问题 多项选择题

患者男,45岁,因“车祸外伤致骨盆及双侧股骨骨折”行急诊手术。术中发现肝破裂,胰破裂,肠系膜多处撕裂,腹膜后血肿。术后送至ICU,给予输血、输液及升温等治疗。患者血压偏低、心动过速及尿量少,输血、输液后无法改善血压和尿量少的情况,且气道压力增高。

关于膀胱压力和处理措施,叙述错误的有(提示膀胱压39cmH2O。)()。

A.膀胱压持续大于20cmH2O并有全身多个脏器病变及功能不全或衰竭时,即可诊断腹腔间隔室综合征(ACS)

B.腹腔压力>40cmH2O为ACSⅣ级

C.Ⅳ级以下ACS可不需积极减压处理

D.该患者需继续加大补液量纠正休克,并输入新鲜血浆提高血浆渗透压,减轻组织水肿

E.CRRT脱水治疗

F.开腹减压,减轻持续高腹压对心、肝、肺、脑、肾的影响

答案

参考答案:B, C, D

多项选择题
单项选择题

Of all the areas of learning the most important is the development of attitudes.. emotional reactions as well as logical thought processes affect the behavior of most people. "The burnt child fears the fire" is one instance; another is the rise of despots like Hitler. Both these examples also point up the fact that attitudes come from experience. In the one case the experience was direct and impressive; in the other it was indirect and cumulative. The Nazis were influenced largely by the speeches they heard and the books they read.

The classroom teacher in the elementary school is in a strategic position to influence attitudes. This is true partly because children acquire attitudes from those adults whose words are highly regarded by them.

Another reason it is true is that pupils often devote their time to a subject in school that has only been touched upon at home or has possibly never occurred to them before. To a child who had previously acquired little knowledge of Mexico his teacher’s method of handling such a unit would greatly affect his attitude toward Mexicans.

The media through which the teacher can develop wholesome attitudes are innumerable. Social studies (with special reference to races, creeds and nationalities), science matters of health and safety, the very atmosphere of the classroom... these are a few of the fertile fields for the inculcation of proper emotional reactions.

However, when children go to school with undesirable attitudes, it is unwise for the teacher to attempt to change their feelings by cajoling or scolding them. She can achieve the proper effect by helping them obtain constructive experiences.

To illustrate, first-grade pupils afraid of policemen will probably alter their attitudes after a classroom chat with the neighborhood officer in which he explains how he protects them. In the same way, a class of older children can develop attitudes through discussion, research, outside reading and all-day trips.

Finally, a teacher must constantly evaluate her own attitudes, because her influence can be negative if she has personal prejudices. This is especially true in respect to controversial issues and questions on which children should be encouraged to reach their own decision as a result of objective analysis of all the facts.

The text specially states that()

A. direct experiences are more valuable than indirect ones

B. whatever attitudes a child learns in school have already been introduced at home

C. teachers can sometimes have an unwholesome influence on children

D. teachers should always conceal their own attitudes