外科习题二（Surgical exercises two）.docVIP

外科习题二（Surgical exercises two） A case analysis: (30 points, 10 points for each item) 1. male patients, 45 years old, farmers. A history of duodenal ulcer for 6 years. 8 hours ago, a sharp pain in the abdominal knife occurred, and then spread to the right lower quadrant and the whole abdomen, accompanied by nausea and vomiting. On admission, P was seen 100 times / minute, BP 120 / 80mmHg, tenderness and rebound pain of the whole abdomen, and the surface of the abdomen was curved and the bowel sounds were obviously weakened. (1) if you are a surgical nurse, try to estimate what happens to the patient (2 points) (2) if you need emergency surgery, what preoperative care should you prepare? (8 points) 2., male patients 43 years old, riding a bike was hit by a car, head to the ground, immediately unconscious for about 10 minutes, wake up for headache, in the course of delivery vomiting 2 times, for the stomach content. Physical examination: T37 degrees centigrade, R16 times per minute, P84 times per minute, BP 110 / 70mmHg. Lethargy, call, open eyes, answer the question correctly. Right temporal touch 4cm * 5cm hematoma, right ear mastoid area with ecchymosis, bilateral pupil circle, about 2.5mm in diameter. The reaction to light sensitive eyes, the bottom of optic disc edema, right ear tract bleeding liquid. The brain nerve examination showed no abnormalities, and the muscle tension of the limbs increased slightly. The pathological reflex was not elicited. The CT examination revealed a fracture of the skull base. The doctor ordered a quiet rest to observe the changes in the condition. (1) briefly describe the nursing essentials of the patient. (6 points) (2) which aspects should the patient observe and how to observe? (4 points) 3., an adult male, after being hit by a car, left chest pain, breathing difficulties. Check: T37 C.P120 / min, R26 / min. BP13/9kPa, lucid, complexion cyanosis, shortness of breath, irritability, pulse rate. Left chest wall soft tissue injury, fif