问题 问答题

病史 病人,女性,65岁,小学文化,退休工人。因突发性上腹部疼痛伴恶心、呕吐、发热1天而来医院就诊。病人于1天前晚饭后突感上腹部胀痛不适,初始呈阵发性,逐渐加重呈持续性并向左侧腰部、左肩部放射,伴剧烈呕吐,呕吐物开始为胃内容物,后转为黄绿色液体和咖啡样物,总吐出物量约2000ml。病人2年前因“胆囊炎、胆石症”行“胆囊切除术”。无烟酒嗜好。已婚,育一子一女,配偶及独生儿女均健,家庭关系融洽,经济状况良好。
身体评估体温38℃,脉搏110次/分,血压120/70mmHg。神志清,精神差,屈膝卧位,查体合作。皮肤黏膜未见黄染及出血点,浅表淋巴结无肿大,五官及心肺检查均正常。腹部稍膨隆,轻度腹壁紧张,全腹压痛,无明显反跳痛,未见肠型及腹部包块,麦氏点无压痛,肝脾未触及,无叩击痛,移动性浊音(-),肠鸣音减弱,双下肢无水肿。
实验室及其他检查血常规:血红蛋白112g/L,红细胞3.9×1012/L,白细胞17.2×109/L,中性粒细胞88%,伴中性粒细胞核左移,血小板102×109/L。血淀粉酶567U/L,尿淀粉酶 697U/L,血清脂肪酶1.7U/L(Cherry-Crandall法)。腹部B超提示胰腺增大,伴少量腹水。

列出护理计划。

答案

参考答案:护理计划

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护理诊断/问题
单项选择题

B

My family and I lived across the street from Southway Park since I was four years old. Then just last year the city put a chain link fence around the park and started bulldozing (用推土机推平) the trees and grass to make ways for a new apartment complex. When I saw the fence and bulldozers, I asked myself, "Why don’t they just leave it alone"

Looking back, I think what sentenced the park to oblivion (被遗忘) was the drought (旱灾) we had about four years ago. Up until then, Southway Park was a nice green park with plenty of trees and a public swimming pool. My friends and I rollerskated on the sidewalks, climbed the trees, and swam in the pool all the years I was growing up. The park was almost like my own yard. Then the summer I was fifteen the drought came and things changed.

There had been almost no rain at all that year. The city stopped watering the park grass. With- in a few weeks I found myself living across the street from a huge brown desert. Leaves fell off the park trees, and pretty soon the trees started dying, too. Next, the park swimming pool was closed. The city cut down on the work force that kept the park, and pretty soon it just got too ugly and dirty to enjoy anymore.

As the drought lasted into the fall, the park got worse every month. The rubbish piled up or blew across the brown grass. Soon the only people in the park were beggars and other people down on their luck. People said drugs were being sold or traded there now. The park had gotten scary, and my mother told us kids not to go there anymore.

The drought finally ended and things seemed to get back to normal, that is, everything but the park. It had gotten into such bad shape that the city just let it stay that way. Then about six months ago I heard that the city was going to "redevelop" certain worn-out areas of the city. It turned out that the city had planned to get rid of the park, sell the land and let someone build rows of apartment buildings on it.

The chain-link fencing and the bulldozers did their work. Now we live across the street from six rows of apartment buildings. Each of them is three units high and stretches a block in each direc- tion. The neighborhood has changed without the park. The streets I used to play in are jammed with cars now. Things will never be the same again. Sometimes I wonder, though, what changes another drought would make in the way things are today.

Why was the writer told not to go to the park by his mother()

A. Because it was being rebuilt.

B. Because it was dangerous.

C. Because it became crowded.

D. Because it had turned into a desert.