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1、电大【健康评估】形考作业一：1举例说明护理诊断与合作性问题的区别。本题主要考查的是护理诊断与合作性问题的区别。护理诊断是护士使用的名词，用于说明个体或群体对健康问题的现存的或潜在的反应，以指导护理。护理诊断侧重于对患者现存的或潜在的健康问题或疾病的反应做出判断。如脑出血是医疗诊断，医生关心的是脑出血的进一步治疗，而护士关心的是患者患脑出血后的反应，相应的护理诊断则可能是“身体移动障碍”、和“皮肤完整性受损的危险”。再如，患者起床时忽觉头晕，对此医生的工作重点在于寻找引起眩晕的原因，做出相应的医疗诊断，而护士更关心的是患者可能因眩晕导致受伤，因而提出“有受伤的危险”这一护理诊断。合作性问题是需要
2、护士通过观察和监测，以及时发现的某些疾病过程中的并发症，护士以执行医嘱和采取护理措施减少其发生的方式处理合作性问题。如长期卧床导致皮肤受压，“有皮肤完整性受损的危险”。只有那些护士不能预防和独立处理的才是合作性问题，如急性广泛前壁心肌梗死的患者于发病后24h内最易出现较为严重的心律失常，如频发期前收缩、室性心动过速，甚至室颤，由于护士无法通过护理措施预防心律失常并发症的发生，此时应提出“潜在并发症：心律失常”这一护理诊断。护士的主要作用是通过连续心电监测以期极早发现严重心律失常的发生。注意：需要说明的是，并非所有的并发症都是合作性问题。如果是护士通过护理措施可预防和处理的，为护理诊断。2长期慢
3、性咳嗽、咳痰可对机体造成哪些不良影响？本题主要考查的是咳嗽是一种保护性反射动作，呼吸道内的分泌物或进入呼吸道的异物，可借咳嗽反射排出体外。咳痰是借助咳嗽将呼吸道内过多的分泌物排出口腔外的动作。长期剧烈、频繁咳嗽可致呼吸肌疲劳、酸痛，使患者不敢有效咳嗽和咳痰，并可致头痛、失眠，或因食欲减退、机体能量消耗增加引起明显消瘦。剧烈咳嗽可因脏层胸膜破裂发生自发性气胸，或因呼吸道粘膜上皮受损产生咯血，也可使胸、腹部手术伤口裂开，骨质疏松者可因剧烈咳嗽导致肋骨骨折。不能有效咳痰者，痰液潴留可诱发或加重肺部感染，并使通气与换气功能受损。注意：对于临床上长期慢性咳嗽、咳痰应给予足够的重视，避免感染的发生。3简述
4、不同部位消化道出血的血便。本题主要考查的是不同部位消化道出血的血便的特点，一般分为上消化道出血和下消化道出血，而且要根据出血量的多少而定。（1）上消化道或小肠出血，粪便可为血液与粪便完全混合或全为血液。（出血量小，通常是黑大便；出血量大，才可能是粪便完全混合；全为血液的罕见。）（2）结肠出血，粪便与血液粪可为部分混合或完全混合。（3）直肠、肛门或肛管出血，血色鲜红附于粪便表面，或为便后有鲜血滴出。（常见痔疮、肛裂等疾病）4例举3个与水肿有关的护理诊断及其相关因素？本题主要考查的是水肿有关的护理诊断及其相关因素，水肿者除上述不同病因的临床表现特点外，无论是隐性或显性水肿，均可因体内液体潴留出现体
5、重增加，常伴尿量减少。患者可因心脏前负荷增加，脉搏增快，血压升高，甚至可发生急性肺水肿。护理诊断：（1）体液过多：水肿与右心功能不全有关；与肾脏疾病所致钠水潴留有关等。（2）皮肤完整性受损有皮肤完整性受损的危险：与水肿所致组织细胞营养不良有关。（3）活动无耐力：与胸、腹腔积液所致呼吸困难有关。（4）潜在并发症：急性肺水肿。注意：中至大量胸水或大量腹水者多取强迫半坐卧位，并可因呼吸困难使活动和运动能力减退。长期持续水肿引起水肿区组织、细胞营养不良，对感染的抵抗力下降，易发生皮肤溃疡和继发感染，且伤口不易修复。电大天堂【健康评估】形考作业二：1、列举各种类型强迫体位的临床意义。本题主要考查的是一些
6、疾病会造成机体某种特征性强迫体位，对机体既是一种保护，也是我们诊断疾病的客观依据。(1)强迫仰卧位：仰卧，双退屈曲，以减轻腹部肌肉的紧张。见于急性腹膜炎。(2)强迫俯卧位：俯卧位可减轻脊背肌肉的紧张度。见于脊柱疾病。(3)强迫侧卧位：胸膜炎病人多卧向患侧，以减轻胸痛；大量胸腔积液病人多卧向患侧，以利健侧代偿性呼吸，减轻呼吸困难。(4)强迫坐位：又称端坐呼吸。病人坐于床沿，两手置于膝盖或床边。该体位可使膈肌下降，有助于胸廓和辅助呼吸肌运动，增加肺通气量，同时可减少回心血量，减轻心脏负担。见于心肺功能不全的病人。(5)强迫蹲位：病人于步行或其他活动过程中，为缓解呼吸困难和心悸而采取的蹲踞体位或膝胸
7、位。见于发绀型先天性心脏病。(6)强迫停立位：活动时心前区疼痛突然发作，病人被迫立刻站立，并以手按抚心前区，待缓解后才离开原位。见于心绞痛发作。(7)辗转体位：腹痛发作时，病人辗转反侧，坐卧不安。见于胆石症、胆道蛔虫症、肠绞痛等。(8)角弓反张位：固颈及脊背肌肉强直，致使病人头向后仰，背过伸，胸腹前凸，躯干呈弓形。见于破伤风、脑炎及小儿脑膜炎。注意：由于存在个体差异，有些人患病时不一定会出现这些强迫体位，或者不明现。2腹部检查的方法、内容、正常与异常体征的表现及其临床意义。本题主要考查的是腹部检查的方法、内容，考虑到腹部叩诊与触诊可能会刺激肠蠕动而影响听诊结果，因此，腹部检查一般按视、听、叩、
