问题 问答题 简答题

左心功能衰竭的表现及护理要点是什么?

答案

参考答案:左心功能衰竭为肺循环淤血和心排血量降低。

【临床表现】

临床主要症状为外周脏器组织灌注不足的综合症状。

(1)呼吸困难:为左心衰最早出现的症状。开始多在较重力活动时出现,休息后可缓解。随着病情加重,呼吸困难症状可在轻体力活动时即出现,并可在夜间出现阵发性呼吸困难,此为左心衰竭的典型表现。

(2)咳嗽、咳痰、咯血:咳嗽也为左心衰竭的早期症状,常在夜间发生并伴有呼吸困难,坐位时可减轻或消失。咳嗽常伴咳白色泡沫状浆液性痰。心功能不全严重时也可出现痰中血丝或咳粉红色泡沫痰。

(3)低心排量症状:可有乏力、头晕、失眠、尿少、发绀、心悸等,其原因主要是由于心、脑、肾等脏器组织灌注不足所致。

(4)体征:多数病人左心室可增大,心率加快,心尖部可闻舒张期奔马律,肺动脉瓣区第二心音亢进。两肺底可闻及湿罗音,有时伴有哮鸣音。湿罗音分布位置可随体位改变而变。血压一般正常,有时脉压减小。

【护理】

使病人保持安静,减少恐惧;给予吸氧、注射镇静剂等。如有肺水肿可吸入通过酒精氧化瓶的氧气,必要时四肢轮流扎止血带。

阅读理解

D

I read about it in the paper, in the subway, on my way to work. I read it, and I couldn't believe it, and I read it again. Then perhaps I just stared at it, at the newsprint spelling out his name, spelling out the story. I stared at it in the swinging lights of the subway car, and in the faces and bodies of the people, and in my own face, trapped in the darkness which roared(隆隆响) outside.

It was not to be believed and I kept telling myself that, as I walked from the subway station to the high school. And at the same time I couldn't doubt it. I was scared, scared for Sonny. He became real to me again. A great block of ice got settled in my belly and kept melting there slowly all day long, while I taught my classes algebra. It was a special kind of ice. It kept melting, sending trickles(涓涓细流)of ice water all up and down my veins(血管), but it never got less. Sometimes it hardened and seemed to expand until I felt my heart was going to come spilling(溢出) out or that I was going to choke or scream. This would always be at a moment when I was remembering some specific thing Sonny had once said or done.

When he was about as old as the boys in my classes his face had been bright and open; and he'd had wonderfully direct brown eyes, and great gentleness. I wondered what he looked like now. He had been picked up, the evening before, in a sudden search on an apartment down-town, for selling and using heroin.

I couldn't believe it: but what I mean by that is that I couldn't find any room for it anywhere inside me. I had kept it outside me for a long time. I hadn't wanted to know. I had had suspicions(怀疑), but I didn't name them, I kept putting them away. I told myself that Sonny was wild, but he wasn't crazy. And he'd always been a good boy, he hadn't ever turned hard or evil or disrespectful, the way kids can, so quick, so quick, especially in Harlem. I didn't want to believe that I'd ever see my brother going down, coming to nothing, all that light in his face gone out, in the condition I'd already seen so many others.

67. The underlined word “it” in Paragraph 1 refers to ____.

A. the swinging light of the subway car    B. the news of Sonny’s being arrested

C. everything trapped in the darkness       D. newspaper

68. We can learn from the passage that ____.

A. the news on the paper was unbelievable.

B. I was too scared to believe the news

C. I was ill because a great block of ice was in my belly

D. Sonny and I hadn’t seen each other for a long time

69. What can be inferred from the last paragraph?

A. Sonny and I were brothers.

B. Sonny had always been a good boy before being arrested.

C. I didn’t care about Sonny.

D. Many young men turned bad in Harlem.

70. Which of the following can best describe the author’s feelings towards Sonny?

   A. Concern, affection, expectation.            B. Concern, hatred, expectation.

C. Affection, regret, sympathy.                  D. Regret, understanding, sympathy.

单项选择题 A1型题