课后习题参考答案 (1)

课后习题参考答案 (1)
课后习题参考答案 (1)

外科护理学

第九章损伤病人的护理

一、名词解释

1、创伤:机械性致伤因子所致的损伤,又称创伤。

2、一期愈合:又称原发愈合。边缘整齐、对合良好,缝合后能顺利愈合的伤口。组织修复以原来的细胞为主,连接处仅有少量纤维组织。愈合后功能良好。

二、选择题

A1/A2型题

1、现场急救严重损伤病人首先应:C

A、抗休克

B、包扎伤口

C、解除窒息

D、镇解止痛

2、促使感染伤口尽早愈合最关键的是:C

A、抬高患肢

B、局部制动

C、应用抗生素

D、充分引流

3、大面积烧伤病人48小时内最重要的全身改变是:C

A、创面脓毒症

B、急性肾功衰

C、低血容量性休克

D、菌血症

4、Ⅲ°烧伤时下列哪项不出现:D

A、痛觉消失

B、皮肤发黄

C、有焦痂

D、有大水疱

5、防治烧伤后严重感染的关键是:B

A、选用有效的抗菌药

B、正确处理创面

C、全身支持治疗

D、做好心理护理

6、男,4岁,双下肢,双臂烧伤3小时来诊,患儿哭闹不止,创面有大水疱,疱型较薄,基底潮红,水肿明显,以下判断不正确的是:A

A、烧伤面积46%

B、浅Ⅱ度烧伤

C、需住院治疗

D、必需抗休克

7、抢救伤员时应当首先处理:C

A、休克

B、止血

C、窒息

D、骨折

8、女性年轻病人下楼时不慎致踝关节扭伤,2小时后来医院就诊,你如何处理:B

A、局部用热水袋

B、局部用冰袋

C、用热水泡脚

D、局部按摩

A3/A4型题

(9~12题共用题干)

患儿,6岁,体重20kg,在家玩耍时不慎打翻开水瓶,双下肢被开水烫伤后皮肤出现大水疱,皮薄,疼痛明显,水疱破裂后创面为红色。

9、该患儿的烧伤面积为:B

A、20%

B、40%

C、46%

D、50%

E、70%

10、此患儿的烧伤深度为:B

第九章损伤病人的护理

A、I度

B、浅Ⅱ度

C、深Ⅱ度

D、Ⅲ度

E、Ⅳ度

11、该患儿烧伤后第一个24小时应补的晶体和胶体液量为:E

A、1040 ml

B、1140 ml

C、1240 ml

D、1340 ml

E、1440 ml

12、对于该患儿的现场处理不正确的是:B

A、迅速脱离热源

B、创面涂抹龙胆紫

C、用自来水大量冲洗双下肢

D、大量补液

E、迅速送往医院

三、简答题

1、简述烧伤的现场急救?

答:主要目的是尽快消除致伤原因、脱离现场和施行生命救治。

(1)迅速脱离热源:

(2)抢救生命:

(3)保护创面和保温:

(4)保持呼吸道通畅:

(5)其他救治措施:

①纠正低血容量:

②镇静止痛、稳定伤员情绪:

③有效地处理严重复合伤:

2、包扎和暴露疗法各适用于哪些情况?

答:包扎疗法适用于四肢烧伤、气候寒冷而病房保温条件差和小面积烧伤的门诊病人。暴露疗法是将创面直接暴露在温暖而干燥的环境中,多用于头颈部、会阴部烧伤或有严重感染的创面和大面积烧伤病人。

3、影响创伤修复的因素有哪些?

答:l.年龄

2.感染

3.异物存留及失活组织过多

4.慢性疾病

5.血液循环障碍

6.营养状况

7.局部制动不够

8.类固醇激素

4、烧伤在临床上分为哪几期?

答:(1)急性体液渗出期(休克期):

(2)感染期:

(3)修复期:

5、烧伤的现场急救措施主要包括哪些?

外科护理学

答:(1)迅速脱离热源:

(2)抢救生命:

(3)保护创面和保温:

(4)保持呼吸道通畅:

(5)镇静止痛、稳定伤员情绪:

(6)有效地处理严重复合伤:

四、论述题

某成年男性,体重60㎏,不慎被沸水烫伤,立即送进医院。护理体检:神志清楚,P104次/分、Bp12/8kPa(90/60mmHg),面部、颈部、胸腹部、双前臂、双手布满大水疱,感觉剧痛,双小腿水疱较小,有拔毛痛,双足呈蜡白色、可见树枝状静脉栓塞网。入院后开始静脉输液,并同时进行清创。

问:(1)估计烧伤总面积?

(2)说出主要的护理诊断?

(3)计算伤后第一个24小时的补液总量:

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