3. State the signs and symptoms of cardiac arrest. (12 points) (Please answer in English, or you will lose the half score(请用英文回答,否则扣一半分)
4. State attentions in administering Sodium Nitroprusside(硝普钠)via intravenous drop for hypertension crisis. (10 points)
Part Ⅴ: Case Analysis ( 20 points )
Male, 20-year-old, suffered from pharyngalgia(咽痛), cough and low-grade fever on May 3th.On the morning of May 6th, he suddenly felt chilling(寒战), ardent fever(高热), headache and aching pain in muscles. Delirium (谵妄) occurred at interval. He was sent to emergecy department in local hospital. Physical examination: T 39.6℃,P 128/min, R 29/min, BP 80/48mmHg. His face was pale, and the limbs are cold and cyanotic(发绀). Question: 1. What is the most likely clinical diagnosis in this case ? (5 points) 2. What are the treatment principles of this case? (7 points) 3. What are the nursing emphasis for the patient?(8 points) 09年春B Part Ⅰ: Term Definition ( 5 points each, 15 points totally ) 1. Heat illness:
2. Cardiopulmonary cerebral resuscitation:
3. Cardiogenic shock:
Part Ⅱ: True or False ( 2 points each, 10 points totally )
1. Triage work should be performed by experienced nurse. ( )
2. Epinephrine(盐酸肾上腺素) is the preferred drug used in cardiac arrest of any etiology. ( )
3. The key point to treat hyperthermia(超高热) crisis is to quickly lower body temperature to 38.5℃.( )
4. The diagnosing of MODS must be provided with two items: systemic inflammatory response syndrome and organs dysfunction. ( )
5. The depth of endotracheal pipe which insert to is from apexnasi to ear lobe. ( )
Part Ⅲ: Single Choice ( 3 points each, 15 points totally ) 1. What is not the characteristic of PEMC? ( )
A. urgent B. floating C.bad conditions of the first-aid environment D. diseases often are simple
2. The emergency department should be set with following principles except ( ) A. be close with the inpatient department B. with ditinguishing mark C. be easily accessable
D. independently at one side of hospital
3. The best index for shock patient to indicate volume of supplementary fluid is ( ). A. urine output B.blood pressure C. pulse D. CVP
4. Which is not correct in the following nursing interventions for hyperthermia crisis patient? A. lie on the bed to rest B.strengthen airway management C. strengthen oral care D. nothing by mouth
5. Whether 2-rescuer CPR, perform chest compressions and rescue breaths in a ratio of ( ) before artificial airway is established.
A. 30:2 B.15:2 C. 5:1 D. above all not
Part Ⅳ: Brief Answers ( 10 points each for question 1 and question 2, 8 points for question 3, 12 points for question 4, 40 points totally )
1. Briefly state treatment principls of acute poisoning. (10 points)
2. Briefly state treatment principles of coma. (10 points)
3. Briefly state nursing emphasis for drowning patient? (8 points)(Please answer in English, or you will lose the half score请用英文回答,否则扣一半分)
4. Briefly state key points of nursing for shock patient?(12 points)
Part Ⅴ: Case Analysis ( 20points )
Male, 16-year-old, had been buried and both lower extremities be crushed for 46hrs by earthquake. 8 days later be transferred to a general hospital. At present, the total urine volume for 24hrs is 1500ml or so. Urine color is dark brown. Medical examination: T36.5℃,P120/min,R30/min,Bp140/70mmHg. Hypemia(贫血) appearance. There are generous of dry and moist rales in lungs. Both lower extremities are swollen(肿胀), there are many wounds and necrotic tissue(坏死组织). Lab exam: Blood Rt: WBC16.5×109/L, N 91.9%, Hb56g/L, Liver function: ALT203IU/L, AST553IU/L, LDH1795IU/L, Serum total bilirubin 38.7umol/L. Renalfunction:Cr282.8μmol/L,UREA35.34mmol/L.Electrolytes:K+5.88mmol/L,Na+130.3mol/L,Cl—102.6mmol/L, Ca2+1.59mmol/L, Blood gas analysis: pH7.341,TCO217.8mmol/L, PCO230.9mmHg, PO239mmHg, SaO271.5%. Question:
1. What diagnosis do you consider to the patient? (6 points)
2. What are nursing emphasis for this patient? (14 points)
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