقدار غذایی که در هر وعده به بیمار می‌دهید را به دقت ثبت کنید.


 

 



برای مشاهده اسلایدهای تعاملی اینجا کلیک کنید.

ویدیو این قسمت در دست تهیه است.

 

شناسه

تهیه کننده: نجمه نادری

متخصص علمی محتوا: دکتر عباس خسروی، دکتر گلنار ثابتیان و دکترشهرام پایدار

Refernces:

1.درسنامه پرستاری داخلی جراحی برونرسودارث، اس‍م‍ت‍ن‍ر (1385)، س‍وزان‌ اوک‍ان‍ل‌

2.      www.mdconsult.com/public/patient/view

3.       www.critcaremd.com

4.       www.myicucare.org/Critical_Care_Team

5.      www.ncbi.nlm.nih.gov/pubmed/11863143

6.      www.tju.edu/jmc 

7.      www.mc.vanderbilt.edu/root/vumc.php?site=neurocritical

8.      www.stonybrooksurgery.org

9.      libraries.umdnj.edu/camlbweb/hrc/critical

10.   www.uhn.ca

آخرین بروزرسانی ( يكشنبه ، 1 دی 1392 ، 15:04 )  

تماس با سرپرست

Untitled document

تماس با سرپرست این بخش

دکتر مانوش مهرابی

سرطان پستان

Untitled document

 

نمایه توده بدنی(BMI)

Untitled document

 

آمار بازدیدکنندگان

21274امروزmod_vvisit_counter
18345دیروزmod_vvisit_counter
61402این هفتهmod_vvisit_counter
162022هفته گذشتهmod_vvisit_counter
406513این ماهmod_vvisit_counter
555650ماه گذشتهmod_vvisit_counter
2602997کل بازدیدهاmod_vvisit_counter

بازدیدکنندگان: 286 مهمان حاضر
IP شما: 54.197.171.109
 , 
امروز: 25 شهریور 1393

نظرسنجی مطالب آموزشی سلامت عموم

کیفیت مطالب آموزشی سلامت عموم ارائه شده در این بخش از دیدگاه شما چگونه است؟
 

نشریات

Untitled document book

مجله یادگیری الکترونیکی

Untitled document

 cover01

تصاویر پانورامای شیراز

Untitled document

 44557319

همایش یادگیری الکترونیکی

Untitled document

congress

Display Pagerank