【练习】循环系统（三）
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点1：心肌代谢<span style="color: black;">阻碍</span>性<span style="color: black;">疾患</span>以糖尿病、心肌病最<span style="color: black;">平常</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点2：感染是慢性心力衰竭最<span style="color: black;">平常</span>和最<span style="color: black;">重点</span>的诱因，<span style="color: black;">尤其</span>是<span style="color: black;">呼气</span>道感染。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点3：左心衰竭最早<span style="color: black;">显现</span>的症状是劳力性<span style="color: black;">呼气</span>困难，经<span style="color: black;">休憩</span>后缓解。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点4：咳嗽、咳痰在左心衰竭<span style="color: black;">初期</span><span style="color: black;">就可</span><span style="color: black;">显现</span>，多<span style="color: black;">出现</span>在夜间，坐、立位可减轻。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点5：左心衰竭病人<span style="color: black;">初期</span>的痰液特点为白色<span style="color: black;">泡泡</span>样，如<span style="color: black;">出现</span>急性肺水肿，则咳<span style="color: black;">海量</span>粉红色<span style="color: black;">泡泡</span>痰，为肺泡和支气管淤血<span style="color: black;">导致</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点6：左心衰竭病人<span style="color: black;">显现</span>交替脉，是左心衰竭的特征性体征。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点7：右心衰竭病人<span style="color: black;">初期</span>在身体的下垂部位和组织疏松部位可出的凹陷陷性水肿。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点8：全心衰竭病人表现为右心衰竭的症状时，肺於血的临床表现可减轻。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点9：慢性心力竭x线<span style="color: black;">检测</span>中，<span style="color: black;">初期</span>肺静脉压<span style="color: black;">升高</span><span style="color: black;">重点</span>表现为肺门血管影<span style="color: black;">加强</span>；肺动脉压力<span style="color: black;">升高</span>可见右下肺动脉增宽。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考点10：慢性心力竭X线<span style="color: black;">检测</span>中，肺小叶间隔内积液可表现为KerleyB线是在肺野外侧清晰可见的水平线状影，是慢性肺淤血的特征性表现。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-5588fd17302f56c31c1454f4c7571f7f_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题1.法洛四联症患儿脑缺氧<span style="color: black;">爆发</span>时，应采取的体位是（D）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.俯卧位</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.平卧位</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.半坐卧位</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.膝胸卧位</p>E.侧卧位
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题2.房颤病人<span style="color: black;">重点</span>应观察（D）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.P波的频率</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.病人的主诉</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.血压的变化</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.心室率的改变</p>E.脉搏的改变
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题3.风湿性心脏病心房颤动病人<span style="color: black;">忽然</span>抽搐、偏瘫<span style="color: black;">首要</span>应<span style="color: black;">思虑</span>（D）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.心力衰竭加重</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.强心苷类中毒</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.低钾血症</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.脑栓塞</p>E.蛛网膜下腔<span style="color: black;">流血</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题4.高血压、动脉粥样硬化的老年<span style="color: black;">病人</span>，<span style="color: black;">膳食</span>需<span style="color: black;">重视</span>（E）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.高胆固醇<span style="color: black;">食品</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.高动物脂肪<span style="color: black;">食品</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.高糖<span style="color: black;">食品</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.高钠<span style="color: black;">食品</span></p>E.高钙<span style="color: black;">食品</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题5.高血压<span style="color: black;">病人</span>，65岁，<span style="color: black;">出现</span>广泛前璧急性心肌梗死3小时入院。下列哪种<span style="color: black;">状况</span>提示该<span style="color: black;">病人</span><span style="color: black;">不可</span>应用溶栓治疗（B）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.室性早搏二联律</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.血压180/115mmHg</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.3年前做过胆囊切除术</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.伴发急性左心襄竭</p>E.年龄大于60岁
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">解析：溶栓治疗适应证：发病<span style="color: black;">少于</span>6小时，年龄≤70岁，<span style="color: black;">没</span>近期（<2周）的活动性<span style="color: black;">流血</span>、脑卒中、<span style="color: black;">流血</span>倾向。禁忌证：糖尿病视网膜病变、活动性消化性溃疡、严重高血压未能<span style="color: black;">掌控</span>（血压>180／110mmHg）和严重肝、肾功能<span style="color: black;">阻碍</span>等。综合<span style="color: black;">以上</span>适应证和禁忌证，该<span style="color: black;">病人</span>的血压过高是其<span style="color: black;">不可</span>进行溶栓治疗的<span style="color: black;">重点</span><span style="color: black;">原由</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题6.各类休克的共同病理改变是（C）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.血压下降</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.脉压缩小</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.有效循环血量锐减</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.中心静脉压下降</p>E.血管张力降低