8、触的顺序进行。腹部视诊的主要内容有腹部外形、呼吸运动、腹壁静脉、腹部皮肤、胃肠型和蠕动波以及疝等。听诊内容主要有肠鸣音、振水音和血管杂音。腹部叩诊主要用以了解腹腔实质脏器的大小、位置与有无叩痛，胃肠道充气情况，腹腔内有无积气、积液和肿块等。触诊是腹部检查的主要方法。浅部触诊系用手指掌面轻触腹壁，主要用于检查腹壁紧张度、抵抗感、浅表的压痛、包块、搏动和腹壁上的肿物。深触诊包括深压、滑动触诊和双手触诊等，用于检查腹腔内脏器大小、形态、压痛、反跳痛以及腹腔内包块等。注意：对于腹部正常与异常体征的表现及其临床意义请结合临床，参见教材。3何为脉压增大，脉压增大的临床意义。本题主要考查的是脉压的概念，以及
9、脉压增大的临床意义。脉压是指动脉收缩压与舒张压的差值，通常为3040mmHg，所谓脉压增大就是脉压大于40 mmHg。脉压增大主要见于主动脉瓣关闭不全、动脉导管未闭、动静脉瘘、甲状腺功能亢进、严重贫血和主动脉硬化等。注意：由于存在个体差异，许多正常人的脉压常常大于40mmHg，因此不能根据脉压的增大或减小来确诊疾病。4、导致营养不良的主要原因是什么?本题主要考查的是哪些原因可以导致营养不良，其中主要是病理性的。营养不良：临床表现为消瘦，重者可呈恶病质。其发生主要是由于摄食不足或消耗增多。多见于长期或严重的疾病，如消化遭疾病所致摄食障碍或消化吸收不良，神经系统、肝、肾病变引起的严重恶心和呕吐，活
10、动性结核、肿瘤、糖尿病、甲状腺功能亢进症等所致的热量、蛋白质、脂肪消耗过多等。注意：营养不良要从多个角度考虑，找到主要原因，治疗原发疾病是根本，在给予营养支持。5、如何鉴别黄疸与其他原因所致的皮肤或巩膜黄染。本题主要考查的是在对患者查体过程中如何鉴别黄疸与其他原因所致的皮肤或巩膜黄染，主要考虑以下一些因素：因胆道阻塞、肝细胞损害或溶血性疾病致血清内胆红素浓度增高而使皮肤黏膜乃至体液及其他组织黄染者为黄疸。黄疸引起的黄染首先出现于巩膜、硬腭后部及软腭黏膜，随血中胆红素浓度继续增高，黄染更明显时才见于皮肤。黄疸所致的巩膜黄染是连续的，近角巩膜缘处黄染色淡，远离角巩膜缘处黄染色深。此外，过多食用胡萝
11、卜、南瓜、橘子等使血中胡萝卜素含量增高，或长期服用阿的平、呋喃类等含有黄色素的药物也可引起皮肤黄染。前者所致的黄染多见于手掌、足底、前额及鼻部皮肤，一般不出现于巩膜和口腔黏膜，后者黄染首先出现于皮肤，重者也可出现于巩膜，但近角巩膜缘处黄染色深，远离角膜缘处黄染色淡，此为与黄疸的重要区别。注意：对于皮肤或巩膜黄染也要综合考虑。电大天堂【健康评估】形考作业三：1自我概念的评估的内容和常用方法有哪些？本题主要考查的是自我概念的评估内容，护理人员通常用哪些方法去对病人进行自我概念的评估。一般采用问诊、观察、画人测验、评定量表测评等方法对个体身体意象、社会认同、自我认同以及自尊等方面进行综合评估，以了解
12、个体对自我概念的感知与评价、影响个体自我概念的相关因素及个体自我概念方面现存的或潜在的威胁。问诊是为了解被评估者自我概念主观资料的方法；观察法用于收集患者外表、非语言行为以及与他人的互动关系等与自我概念有关的客观资料；画人测验适用于儿童等不能很好地理解和回答问题者，让患者画一个人像并对其进行解释，从中了解患者对身体意象改变的理解与认识。常用的可直接测定个体自我概念的量表有Rosenberg自尊量表、Pieer-Harries的儿童自我概念量表、Michigan青少年自我概念量表以及Coopersmith青少年自尊量表等。注意：每个量表都有其特定的适用范围，应用时应仔细选择。2简述角色适应不良的
13、定义、常见类型和表现。本题主要考查的是角色适应不良的概念、常见类型和表现。角色适应不良指发生于个体的角色表现与角色期望不协调或无法达到角色期望的要求时，是由来自社会系统的外在压力所引起的主观情绪反应。常见类型和表现有：1）角色冲突：为角色期望与角色表现之间差距太大，使个体难以适应而发生的心理冲突与行为矛盾。2）角色模糊：是指个体对角色期望不明确而知道承担这个角色所致的不适应反应。3）角色负荷过重和角色负荷不足：角色负荷过重是指个体角色行为难以达到过高的角色期望。角色负荷不足则是对个体的角色期望过低，不能完全发挥其能力。4）角色匹配不当：是指个体的自我概念、自我价值观或自我能力与其角色期望不匹配
14、。角色适应不良的表现：角色适应不良时可发生角色紧张，在生理方面表现为疲乏、头痛、头晕、睡眠障碍、心率加快、心律异常、血压升高等症状和体征；在心理方面表现为焦虑、紧张、易激惹、抑郁、自责或绝望等不良情绪。注意：角色负荷过重或不足是相对的，与个体的知识、技能、经历、观念以及动机是否与角色需求吻合有关。3如何对影响个体健康的环境因素进行评估？本题主要考查的是如何对影响个体健康的环境因素进行评估，通常采用问诊、实地考察和量表评定等方法对环境进行评估。（1）通过问诊了解是否存在影响患者健康的物理环境（家庭和工作环境）和社会环境（经济、教育水平和生活方式）因素。（2）通过实地考察可补充问诊的不足，全面了解
