问题 单项选择题 案例分析题

患者,男性,65岁。三日内活动中突发晕厥伴意识丧失两次,急诊以“晕厥原因待查”收入院。

该病人2日未排便,不恰当的护理措施是()

A.心理疏导:向病人解释床上排便对控制病情的重要意义

B.指导进食清淡易消化含纤维素丰富的食物

C.适当腹部按摩(按顺时针方向)以促进肠蠕动

D.遵医嘱给予通便药物或灌肠

E.指导病人增加活动量,用力排便

答案

参考答案:E

解析:用力排便会增加心脏负荷而加重病情甚至会再次诱发晕厥,所以答案选E。【该题针对“.心律失常”知识点进行考核】

问答题 简答题
填空题

[A] Assumed inhospitableness to social development

[B] Price paid for misconceptions

[C] Evolutionary adaptation to forest ecology

[D] False beliefs revised

[E] Extreme impoverishment and backwardness

[F] Ignorance of early human impact

[G] Popular view on residents

In 1942 Alan R Holmberg, a doctoral student in anthropology from Yale University, USA, ventured deep into the jungle of Bolivian Amazonia and searched out an isolated band of Siriono Indians. The researcher described the primitive society as a desperate struggle for survival, a view of Amazonia being fundamentally reconsidered today.

The Siriono, Hohnberg wrote, led a " strikingly backward" existence. Their villages were little more than clusters of huts. Life itself was a perpetual and punishing search for food: some families grew manioc and other starchy crops in small garden plots cleared from the forest, while other members of the tribe scoured the country for small game and promising fish holes. When local resources became depleted, the tribe moved on. As for technology, Holmberg noted, the Siriuno " may be classified among the most handicapped peoples of the world". Other than bows, arrows and crude digging sticks, the only tools the Siriono seemed to possess were "two machetes worn to the size of pocket-knives".

Although the lives of the Siriono have changed in the intervening decades, the image of them as Stone Age relics has endured. To casual observers, as well as to influential natural scientists and regional planners, the luxuriant forests of Amazonia seem ageless, unconquerable, a habitat totally hostile to human civilization. The apparent simplicity of Indian ways of life has been judged an evolutionary adaptation to forest ecology,, living proof that Amazonia could not--and can’t sustain a more complex society. Archaeological traces of far more elaborale cullures have been dismissed as the ruins of invaders from outside the region, abandoned lo decay in the uncompromising tropical environment.

The popular conception of Amazonia and its native residents would be enormously consequential if it were true. But the human history of Amazonia in the past 11000 years betrays that view as myth. Evidence gathered in recent years fiom anthropology and archaeology indicated that the region has supported a series of local/indigenous cultures for eleven thousand years; an extensive network of complex societies—some with populations perhaps as large as 10000—thrived there for more than 1,000 years before the arrival Europeans. Far from being evolutionarily retarded, prehistoric Amazonian people de eloped technologies and cultures that were advanced for their time. If the lives of Indians today seem "primitive", the appearance is not the result of some environmental adaptation or ecological barrier; rather it is a comparatively recent adaptation to centuries of economic and political pressure.

The evidence for a revised view of Amazonia will take many people by surprise. Ecologists have assumed that tropical ecosystems were shaped entirely by natural forces and they have focused their research on habitats they believe have escaped human influence. But as the University of Florida eeologist, Peter Feinsinger, has noted, an approach that leaves people out of the equation is no longer sensible. The archaeological evidence shows that the natural history of Amazonia is to a surprising extent tied to the activities of its prehistoric inhabitants.

The realization comes none too soon. In June 1992 political and environmental leaders from across the world met in Rio de Janeiro to discuss how developing countries can advance their economies without destroying their natural resources. The challenge is especially difficult in Amazonia. Because the tropical forest has been depicted as ecologically unfit for large-scale human occupation, some environmentalists have opposed development of any kind. Ironically, one major casualty of that extreme position has been the environment itself. While policy makers struggle to define and implement appropriate legislation, development of the most destructive kind has continued on a large scale over vast areas.

The other major casualty of the "naturalism" of environmental scientists has been the indigenous Amazonians, whose habits of hunting, fishing, and slash-and-burn cultivation often have been represented as harmful to the habitat. In the clash between environmentalists and developers, the Indians have suffered the most. The new understanding of the pre-history of Ainazonia, however, points toward a middle ground. Archaeology makes clear that with judicious management selected parts of the region could support more people than anyone thought before. The long-buried past, it seems, offer hope for the tuture.

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