【正文】
ace is a rectangular, indoor court. The principal pieces of equipment are the two elevated baskets, one at each end (in the long direction) of the court, and the basketball itself. The ball is spherical in shape and is inflated. Basketballs range in size from in (7276 cm) in circumference, and in weight from 1822 oz (510624 g). For players below the high school level, a smaller ball is used, but the ball in men39。合并其他呼吸系統(tǒng)疾病,如哮喘、阻塞性肺病、肺部感染等,應(yīng)于處理后再手術(shù)。⑤改善營養(yǎng)狀況:食管癌病人往往處于營養(yǎng)不良的狀態(tài),蛋白質(zhì)缺乏,并常伴有血容量不足,耐受術(shù)中、術(shù)后失血或休克的能力降低。對(duì)于60歲以上的病人及有慢性支氣管炎、肺氣腫的病人應(yīng)作肺功能檢查。問:①分析此病人病史中與食管癌發(fā)病相關(guān)的因素。②每日幫助患者起坐及變換體位,使引流充分通暢。男性,35歲。這種情況往往在手術(shù)當(dāng)天或手術(shù)后次曰容易見到,因此,在醫(yī)生拔除病人的傷口引流管之前,保持引流管的通暢非常重要。大家可以根據(jù)自己的實(shí)際情況,選擇適合自己的方法進(jìn)行鍛煉。答:①保持外耳道、鼻腔和口腔清潔。 簡述尿路結(jié)石的主要預(yù)防措施。第七天以雞蛋湯,稀飯為主,每次200毫升。TUR綜合癥:是用高頻電經(jīng)尿道將肥大的前列腺或前列腺腫瘤切除的一種手術(shù)。問:可能選擇的手術(shù)方式?為什么?術(shù)前應(yīng)做哪些準(zhǔn)備?答:對(duì)于腸癌肝轉(zhuǎn)移,聽你的意思醫(yī)生讓你開刀,說明轉(zhuǎn)移在肝上的只是局限在一葉上,而不是整個(gè)肝彌漫性轉(zhuǎn)移。 (4)治愈率高,并發(fā)癥小,90%左右的病人可以經(jīng)過內(nèi)鏡治愈。體檢:一般情況差, 39。也可配合針刺足三里。139。1周內(nèi)加強(qiáng)呼吸功能鍛煉。答:(1)造口位置應(yīng)使病人自已能看清楚,便于自己護(hù)理。嚴(yán)密觀察病情變化,若病情加重。病因可以是先天性發(fā)育畸形如腸閉鎖、腸狹窄、腸旋轉(zhuǎn)不良、環(huán)狀胰腺、疝氣嵌頓等。膽絞痛:屬祖國醫(yī)學(xué)的“腹痛”范疇。男性, 65歲,慢性便秘多年。②心力衰竭型:表現(xiàn)為全心衰竭,以右心衰竭為主,故患者有心動(dòng)過速、下肢浮腫、肝脾腫大、呼吸困難等。C,脈搏132次/分,寒戰(zhàn)、大汗、煩躁和嘔吐等 表現(xiàn)。答:(1)術(shù)后3天內(nèi)護(hù)理要點(diǎn):①硬膜外麻醉后護(hù)理,平臥,血壓平穩(wěn)后,取半臥位;②術(shù)后當(dāng)天禁食,做好輸液護(hù)理;第2天進(jìn)流質(zhì);③鼓勵(lì)病人早期下床活動(dòng);④觀察和預(yù)防并發(fā)癥。答:護(hù)理措施:①護(hù)士態(tài)度熱情、和藹,以熟練的技術(shù)獲得病人的信賴。注意:中至大量胸水或大量腹水者多取強(qiáng)迫半坐臥位,并可因呼吸困難使活動(dòng)和運(yùn)動(dòng)能力減退。)(2)結(jié)腸出血,糞便與血液糞可為部分混合或完全混合。長期劇烈、頻繁咳嗽可致呼吸肌疲勞、酸痛,使患者不敢有效咳嗽和咳痰,并可致頭痛、失眠,或因食欲減退、機(jī)體能量消耗增加引起明顯消瘦。合作性問題是需要護(hù)士通過觀察和監(jiān)測,以及時(shí)發(fā)現(xiàn)的某些疾病過程中的并發(fā)癥,護(hù)士以執(zhí)行醫(yī)囑和采取護(hù)理措施減少其發(fā)生的方式處理合作性問題。 3.根據(jù)成人第一個(gè) 24 小時(shí)補(bǔ)丟失液的計(jì)算公式進(jìn)行計(jì)算。 實(shí) 驗(yàn) 室 檢 查 : pH , , (55mmHg),PaO250mmHg,K+,Na+135mmol/L, Cl101mmol/L。 答:營養(yǎng)是改善病人全身情況和組織修復(fù)的物質(zhì)基礎(chǔ)。 病人可出現(xiàn)神志、 血壓、心率、脈搏、呼吸、尿量等一系列變化,在臨床護(hù)理中,對(duì)休 克病人的觀察和護(hù)理尤為重要。這時(shí)也應(yīng)該在床上做一些鍛煉,家屬可協(xié)助作下肢向心方向 按摩(從病人足底向上按摩)來促進(jìn)血液循環(huán)。 簡述術(shù)后病人早期活動(dòng)的好處。補(bǔ) 液過程中加強(qiáng)血壓及尿量的觀察,根據(jù)患者年齡,心腦血管的情況, 血壓、血糖、電解質(zhì)、血漿滲透壓、尿量等隨時(shí)調(diào)整補(bǔ)液量。 (2)濃度不高:靜脈輸液鉀濃度不大于 %,禁止靜脈直接 推注氯化鉀,以免血鉀突然升高導(dǎo)致心臟驟停。 簡述腸內(nèi)營養(yǎng)病人胃腸道反應(yīng)的原因。 簡述局麻不良反應(yīng)及其預(yù)防。