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护理考研真题系列解析-26中南大学-3

  • 2026-02-01 22:39:27
护理考研真题系列解析-26中南大学-3
中南大学26护理综合真题解析

论述1.患者进行甲状腺癌术，甲状腺癌切除术后进入麻醉监测室，进入普通病房的要求。

答案整理：
转入普通病房的基本标准为:①意识完全清醒;②能维持气道通畅, 气道保护性反射恢复，呼吸和氧合恢复至术前基础水平;③循环稳定,没有不明原因的心律不齐或严重的出血，心排血量能保证充分的外周灌注;④疼痛和术后恶心呕吐得到控制，并有转出PACU后的镇痛措施;⑤体温在正常范围内;⑥提出对术后氧疗和补液的建议;⑦已完善所有麻醉后苏醒与恢复早期的记录, 包括从PACU转出的记录单，也可采用麻醉后评分法评定病人苏醒进展，确定病人是否能够转出PACU。

论述2.病人打了石膏我们应该预防什么，怎么预防。

答案整理：
病人石膏固定后需预防并发症发生。
（1）骨筋膜室综合征：好发于前臂掌侧和小腿，应密切观察石膏固定肢体的末梢血液循环，注意评估“5P”征：疼痛（pain）、苍白（pallor）、感觉异常（paresthesia）、麻痹（paralysis）及脉搏消失（pulseless）。一旦出现肢体血液循环受阻或神经受压的征象，立即将患肢平放于心脏水平，并通知医师全层剪开固定的石膏，严重者须拆除，甚至行肢体切开减压术；酌情给予病人持续吸氧，湿敷硫酸镁或静脉滴注甘露醇以促进患肢消肿，监测肾功能和血电解质等；因病人常并发肌红蛋白尿，应给予足量补液以促进排尿。
（2）化脓性皮炎：多因石膏塑形不好，石膏未干固时搬运或放置不当等致石膏凹凸不平引起；部分病人可能将异物伸入石膏内搔抓石膏下皮肤，导致肢体局部皮肤受损。注意不能伸入石膏下搔抓皮肤。
（3）石膏综合征：缠绕石膏绷带时不可过紧，且上腹部应充分开窗；调整室内温度在25℃左右、湿度为50%～60%；少量多餐，避免过快过饱及进食产气多的食物等。
（4）失用综合征：石膏固定期间应加强未固定肢体的功能锻炼。
（5）出血：创面出血时，血液或渗出液可能渗出石膏外，应用记号笔标记出范围、日期，并详细记录。如血迹边界不断扩大须及时报告医师，必要时协助医师开窗以彻底检查。
（6）其他：由于行石膏固定术后长期卧床，病人还可能出现压力性损伤、坠积性肺炎、便秘和泌尿道感染等并发症，应加强观察并及时处理。

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  1. CONNECT:[ UseTime:0.000601s ] mysql:host=127.0.0.1;port=3306;dbname=www_sjds;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000575s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000279s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000292s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000532s ]
  6. SELECT * FROM `set` [ RunTime:0.002099s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000656s ]
  8. SELECT * FROM `article` WHERE `id` = 460435 LIMIT 1 [ RunTime:0.002072s ]
  9. UPDATE `article` SET `lasttime` = 1770175381 WHERE `id` = 460435 [ RunTime:0.003946s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.004385s ]
  11. SELECT * FROM `article` WHERE `id` < 460435 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000789s ]
  12. SELECT * FROM `article` WHERE `id` > 460435 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.005240s ]
  13. SELECT * FROM `article` WHERE `id` < 460435 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.002364s ]
  14. SELECT * FROM `article` WHERE `id` < 460435 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.000788s ]
  15. SELECT * FROM `article` WHERE `id` < 460435 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.004231s ]
0.102713s