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">解析：各类休克的<span style="color: black;">一起</span>病理生理<span style="color: black;">基本</span>是有效循环血量锐减和组织灌注不足，以及由此<span style="color: black;">引起</span>的微循环改变、代谢变化和内脏器官继发性损害。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题7.鼓励<span style="color: black;">长时间</span>卧床的心力衰竭<span style="color: black;">病人</span>在床上作下肢活动，其目的<span style="color: black;">重点</span>是（D）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.减少回心血量</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.预防压疮</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.防止肌肉萎缩</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.防止下肢静脉血栓形成</p>E.及早恢复体力
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题8.关于冠心病<span style="color: black;">病人</span>保持大便通畅的叙述，不正确的是（C）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.卧床会使肠蠕动臧慢</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.<span style="color: black;">膳食</span>中需<span style="color: black;">增多</span>粗纤维<span style="color: black;">食品</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.便秘时采用<span style="color: black;">海量</span>不<span style="color: black;">保存</span>撒肠以导四</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.用力排便可诱发和加重心力襄竭</p>E.用力排便可诱发严重<span style="color: black;">心率</span>失常
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">解析：<span style="color: black;">海量</span>不<span style="color: black;">保存</span>灌肠是将500～1000ml溶液<span style="color: black;">经过</span>肛管，由肛门经直肠灌入结肠，刺激肠蠕动，清除肠腔粪便和积气；其目的是解除便秘、清洁肠道、稀释和清除肠道内的有害物质、降温等。冠心病（尤其是心肌梗死）是中老年人<span style="color: black;">平常</span>病，急性期<span style="color: black;">通常</span>都<span style="color: black;">需求</span>病人卧床<span style="color: black;">休憩</span>，却更加剧了便秘。若用力排便，易加重病情，<span style="color: black;">导致</span><span style="color: black;">心率</span>失常、心力衰竭、心绞痛<span style="color: black;">乃至</span>猝死等不良后果；若为<span style="color: black;">认识</span>除病人的痛苦，采用<span style="color: black;">海量</span>肥皂水不<span style="color: black;">保存</span>灌肠，病人<span style="color: black;">常常</span><span style="color: black;">不可</span>耐受，且排完一次便后，大便干燥还需灌肠，这会形成治疗<span style="color: black;">办法</span>与卧床<span style="color: black;">休憩</span>之间的矛盾。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题9.关于急性病毒性心肌炎<span style="color: black;">病人</span>的护理<span style="color: black;">办法</span><span style="color: black;">不当</span>的是（C）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.活动期应绝对卧床<span style="color: black;">休憩</span>4周~3个月</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.给予<span style="color: black;">饱含</span>维生索和<span style="color: black;">优秀</span>蛋白质<span style="color: black;">膳食</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.只要<span style="color: black;">病人</span>症状消失<span style="color: black;">就可</span><span style="color: black;">指点</span>其<span style="color: black;">起始</span>适当<span style="color: black;">增多</span>活动量</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.避免刺激性<span style="color: black;">食品</span></p>E.<span style="color: black;">重视</span>有<span style="color: black;">没</span><span style="color: black;">心率</span>失常和心功能改变
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">解析：急性病毒性心肌炎<span style="color: black;">病人</span>的护理<span style="color: black;">办法</span><span style="color: black;">包含</span>：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">①心电监护，<span style="color: black;">重视</span>观察有<span style="color: black;">没</span><span style="color: black;">心率</span>失常和心功能改变，<span style="color: black;">出现</span>严重缓慢型<span style="color: black;">心率</span>失常时，应做好急救准备；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">②<span style="color: black;">膳食</span>宜<span style="color: black;">选取</span>易消化、<span style="color: black;">饱含</span><span style="color: black;">优秀</span>蛋白质和<span style="color: black;">饱含</span>维生素的<span style="color: black;">食品</span>，避免刺激性；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">③活动期或伴有严重<span style="color: black;">心率</span>失常、心力衰竭者要绝对卧床<span style="color: black;">休憩</span>4周至2～3个月，待症状消失且心肌酶、病毒中和抗体、白细胞、红细胞沉降率等化验及体征恢复正常后，方可<span style="color: black;">逐步</span>起床<span style="color: black;">增多</span>活动量。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">考题10.关于小儿血压及<span style="color: black;">测绘</span><span style="color: black;">办法</span>，以下说法哪项是错误的（C）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A.血压与心搏出量及外周血管阻力<span style="color: black;">相关</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B.小儿血压较成人低</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C.<span style="color: black;">测绘</span>血压袖带的宽度应为上臂长度的1/3</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D.舒张压为收缩压的2/3</p>E.下肢血压比上肢高
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-4ab176fa985dfa112f2228e9d021ca9e_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
楼主的文章非常有意义，提升了我的知识水平。 回顾过去一年，是艰难的一年；展望未来，是辉煌的一年。
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