至于怎樣活動(dòng),要根據(jù)手術(shù)病人的耐受程度,一般手術(shù)后病人清 醒即可做深呼吸,手術(shù)后 6 小時(shí)只要血壓正常平穩(wěn),沒有出血情況, 可以開始每 2~3 小時(shí)翻一次身,床上作伸屈臂和登腿、握拳、屈足、 翹趾。 答:預(yù)防:有吸煙嗜好者術(shù)前兩周應(yīng)停止吸煙,減少呼吸道分泌物, 術(shù)前有呼吸道感染者應(yīng)用抗菌藥有效控制感染,術(shù)前練習(xí)深呼吸,術(shù) 后鼓勵(lì)咳嗽,避免限制呼吸的固定,防止術(shù)后嘔吐物誤吸。②行 各種護(hù)理操作時(shí)動(dòng)作應(yīng)輕柔, 病房環(huán)境安靜, 病人雖然處于休克狀態(tài), 神志模糊, 但是也有一定意識(shí), 讓病人情緒穩(wěn)定, 并保護(hù)肢體和皮膚。因此,營養(yǎng)治療自始自終都是整個(gè)燒傷臨床過程中 的重要治療措施之一。 輕度燒傷?中度燒傷? 重度燒傷?特重?zé)齻?2.根據(jù)護(hù)理診斷標(biāo)準(zhǔn),結(jié)合本病例中病人的臨床表現(xiàn)和實(shí)驗(yàn)室 檢查結(jié)果,做出具體的護(hù)理診斷并寫出其中三個(gè)。本題主要考查的是護(hù)理診斷與合作性問題的區(qū)別。護(hù)士的主要作用是通過連續(xù)心電監(jiān)測以期極早發(fā)現(xiàn)嚴(yán)重心律失常的發(fā)生。注意:對(duì)于臨床上長期慢性咳嗽、咳痰應(yīng)給予足夠的重視,避免感染的發(fā)生。患者可因心臟前負(fù)荷增加,脈搏增快,血壓升高,甚至可發(fā)生急性肺水腫。答:(1)保護(hù)患側(cè)上肢:避免皮膚曬傷和其他損傷。④適當(dāng)使用鎮(zhèn)靜劑或抗焦慮藥。查體溫T36. 6176。②增強(qiáng)心肌的收縮力。 女性, 40歲,原發(fā)性甲亢2年,人院前1個(gè)月基礎(chǔ)代謝率+ 40% ,性情急躁,檢查發(fā)現(xiàn)甲狀腺腺體較大。問:為避免術(shù)后復(fù)發(fā)該病人術(shù)前準(zhǔn)備中最重要的措施是什么?該病人行茄修補(bǔ)術(shù)后的護(hù) 理措施是什么?答:中醫(yī)甲亢病??茖<医M提出:甲亢之病,虛實(shí)挾雜,本虛而標(biāo)實(shí);本虛為肝、腎、脾三臟不足;標(biāo)實(shí)為肝郁,心火及痰凝。急性梗阻性化膿性膽管炎:主要是由于膽管突然受阻和嚴(yán)重的膽道感染所引起,膽結(jié)石是引起膽管阻塞的主要原因,膽管里的結(jié)石平時(shí)可不阻塞膽管,但結(jié)石有時(shí)會(huì)因位置改變突然堵在膽管的某一部位,如膽總管的下端,便會(huì)造成膽管的急性阻塞。常見于各種重癥肺炎、敗血癥、腸炎所致的中毒性腸麻痹或低血鉀引起的麻痹性腸梗阻。答:①心理護(hù)理。(4)造口部位應(yīng)避開瘢痕、皮膚凹陷、皺褶、浸潤區(qū)、腰帶處及骨髂突起處,應(yīng)利于裝載造口器材,因此,病人應(yīng)有平臥、站立及彎腰等姿式下造口部位,看對(duì)造口護(hù)理有無影響,然后用甲紫在造口處做好標(biāo)記,并記錄在病歷上。答:正確使用彈力襪,選擇適合患者的型號(hào)及壓力。 診斷為粘連性腸梗阻。對(duì)反復(fù)頻繁發(fā)作的粘連性腸梗阻也應(yīng)考慮手術(shù)治療。C, P126次/ 分, R24次/分, BP 10. 6/8. 0 kPa,四肢濕冷,皮膚發(fā)花,心肺 (一) ,腹軟,右上腹壓痛( + ) ,反跳痛( + ) ,肌緊張( + ) , Murphy征( + ) ,腸鳴音弱。 如果十二指腸鏡取石失敗,我們采取腹腔鏡膽總管探查(即“打眼”的方法),一次性手術(shù)治愈疾病,成功率在95%以上。關(guān)于直腸癌手術(shù)是否保肛則需要看腫瘤距離肛門的距離而定。脊髓損傷的程度和臨床表現(xiàn)取決于原發(fā)性損傷的部位和性質(zhì)。食管癌病人手術(shù)后飲食應(yīng)循序漸進(jìn)、少量多餐,促進(jìn)消化功能的恢復(fù)。 ③積極治療尿路感染 ④長期臥床病人,應(yīng)鼓勵(lì)及幫助其多活動(dòng),借以減少骨質(zhì)脫鈣,增進(jìn)尿流暢通。④嚴(yán)禁不腦脊液鼻漏者從鼻腔吸痰、或放置胃管,禁止耳、鼻滴藥,沖洗和堵塞,禁忌做腰穿。如果引流不暢,可能會(huì)導(dǎo)致傷口內(nèi)積血,容易繼發(fā)感染,嚴(yán)重積血形成的血腫還可能壓迫已經(jīng)減壓以后的脊髓。三、病例分析題:男性, 78歲,摔傷后4小時(shí),右側(cè)額部著地,進(jìn)行性意識(shí) 障礙加重1小時(shí),肢體無自主活動(dòng)。急診醫(yī)師立即給予胸腔閉式引流。 ④定期胸部X線攝片,了解肺膨脹和胸膜腔積液情況。缺鉬時(shí)植物中硝酸鹽積聚,在一定條件下會(huì)促進(jìn)亞硝酸胺致癌物的生成。有吸煙習(xí)慣的人,至少于術(shù)前2周停止吸煙。⑥心血管系統(tǒng)疾?。盒g(shù)前發(fā)現(xiàn)有高血壓的病人,如在213/136千帕以下者,可不用降壓藥物,如高血壓較明顯,可在術(shù)前適當(dāng)應(yīng)用降壓藥,但不要求血壓降至正常。手術(shù)完畢后,應(yīng)監(jiān)測血糖及尿糖,及時(shí)調(diào)整胰島素用量。