外科习题二（Surgical problem 2）.docVIP

外科习题二（Surgical problem 2） 1. Case analysis: (30 points, 10 points per question) 1. Male patient, 45 years old, farmer. There was a 6 year history of duodenal ulcer. A sudden abdominal knife cut pain 8 hours ago, followed by right lower abdomen and full abdomen, with nausea and vomiting. The patient was admitted to the hospital with P 100 / min, BP 120/80mmhg, full abdominal tenderness, anti-jumping pain, and a plate-like abdomen, with a significantly reduced bowel tone. (1) if you are a nurse, try to estimate what happened to the patient. (2 points) (2) if emergency surgery is needed, what preoperative nursing preparation should you do now? (8) 2. Male patient, 43, was hit by a car and hit his head on the ground. He was in a coma for about 10 minutes. After waking up, he complained of a headache and vomited twice during the delivery, which was the contents of the stomach. Physical examination: T37 ℃, R16 times/min, P84 times/min, BP 110/70 MMHG. Narcolepsy, when called, open your eyes and answer questions correctly. Right temporal scalp hit 4 cm x 5 cm hematoma, right after the mastoid area with ecchymosis, bilateral pupil big circle and so on, the diameter of about 2. 5 mm, light responsive, optic disc edema, eyes bottom right ear bleeding liquid. There was no abnormality in the cerebral nerve examination, and the limb muscle tension increased slightly, and the pathologic reflex was not raised. CT examination indicated skull base fracture. The doctor ordered a quiet rest to observe the changes. (1) describe the nursing points of the patient. (6) (2) which aspects should the patient observe and observe? (4) 3. An adult male, after being hit by a car, has severe pain in his left chest and difficulty in breathing. Physical examination: T37 ℃. P120 times/min, the R26 times/min. BP13/9kPa, shen zhi qing, complexion purple, gas, fidgety, pulse speed. Left chest wall soft tissue injury, the 5th rib can be seen a 3cm x 2cm wound, the ribs are broken, there is gas going in