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。
在精神状态检查中,“自知力”评估的是什么?
A patient with anxiety asks for her PRN lorazepam every time it is due. What is the best nursing approach?
哪种模式定义了双相 II 型障碍?
治疗师帮助一位惊恐障碍来访者坐在椅子上旋转,故意引发头晕,且不使用安全行为。这种技术叫什么?为什么使用它?
A patient with suspected sepsis has blood cultures ordered and a first antibiotic dose due. What should the nurse do?
A patient with heart failure starts taking naproxen regularly for back pain. Why is this a concern?
答案: B · 患者是否理解自己有精神健康问题并需要帮助
自知力是患者对自己疾病及其影响的认识。判断力是做出合理决定的能力,例如捡到失物钱包时该怎么办。
答案: B · Assess her anxiety each time, offer other coping strategies and give it if indicated
Each PRN dose requires an assessment of need and an evaluation afterwards. Offering other strategies supports coping skills, and patterns of use are discussed with the team.
答案: C · 至少一次轻躁狂发作和至少一次重性抑郁发作
双相 II 型需要有轻躁狂发作和重性抑郁发作,但没有躁狂发作。只要有一次躁狂发作就诊断为双相 I 型。
答案: D · 内感性暴露,使来访者认识到身体感觉并不危险
内感性暴露引发所恐惧的身体感觉,使来访者能够检验灾难化预测并产生习惯化。它是惊恐障碍 CBT 的核心组成部分。
答案: D · Take the blood cultures first, then give the antibiotic at once
Cultures are taken before antibiotics so the organism can be identified, but antibiotics must not be delayed in sepsis. Taking cultures quickly and then giving the antibiotic meets both aims.
答案: C · NSAIDs cause salt and water retention and can worsen heart failure
NSAIDs inhibit renal prostaglandins, causing sodium and water retention and reducing the effect of diuretics. They can trigger decompensation of heart failure and are usually avoided.
ExamProblems · examproblems.com/courses/mental-health-nursing