s bounce. Inside the covering or casing, a rubber bladder holds air. The ball must be inflated to a pressure sufficient to make it rebound to a height (measured to the top of the ball) of 4954 in ( m) when it is dropped on a solid wooden floor from a starting height of 6 ft ( m) measured from the bottom of the ball. The factory must test the balls, and the air pressure that makes the ball legal in keeping with the bounce test is stamped on the ball. During the intensity of high school and college tourneys and the professional playoffs, this inflated sphere mands considerable attention. Basketball is one of few sports with a known date of birth. On December 1, 1891, in Springfield, Massachusetts, James Naismith hung two halfbushel peach baskets at the opposite ends of a gymnasium and outlined 13 rules based on five principles to his students at the International Training School of the Young Men39。 and Japan in 1900. From 1891 through 1893, a soccer ball was used to play basketball. The first basketball was manufactured in 1894. It was 32 in (81 cm) in circumference, or about 4 in (10 cm) larger than a soccer ball. The dedicated basketball was made of laced leather and weighed less than 20 oz (567 g). The first molded ball that eliminated the need for laces was introduced in 1948。s professional leagues were attempted and failed, including the Women39。s Harlem Globetrotters, which was actually from Chicago. While these teams had some notable players, no superstars, such as Babe Ruth, Jack Dempsey, or Red Grange, emerged to capture the public39。s skills. Despite the pointshaving scandal, college ball thrived in the 1950s, largely because it had prolific scorers and more great players than in any previous decade. Frank Selvy of Furman and Paul Arizin of Villanova both averaged over forty points early in the decade, while Clarence Bevo Francis of tiny Rio Grande College in Ohio amazed fans by scoring 116 points in one game while averaging 50 per game for a season. The decade also witnessed some of the most talented and plete players ever. Tom Gola at LaSalle, Bill Russell at San Francisco, Wilt Chamberlain at Kansas, Elgin Baylor at Seattle, Jerry West at West Virginia, and Oscar Robertson at Cincinnati, all had phenomenal skills that have since been the measure of other players. And in 1960 one of the best teams ever, Ohio State, won the NCAA title led by Jerry Lucas and John Havlicek. Professional basketball underwent major