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。
精神科护理：速成包
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。
1公式与方法
2练习题
1.精神科护理中等
A patient who started a high-dose corticosteroid (prednisolone or prednisone) a week ago is now euphoric, sleeping little and talking very fast. What should the nurse suspect?
- AAlcohol withdrawal
- BA normal reaction to feeling better from the treatment
- CMood changes caused by the corticosteroid
- DLithium toxicity
2.精神科护理困难
A patient who has taken haloperidol for many years now has repeated lip smacking and tongue movements. Which action is most appropriate?
- AIncrease the haloperidol dose, because a higher dose suppresses the abnormal movements of the mouth and tongue
- BReport the movements, assess them with a scale such as the AIMS and ask for a medication review
- CReassure the patient that the movements will soon stop on their own
- DGive benztropine, because it reliably reverses these movements
3.临床心理学中等
罗森汉的研究《On being sane in insane places》引发了对什么的担忧？
- A精神科诊断的效度
- B抗抑郁药的安全性
- C动物研究的伦理
- DCBT 的有效性
4.临床心理学困难
为什么心理学取向的支持者批评精神疾病的医学模式？
- A它完全拒绝使用药物
- B它否认大脑和生物学因素对行为或情绪有任何作用
- C它可能忽视心理和社会原因，并削弱人们的能动感
- D它只以梦的解析为基础
5.药理学中等
阿片类药物过量的解毒剂是哪种药？
- A氟马西尼
- B乙酰半胱氨酸
- C纳洛酮
- D阿托品
6.药理学困难
A patient taking digoxin has nausea, yellow-green vision and a dangerous arrhythmia. Which specific treatment can bind the drug?
- AProtamine sulfate
- BDigoxin immune Fab (antibody fragments)
- CFlumazenil
- DIntravenous vitamin K (phytomenadione) given slowly
3溶液
1.精神科护理
答案: C · Mood changes caused by the corticosteroid
为什么是这个答案
High-dose corticosteroids can cause mood changes, including mania, depression and psychosis. The nurse reports the change so the prescriber can review the dose and treatment.
答案
C · Mood changes caused by the corticosteroid
2.精神科护理
答案: B · Report the movements, assess them with a scale such as the AIMS and ask for a medication review
为什么是这个答案
These are signs of tardive dyskinesia, which can be permanent. Early detection and review of the antipsychotic are key; anticholinergic drugs do not treat tardive dyskinesia and may worsen it.
答案
B · Report the movements, assess them with a scale such as the AIMS and ask for a medication review
3.临床心理学
答案: A · 精神科诊断的效度
为什么是这个答案
自称听到一个词的假病人被收治并住院数周，表明诊断受情境影响。此后该研究的方法也受到质疑。
答案
A · 精神科诊断的效度
4.临床心理学
答案: C · 它可能忽视心理和社会原因，并削弱人们的能动感
为什么是这个答案
医学模式把障碍视为有生物学原因的疾病，这减少了指责，但可能忽视生活事件、意义和情境，并可能助长对药物的被动依赖。
答案
C · 它可能忽视心理和社会原因，并削弱人们的能动感
5.药理学
答案: C · 纳洛酮
为什么是这个答案
纳洛酮能逆转阿片类引起的呼吸抑制。氟马西尼逆转苯二氮䓬类，乙酰半胱氨酸用于对乙酰氨基酚过量，阿托品用于心动过缓或有机磷中毒。
答案
C · 纳洛酮
6.药理学
答案: B · Digoxin immune Fab (antibody fragments)
为什么是这个答案
Digoxin immune Fab binds digoxin in the blood and makes it inactive. It is used for life-threatening toxicity, such as serious arrhythmias or severe hyperkalaemia.
答案
B · Digoxin immune Fab (antibody fragments)
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