15、个体所处的工作、家庭或医院环境中是否存在健康危险因素。（3）量表评定：如通过跌倒危险因素评估表评估病室中有无引起病人跌倒的危险因素。量表填写以“”表示存在，“”表示没有或不适用，“不详”表示资料待查，必要时注明脚注编号。当病人有表中所列的跌倒危险因素时，请填写此表并每周评估1次，直到出院。注意：通过问诊、实地考察，我们可以获得许多与病人相关的环境资料，我们要注意区分主次，努力找出影响患者健康的危险因素。4文化休克的定义，病人产生文化休克的原因是什么？本题主要考查的是文化休克的定义，病人是为什么会产生文化休克。文化休克指人们生活在陌生文化环境中所产生的迷惑与失落的经历。常发生于个体从熟悉的环境到
16、陌生的环境，由于沟通障碍、日常活动改变、风俗习惯及态度、信仰的差异而产生的生理、心理适应不良。对于住院病人，医院就是一个陌生的环境。与家人分离、缺乏沟通、日常活动改变、对疾病和治疗的恐惧等可导致住院病人发生文化休克。如：病人刚入院，对医生、护士、环境、自己将要接受的检查或治疗都很陌生，还可能会一下接触许多新名词，如备皮、X线胸部透视，核磁共振等，都会使病人感到迷茫。经过一段时间病人开始意识到自己将住院一段时间，对疾病和治疗转为担忧，因思念家人而焦虑，因不得不改变自己的生活习惯而产生受挫折感。注意：患者产生文化休克的原因很多，护理人员应当在医患沟通的过程中发现最主要的原因，帮助他们解决心理上的问
17、题，适应新的环境。电大天堂【健康评估】形考作业四：1简述血液标本采集的类型、时间及采集部位。本题主要考查的是血液标本采集的类型、时间及采集部位。类型：血液标本按性质可分为全血、血浆和血清3种类型。血液标本的采集时间通常情况下采血时间以上午79时较为适宜。考虑到体位和运动对检验结果的影响，静脉血液标本最好于起床后1h内采集，门诊病人静坐半小时以后再采血。血液标本的采集部位：（1）静脉采血：是目前最常用的采血方法，首选的采血部位是肘部静脉，肘部静脉不明显时可用腕部或踝部等处的静脉。（2）皮肤穿刺采血：又称毛细血管或末梢采血。一般使用采血针，在消毒后的指端或耳垂等部位采集血液。（3）动脉采血：主要用
18、于血气分析。多在股动脉，有时也在桡动脉或肱动脉采血。采集的血液标本必须与空气隔绝，立即送检。注意：不同的血液测定项目对血液标本的采集时间有不同的要求2简述常用的6个心前区导联探查电极的放置部位。本题主要考查的是常用的6个心前区导联探查电极的放置部位，对医务人员熟练进行心电图检查有非常重要的意义。心前区导联的电极位置导联名称正极（探查电极）负极V1胸骨右缘第4肋间中心电端V2胸骨左缘第4肋间中心电端V3V2与V4连线中点中心电端V4左锁骨中线平第5肋间中心电端V5左腋前线与V4同一水平中心电端V6左腋中线与V4同一水平中心电端注意：有些患者可能由于生理或病理上的原因，心脏大小、位置可能发生变化，
19、在做心电图时要特别小心。3病员男性，21岁，1天前因进餐后半小时开始感上腹部不适，伴恶心、呕吐，继而出现腹泻，为黄色水样便，急诊以“急性胃肠炎”推送入院。入院查体：急性痛苦病容，精神差，眼眶凹陷，皮肤无弹性，T36.，P120次分，R20次分，BP8055mmHg。问：该病人的护理评估要点有哪些?提出主要的护理诊断。本题主要考查的是急性胃肠炎的护理诊断和护理评估的综合分析题。护理评估的要点：主要从病史、身体评估和有关检查来进行。（1）腹痛的缓急，诱发因素，疼痛的部位、性质、持续时间、伴随症状（恶心、呕吐）；（2）腹泻的次数、量、大便的性状（黄色水样便）；（3）身体评估（急性痛苦病容，精神差，眼
20、眶凹陷，皮肤无弹性，T36.，P120次分，R20次分，BP8055mmHg）。护理诊断：（1）疼痛：上消化道粘膜炎症有关；（2）腹泻：与胃肠道炎症有关；（3）组织灌注异常：脱水、低血压，与大量腹泻有关；（4）营养失调。4叙述心电图的各波段的名称与临床意义。本题主要考查的是心电图的各波段的名称与临床意义，对各种心脏病的诊断有非常重要的意义临床心电学对这些波段规定了统一的名称：P波：最早出现的振幅较小的波，反映心房除极过程的电位变化；PR段：自P波终点至QRS波群起点间的线段，反映心房复极过程及房室结、希氏束、束支的电活动；PR间期：自P波起点至QRS波群起点间的线段，反映自心房开始除极至心室开
21、始除极的时间； QRS波群：为振幅最大的波，反映心室除极过程的电位变化。ST段：自QRS波群终点至T波起点间的线段，反映心室早期缓慢复极过程的电位变化； T波：为ST段后一个圆钝而较大的波，反映心室快速复极过程的电位变化；J点：QRS波与ST段的交点，用于ST段偏移的测量；QT间期：自QRS波群起点至T波终点的水平距离，反映心室除极与复极过程的总时间。U波：为T波之后出现的振幅很小的波，反映心室后继电位，其产生机制尚不清楚。注意：心电图不能完全作为诊断心脏疾病的标准，其中最主要的P波的位置、PR段、QRS波群、PR间期、ST段。Visa-free policy brings Chengdu b
22、iz, tourism boost. Making national headlines several times, Chengdus 72-hour visa-free policy has attracted wide attention from both Chinese and foreign experts and businessmen since it took effect on Sept 1 last year. The program permits citizens from 51 countries and regions including the United S
