问题 问答题

患者男,18岁,两周来发现双下肢水肿,纳差,近3天加重入院,经血、尿检查确诊为肾病综合征,体检:心、肺(—),腹部膨隆、腹壁水肿,移动性浊音(+),腰骶部及双下肢明显凹陷性水肿。列出护理诊断并制定护理措施。

答案

参考答案:

护理诊断: 

体液过多:与肾病综合症大量蛋白丢失、低白蛋白血症有关 

有感染的危险:与肾病综合症导致机体抵抗力下降有关 

知识缺乏:缺乏疾病防治知识 

潜在并发症:血栓栓塞 

护理措施: 

(1)监测病情: 

1)评估病人水肿情况,定期测体重、腹围,记录24小时出入量。 

2)监测病人生命体征,注意有无高血压、蛋白尿及相关临床表现。 

3)定期抽血,监测电解质情况。 

(2)饮食护理 

1)给优质正常量蛋白饮食,保证食物热量供应。 

2)控制入量,量出为入。入量以前一日尿量+500毫升为宜。 

3)限制钠盐摄入,摄入量应根据病人电解质情况调整。 

(3)预防褥疮护理:卧床病人要勤翻身,注意受压部位皮肤;促进局部血液循环;保持床单位干燥、整洁,无渣屑;密切观察有无褥疮发生。 

(4)药物护理 

遵医嘱使用降压、利尿、激素及细胞毒性药物等,观察药物疗效及不良反应。 

(5)预防并发症 

注意病室环境清洁,加强口腔及皮肤护理,预防感染。观察病人有无感染征象如发热及局部炎症表现;注意有无血栓栓塞表现,发现异常及时报告医生处理。 

(6)健康教育:尊医嘱用药,定期复诊;坚持饮食计划,保持愉快情绪;积极预防感染,学会自我监测病情变化,发现异常及时就医。 

阅读理解

Three years ago, five parrots were set free in a wild place of Arizona, thousands of miles from the Channel Islands in Jersey where they had been looked after by zookeepers. No evolutionary strategies informed them how to behave in this new landscape of mountainous pine forest unoccupied by their kind for 50 years. To the researchers’ surprise, they failed to make contact with a group of wild parrots imported from Mexico and set free at the same time. Within 24 hours the reintroducing ended in failure, and the poor birds were back in cages, on their way to the safety of the Arizona reintroduction programme.

Ever since then, the programme has enjoyed great success, mainly because the birds now being set free are Mexican birds illegally caught in the wild, confiscated (没收) on arrival north of the border, and raised by their parents in the safety of the programme. The experience shows how little we know about the behaviour and psychology (心理) of parrots, as Peter Bennett, a bird researcher, points out: “Reintroducing species of high intelligence like parrots is a lot more difficult. People like parrots, always treating them as nothing more than pets or valuable ‘collectables’.”

Now that many species of parrot are in immediate danger of dying out, biologists are working together to study the natural history and the behaviour of this family of birds. Last year was an important turning point: conservationists founded the World Parrot Trust, based at Hayle in Cornwall, to support research into both wild and caged birds.

Research on parrots is vital for two reasons. First, as the Arizona programme showed, when reintroducing parrots to the wild, we need to be aware of what the birds must know if they are to survive in their natural home. We also need to learn more about the needs of parrots kept as pets, particularly as the Trust’s campaign does not attempt to discourage the practice, but rather urges people who buy parrots as pets to choose birds raised by humans.

小题1:What do we know about the area where the five parrots were reintroduced?

A.Its landscape is new to parrots of their kind.

B.It used to be home to parrots of their kind.

C.It is close to where they had been kept.

D.Pine trees were planted to attract birds.小题2:The reintroducing experience three years ago shows that man-raised parrots

A.can find their way back home in Jersey

B.are unable to recognize their parents

C.are unable to adapt to the wild

D.can produce a new species小题3:Why are researches on parrots important according to the passage?

A.The Trust shows great concern for the programme.

B.We need to know more about how to preserve parrots.

C.Many people are interested in collecting parrots.

D.Parrots’ intelligence may some day benefit people.小题4:According to the passage, people are advised ______.

A.to treat wild and caged parrots equally

B.to set up comfortable homes for parrots

C.not to keep wild parrots as pets

D.not to let more parrots go to the wild

问答题