1.Urinary retention patients should not be catheterized more than how many milliliters at a time? Why? Answer: Urinary retention should not be catheterized more than 1,000 ml at a time. This is because a large amount of urination can lead to a sudden decrease in intra-abdominal pressure, and a large amount of blood stays in the blood vessels of the abdominal cavity causing a sudden drop in blood pressure, which can lead to collapse. In addition, the sudden decompression of the bladder can cause rapid congestion of the bladder mucosa, resulting in hematuria. 2.What are the complications of coma patients? Answer: Comatose patients are prone to: (1) decubitus ulcers; (2) respiratory complications, such as aspiration pneumonia; (3) corneal dryness, inflammation, ulcers or conjunctivitis; (4) stomatitis. 3.What is the purpose of choosing the correct lying position for the patient? Answer: The purpose of choosing the correct lying position is to make the patient: (1) feel comfortable and reduce fatigue; (2) alleviate the symptoms of certain diseases; (3) facilitate the patient’s examination, treatment and surgery. 4.What should be paid attention to when carrying patients with internal bleeding? Answer: The most common internal bleeding are: tuberculosis hemorrhage, upper gastrointestinal hemorrhage, liver and spleen rupture. Internal hemorrhage occurs mostly acute, the patient is often in a state of severe shock, so it is necessary to rescue every second, after the shock improves, and then carry. (1) If the hemorrhage of tuberculosis, known hemoptysis lesion is located on which side, should be placed on the affected side of the ice bag or sandbag compression to stop bleeding, before transporting a small amount of blood transfusion or intravenous injection of posterior pituitary heparin to stop bleeding, to take a semi-recumbent position, the head is tilted to the side to prevent sudden hemoptysis occurs asphyxiation. (2) In case of gastrointestinal hemorrhage, the patient should be placed in the head-high-feet-low position, so that the blood can flow to the abdominal cavity, and the patient should be steadily supported at the waist and back, avoiding the holding of the chest and abdomen, so as not to aggravate the hemorrhage. (3) If the liver and spleen rupture bleeding, because of its large amount of bleeding, shock occurs quickly, should also be the first blood transfusion rehydration, shock after the improvement of transportation. When liver rupture, take the right side position, when spleen rupture, take the left side position to reduce bleeding, if open splenic rupture, should be quickly with sterile warm water pads or hemostatic sponges filled with hemostasis and then transported. (4) Pay attention to the skin tube of the infusion set not to bend, keep the infusion smooth. 5.What is the cause of penicillin allergic reaction? Answer: Allergic reaction is caused by the interaction of antigen and antibody. Penicillin G is a kind of semi-antigen, which becomes a full antigen after entering into the body and combining with the tissue protein, stimulating the body to produce specific antibody, which exists in the body. When the allergic person meets the corresponding antigen into the body, the allergic reaction occurs. 6, penicillin anaphylaxis rescue points are? Answer: The key point is to be rapid and timely, on-site rescue. (1) Immediately stop the drug, lying down, keep warm, give oxygen inhalation. (2) Immediate subcutaneous injection of 0.1% epinephrine hydrochloride 0.5 ~ 1 ml, pediatric discretion. If symptoms are not relieved, inject 0.5 ml subcutaneously or intravenously every 20-30 minutes. At the same time, give dexamethasone 5 mg intravenously, or use hydrocortisone 200-300 mg added to 5%-10% dextrose solution for intravenous drip. (3) Antihistamine drugs: such as isoprinosine hydrochloride 25-50 mg or phenylephrine 40 mg intramuscular injection. (4) Acupuncture therapy: e.g. take Renzhong, Neiguan and other parts. (5) After the above treatment, the condition does not improve, blood pressure does not rise, need to expand blood volume, available dextrose. If necessary, use antihypertensive drugs, such as dopamine, alamine, norepinephrine and so on. (6) Respiratory stimulants, such as Niclosamide, Silymarin, etc. can be used for respiratory suppression. If necessary, artificial respiration or tracheotomy should be performed. (7) In case of cardiac arrest, intracardiac injection of cardiotonic agents and chest compressions should be performed. (8) When muscle tone is reduced or paralyzed, subcutaneous injection of neostigmine 0.5 ~ 1 mg. At the same time of resuscitation, the condition should be closely observed, such as the state of consciousness, blood pressure, temperature, pulse, respiration, urine output and general condition, etc., and the corresponding first aid measures should be taken according to the change of the condition. 