23、tates, Australia, Canada and Japan who have valid visas and flight tickets to a third country to spend three days in the city. The capital of Sichuan province is the first city in the western region of China to offer foreign tourists a three-day visa and the fourth nationwide to adopt the policy fol
24、lowing Shanghai, Beijing and Guangzhou. Li Zhiyong, deputy dean of the tourism institute at Sichuan University, said the move contributes to a large increase in the number of overseas tourists and raises the citys level of internationalization. The policy will also bring direct economic revenue, Li
25、said. Chengdu has many cultural legacies and is also a paradise for panda lovers with the worlds largest breeding and research center. Three days are long enough for foreign visitors to visit those iconic tourist spots, he noted. The city is home to the remains of the Jin sha civilization that dates
26、 back more than 3,000 years as well as the Qing cheng Mountains and the Du jiang yan irrigation system. Qing cheng has long been recognized as the birthplace of Taoism, Chinas ancient indigenous religion, while Du jiang yan is considered to be the oldest functioning water-control project in the worl
27、d. Chengdu ranked third in tourist facilities, management and services among 60 Chinese cities in a customer satisfaction survey released last year. But, Li added that efforts are still needed to develop more tourism products, improve English services and provide accurate translation of traffic sign
28、s and scenic billboards. Zhao Yun, chairwoman of British Chamber of Commerce Southwest China, told China Daily that his colleagues found the policy very convenient. A British client once flew here and stayed for just one day to check her ordered goods, she said. Zhao was born in Shanxi province, but
29、 she has lived in Chengdu for more than 10 years. My life was like a running race moving from place to place. I also lived in Beijing and Shanghai before, she said. But Chengdu is a place that you never want to leave once settling down. It is now my second hometown, she said. If the environment is f
