精神科护理
方法
- 判断是否存在即时风险:自杀、暴力、药物急症或躯体疾病。
- 先保障安全:观察、移除危险物品、缓和局面、停用有害药物、寻求帮助。
- 选择治疗性回应:承认感受、陈述现实,避免虚假的安慰和“为什么”式提问。
- 尊重权利:采用限制最少的方案,知情同意,以及保密及其限度。
公式表、每个专题的关键方法步骤和 6 道练习题,完整解答附在最后。
A man taking risperidone reports breast enlargement and his partner says he has lost interest in sex. Which effect is the most likely cause?
A patient with dementia repeatedly walks towards the ward exit, saying he must go to work. What is the most appropriate action?
根据克拉克的惊恐认知模型,惊恐发作源于:
华生和雷纳的"小艾伯特"研究常被引用来证明:
哪项体征是阿片类药物中毒的典型表现?
治疗类风湿关节炎的甲氨蝶呤每周服用一次。一名患者误将同样剂量每天服用。主要危险是什么?
答案: C · Raised prolactin
Blocking dopamine in the tuberoinfundibular pathway raises prolactin. This can cause gynaecomastia, galactorrhoea, menstrual problems and sexual dysfunction; risperidone and first-generation antipsychotics commonly cause it.
答案: B · Walk with him, acknowledge his concern and gently redirect him to an activity
Wandering often has a reason, such as a past routine, boredom or a physical need. Redirection, meaningful activity and a safe environment are preferred over restraint, which increases agitation and the risk of injury.
答案: A · 对正常身体感觉的灾难化误解
克拉克提出,人们把心悸或头晕等感觉解释为灾难即将来临的信号,这会加剧焦虑和这些感觉,形成恶性循环。
答案: B · 恐惧可以通过经典条件作用习得
白鼠多次与巨响配对出现后,艾伯特开始害怕白鼠,而且这种恐惧泛化到了相似的物体上。这项研究现在因伦理和方法问题而受到批评。
答案: B · 针尖样瞳孔
阿片类药物中毒的典型表现是针尖样瞳孔、呼吸缓慢或浅表以及意识水平下降。纳洛酮可以逆转这些作用。
答案: A · 甲氨蝶呤中毒引起的骨髓抑制和黏膜炎
甲氨蝶呤抑制二氢叶酸还原酶。每日服用会对骨髓和肠黏膜等分裂旺盛的组织产生毒性,可能致命。亚叶酸用作解救治疗。
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