7.How to prevent penicillin allergic reaction? Answer: (1) Ask about the history of penicillin allergy, and then do the allergy test later, where there is a history of allergy is contraindicated to do the allergy test. (2) Prohibit those who have positive allergy test. (3) Positive patients should be specially marked on their medical records and informed to the patients and their families. (4) Patients who have used penicillin and need to inject penicillin three days after stopping the drug should do the allergy test again. (5) Penicillin solution should be used now. 8.What is the concentration of streptomycin, tetanus antitoxin and cytochrome C skin test solution? Answer: Streptomycin skin test solution contains 250 units per 0.1 ml; tetanus antitoxin contains 15 international units per 0.l ml; cytochrome C contains 0.075 mg per 0.1 ml. 9, what is the elemental diet ? Answer: The elemental diet is a highly nutritious diet that can be absorbed directly without digestion, or elemental diet, even in the absence of digestive juices, can be completely absorbed by the small intestine. Its characteristics are: high nutritional value, comprehensive and balanced nutrients, clear composition, no dregs without fiber, compression, less feces, portable, easy to save. 10, the significance of the amount of fluid in and out of the memory? Answer: (1) The amount of fluid in and out of the record on the critical, coma, surgery, surgery and a variety of serious trauma patients provide an important basis for treatment, in order to observe the body’s needs and consumption is balanced and treatment response. (2) Adjustment of therapeutic measures, fluid intake and output, water electrolytes, acid-base balance and nutritional supply, etc., at any time to ensure the effectiveness of treatment. If you can not accurately record the amount of fluid in and out, it will cause wrong judgment to the development of the disease, bring disadvantage to the therapeutic measures, make the physiological and pathological changes, metabolic disorders, affecting the recovery of the lesion, so the significance of accurate recording of the amount of fluid in and out is very important. 11.Why should we strengthen the observation on the sudden drop of body temperature of patients with high fever? Answer: When the body temperature of hyperthermia patients suddenly drops, it is often accompanied by a lot of sweating, which causes a large loss of body fluids, and in the old and weak and cardiovascular disease patients are very likely to have a drop in blood pressure, rapid pulse, cold limbs and other defecation or shock manifestations, and therefore should be observed. Once the above situation occurs, immediately cooperate with the doctor for timely treatment. Inappropriate use of antipyretics, similar situations can occur, so patients with high fever should be careful with antipyretics. 12.Why should patients with chronic pulmonary heart disease take continuous low-flow oxygen? Answer: Because of long-term arterial carbon dioxide partial pressure increases, the respiratory center of carbon dioxide stimulation sensitivity decreases, mainly relying on hypoxia to stimulate the aortic body and the carotid sinus chemoreceptors, through the reflex to maintain respiration. At this time, if the patient is given high-flow oxygen, the partial pressure of oxygen will rise suddenly, and the hypoxia will be lifted, and the role of reflex stimulation of respiration through carotid sinus will be weakened or disappeared, resulting in respiratory pause or shallowness, and aggravating the carbon dioxide retention and respiratory acidosis, so the patient has to be given oxygen at a low flow rate. 13.What are the 7 main signals for early detection of tumor? Answer: 7 main signals of tumor: (1) change of urinary and bowel habits; (2) ulcers that do not heal for a long time; (3) abnormal bleeding or secretion; (4) fibrous growths or lumps in breast or other parts of the body; (5) dyspepsia or difficulty in swallowing; (6) warts and moles that are obviously changed; (7) frequent coughing or hoarseness. 14. Why should patients with left heart insufficiency take the semi-sitting position? Answer: Difficulty in breathing when lying down. Taking a high pillow position or semi-sitting position can reduce the return blood volume, reduce pulmonary congestion, the diaphragm decreases lung capacity increases, so that dyspnea is reduced. 15.What is sudden cardiac death? Answer: Sudden cardiac death refers to the sudden death of a patient who is originally healthy or whose lesion is in the process of significant improvement due to cardiac reasons. 16. What are the symptoms caused by low potassium? Answer:Low potassium can cause nausea, vomiting, limb weakness or paralysis, low blood pressure and cardiac arrhythmia. 17.What are the three major comorbidities in patients with myocardial infarction? Answer: (1) Acute heart failure: Dyspnea, coughing up pink foamy sputum, heart rate >120 beats/. (2) Cardiogenic shock: blood pressure drop, cold limbs, pale face. (3)Serious arrhythmia: ventricular premature beats more than 5 times/minute, may also appear multi-source ventricular premature bradycardia 40 ~ 50 times/minute and ventricular fibrillation. 