30、urther improved, the city will attract more people to visit and live, with the 72-hour visa-free policy and compelling conditions in transportation, culture, climate and cuisine, he said. Foreigners also gave positive feedback on the policy. A spokesman from Dell Inc said the company has a global hu
31、b of operation in Chengdu, so the three-day visa has an immediate and positive influence on the companys business development. Rudy Buttignol, president of the public broadcasting company in British Columbia, Canada, said his work requires frequent travel to Chengdu and the policy makes the trips ea
32、sier. Data from the citys public security bureau shows some 100 foreign visitors enjoyed the 72-hour policy by the end of March, most of them from the United States, the United Kingdom and Germany. Chengdu also reported robust growth in its overall tourist industry last year. Official statistics sho
33、w that it received some 150 million tourists last year, an increase of 28 percent from 2012. Around 1.7 million came from abroad, an increase of 12 percent. Total revenue from tourism surpassed 133 billion yuan ($21.7billion). During his visit to Kazakhstan in September, Chinese President Xi Jinping
34、 proposed that China and Central Asia join hands to build a Silk Road economic belt to boost cooperation. The idea has been widely echoed in Central Asian countries, becoming an encouraging blueprint for Chinese areas along the Silk Road that has linked Asia and Europe for more than 2,000 years. In
35、the next three weeks, China Daily reporters will travel through the belt in China and in Kazakhstan, Uzbekistan and Turkey. They will show the progress and expectations of the countries, businesses and peoples on the route. Shaanxi - the start of the ancient Silk Road - has positioned itself as the
36、new starting point for the development of the Silk Road Economic Belt, which will strengthen Chinas cooperation with Central Asian countries, a senior official said. Shaanxi Governor Lou Qinjian said the province is fresh, rich and unique, as it was when it anchored one end of the ancient Silk Road.
