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 woman calls the emergency department after a sexual assault an hour ago. What advice helps to preserve forensic evidence?
一名精神分裂症患者拒绝服用抗精神病药,说它让他觉得迟钝。最佳的初始回应是什么?
哪种人格障碍的特点是普遍地漠视他人权利?
为什么 DSM-5 用单一的"物质使用障碍"取代了"物质滥用"和"物质依赖"?
When does oseltamivir give the most benefit in influenza?
Why is the TPMT enzyme often tested before azathioprine is started?
答案: B · Avoid showering or changing clothes, and bring any clothing already removed in a paper bag
Not washing, changing or eating where possible helps keep evidence. Paper bags are used because plastic traps moisture and can degrade biological evidence. Her medical needs and choices remain the priority.
答案: D · 了解他的原因和副作用,并告知团队,以便复核治疗
患者有权被倾听,并且在大多数情况下有权拒绝治疗。了解原因和副作用有助于团队复核治疗。只有在特定的法律和政策条件下才允许隐蔽给药。
答案: A · 反社会型人格障碍
反社会型人格障碍包括欺骗、冲动、攻击性和缺乏悔意,并在童年有品行障碍的证据。
答案: A · 研究发现这两个类别反映的是同一维度,用严重程度分级描述更好
研究表明,滥用和依赖的标准构成一个连续体。DSM-5 把它们合并为一种障碍,并按符合的标准数量评定严重程度。
答案: A · When started within 48 hours of the first symptoms
Neuraminidase inhibitors work best early, while the virus is multiplying. Started within 48 hours, they shorten illness; in high-risk or hospitalised patients they may still be given later.
答案: C · Low TPMT activity causes toxic levels and marrow suppression
Thiopurine methyltransferase helps inactivate azathioprine and mercaptopurine. People with low or absent TPMT activity need much lower doses or another drug to avoid life-threatening myelosuppression.
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