18.What is hyperthyroid crisis and care? Answer: Hyperthyroidism patients with high fever (body temperature above 40 ℃), heart rate of 140 to 200 beats / min, irritability, vomiting, diarrhea, delirium, coma and other symptoms. If hyperthyroidism crisis occurs, report to the doctor promptly. Nursing care: oxygen, dehydration shock should be cared for according to shock, immediately replenish fluids, observe the changes of T, P, R, BP, high fever should be cooled down, blood pressure drop should be given to raise the pressure, and pay attention to the record of the amount of in and out. 19.What is pheochromocytoma and how to rescue it when it occurs? Answer: Pheochromocytoma is a tumor of chromophilic tissue in the adrenal medulla. During the seizure, oxygen should be given immediately, and ECG should be checked urgently, paying attention to whether there is myocardial infarction and arrhythmia, and observing closely the change of blood pressure. If there is paroxysmal hypertension, report to the doctor immediately, and take effective rescue measures and symptomatic treatment. And pay attention to the occurrence of complications, such as heart failure, arrhythmia, hypertensive encephalopathy, pulmonary infection and other abnormal changes. If there is pheochromocytoma crisis, blood should be drawn immediately to measure urea nitrogen, creatinine, blood glucose and so on, and avoid knocking and pressing the tumor site. 20.What should be paid attention to when using insulin to treat diabetes mellitus? Answer: The use of insulin in the treatment of diabetes mellitus should pay attention to the accuracy of the portion of the drug when pumping, and the injection site should be changed frequently in order to prevent the local tissue hardening, fat atrophy, so that the insulin malabsorption and affect the therapeutic effect; on the other hand, it should pay attention to the observation of the patient’s condition changes, whether there is an overdose of insulin and cause hypoglycemia. If the patient has panic, cold sweat, pallor, rapid pulse or even convulsion, coma, then it should be considered whether there is hypoglycemic reaction, and should be reported to the doctor immediately, and given oral sugar or injected 50% glucose according to the doctor’s instruction. 21.What is the meaning of DIC? What should be noted when applying heparin treatment? Answer: It is mainly due to the increase of blood coagulation, the formation of thrombus in microcirculation, which leads to the consumption of coagulation factors, and secondary fibrinolysis and bleeding clinical syndrome, called DIC. Heparin is a physiological anticoagulant substance in the body, when applying it, we should pay attention to the observation of prothrombinogen time, and the drug should be discontinued when it doesn’t coagulate for more than 30 seconds. 22. What are the clinical symptoms of acute leukemia? Answer: Acute onset, fever, anemia, bleeding tendency and wasting. Some adults and adolescents may have a slow onset of the disease, with symptoms of fatigue, sore throat, poor appetite, yellow face, mild epistaxis and bleeding gums. 23.What is stress ulcer? Answer: Stress ulcer is also called gastric or duodenal ulcer. It can be caused by trauma, shock, infection, burns, drugs, some serious diseases and alcoholism. Its occurrence and mucosal blood flow obstacles, mucosal barrier destruction, H + retrograde diffusion, etc., stress ulcer patients often do not have any gastrointestinal symptoms, mostly sudden abdominal pain, vomiting blood, black stools and even hemorrhagic shock, mostly for the size of the multiple publication of shallow ulcers, ulcers occur in the pylorus. 24.What are the common causes of acute upper gastrointestinal bleeding? Answer: ① ulcer disease; ② acute gastric mucosal lesions; ③ esophageal varices; ④ gastric cardia esophageal mucosal tear syndrome; ⑤ gastric cancer; ⑥ other (including diagnosis is unknown). 25. Why is it easy to cause acute attack of chronic pancreatitis by eating high protein and high fat food? Answer: Acidic foodstuffs, protein decomposition products and fats can stimulate the duodenal mucosa to produce pancreatic secretin, which acts on the pancreas through the blood circulation to secrete a large amount of pancreatic juice to enhance digestion. If patients with chronic pancreatitis enter high-protein and high-fat foods, they can increase the burden on the pancreas due to the large secretion of pancreatic juice, which will cause acute attacks. 26. What are the treatment principles of hepatic coma? Answer: bed rest, increase nutrition, give high sugar, high vitamin diet, limit protein intake, adjust electrolyte disorders, clean and wash the intestine, sodium glutamate or sodium arginine intravenous drip, correct the brain function disorders, pay attention to the treatment of cerebral edema, closely observe the renal function, and correct and treat the triggering factors at any time. 27.Why does cirrhosis cause vomiting blood? Answer:When liver cirrhosis has portal hypertension,side branch circulation is formed,and varicose veins can be formed under esophageal mucosa and gastric fundus mucosa. When the pressure of portal vein increases to a certain degree, the vein is easy to rupture and cause upper gastrointestinal hemorrhage due to some external stimuli. 28.What is pulmonary encephalopathy? Answer: Pulmonary encephalopathy is a syndrome caused by moderate or severe respiratory failure, with central nervous system dysfunction as the main manifestation. In addition to signs of respiratory insufficiency, there are neuropsychiatric symptoms caused by respiratory failure. The symptoms include impaired consciousness, partial pressure of carbon dioxide (PaCO2) >9.8 KPa, and PH value.