37、 It is the best option for accommodating industrial transfers from East China or the world at large, he said on Wednesday in Xian.Lou held a joint interview with 27 media, including China Daily, the first in a series of interviews entitled Chinese Media Along the Silk Road. The interviews will be in
38、 Shaanxi and Gansu provinces and the Xinjiang Uygur autonomous region, as well as Kazakhstan, Uzbekistan and Turkey.The media group held the first interview on Wednesday morning in Xian, the starting point of the ancient Silk Road, a trade channel established more than 2,000 years ago linking China,
39、 Central Asia and Europe.请您删除一下内容，O(_)O谢谢！2016年中央电大期末复习考试小抄大全，电大期末考试必备小抄，电大考试必过小抄Basketball can make a true claim to being the only major sport that is an American invention. From high school to the professional level, basketball attracts a large following for live games as well as television covera
40、ge of events like the National Collegiate Athletic Association (NCAA) annual tournament and the National Basketball Association (NBA) and Womens National Basketball Association (WNBA) playoffs. And it has also made American heroes out of its player and coach legends like Michael Jordan, Larry Bird,
41、Earvin Magic Johnson, Sheryl Swoopes, and other great players. At the heart of the game is the playing space and the equipment. The space is a rectangular, indoor court. The principal pieces of equipment are the two elevated baskets, one at each end (in the long direction) of the court, and the bask
42、etball itself. The ball is spherical in shape and is inflated. Basket-balls range in size from 28.5-30 in (72-76 cm) in circumference, and in weight from 18-22 oz (510-624 g). For players below the high school level, a smaller ball is used, but the ball in mens games measures 29.5-30 in (75-76 cm) i
43、n circumference, and a womens ball is 28.5-29 in (72-74 cm) in circumference. The covering of the ball is leather, rubber, composition, or synthetic, although leather covers only are dictated by rules for college play, unless the teams agree otherwise. Orange is the regulation color. At all levels o
44、f play, the home team provides the ball. Inflation of the ball is based on the height of the balls bounce. Inside the covering or casing, a rubber bladder holds air. The ball must be inflated to a pressure sufficient to make it rebound to a height (measured to the top of the ball) of 49-54 in (1.2-1
45、.4 m) when it is dropped on a solid wooden floor from a starting height of 6 ft (1.80 m) measured from the bottom of the ball. The factory must test the balls, and the air pressure that makes the ball legal in keeping with the bounce test is stamped on the ball. During the intensity of high school a
46、nd college tourneys and the professional playoffs, this inflated sphere commands considerable attention. Basketball is one of few sports with a known date of birth. On December 1, 1891, in Springfield, Massachusetts, James Naismith hung two half-bushel peach baskets at the opposite ends of a gymnasi
47、um and out-lined 13 rules based on five principles to his students at the International Training School of the Young Mens Christian Association (YMCA), which later became Springfield College. Naismith (1861-1939) was a physical education teacher who was seeking a team sport with limited physical con
48、tact but a lot of running, jumping, shooting, and the hand-eye coordination required in handling a ball. The peach baskets he hung as goals gave the sport the name of basketball. His students were excited about the game, and Christmas vacation gave them the chance to tell their friends and people at their local YMCAs about the game. The association leaders wrote to Naismith asking for copies of the rules, and they were published in the Triangle, the school newspaper, on January 15,1892. Naismiths five basic principles center on the ba