Fig. 39. Carrying out closed-chest cardiac massage

Rules of handling dead bodies

Biological death – the final stage finishing life – irreversible cessation of all processes of vital metabolism in cells and tissues, breakdown of albuminous substances and structures. Biological death comes right after clinical death. Biological death is verified by the doctor on the basis of all of the following signs.

1. Absence of spontaneous movements.

2. Cessation of respiration and heartbeat.

3. Maximal pupil dilatation, absence of eye reaction to light.

4. Fall of body temperature (to the level of environmental temperature).

5. Appearance of death spots.

6. Appearance of rigor mortis.

The first three signs are actually signs of clinical death. The following three – are proper signs of biological death which, however, appear rather late. The temperature of the dead body can remain high enough (if the environmental temperature is high); in some cases rigor mortis may not ensue. Therefore in real practice when rendering resuscitationactions biological death is verified on the basis of consensus (i.e. agreement) concluded at present by emergency physician.

The major reference point when verifying biological death is the time factor: 5 6 minutes from the circulatory arrest + 30 minutes of unavailing resuscitation actions.

Death spots on the skin of the dead body (of blue-violet color) appear as a result of posthumous streaming down of blood to the lower parts of body, of vasorelaxation and overflowing of skin vessels and suffusion of tissues near vessels by blood.

Rigor mortis (or cadaveric rigidity) is the process of posthumous induration of skeletal muscles and unstriated muscles of the internals that develops 2-6 hours after death starting with masticatory muscles. Rigor mortis remains for 3-9 days. Rigidity of the cardiac muscle develops in 30 minutes after death.

If the death of the patient occurred in the ward, other patients are asked to go out. The dead body is undressed, put on the back with unbent knees on a stretcher specially intended for this, its eyelids are closed, lower jaw is tied up, it is covered with a bedsheet and taken out to the sanitary room of the department for 2 hours (till death spots appear). Only after this the nurse writes the surname, initials and number of the case history on the hip of the dead body. Things and valuables are passed to the relatives of the deceased on receipt. The bedding from the bed of the deceased are passed for disinfection. The bed and bedside-table are wiped with 5 % solution of chloramine and the bedpan – is soaked in 5 % solution of chloramine.

It is not customary to hospitalize newly admitted patients on the bed where a patient recently died within 24 hours after death.

Pedagogical attestation testing materials for checking theoretical knowledge Of 2^nd year foreign students learning in intermediary language (English)

Subject “General Medical Attendance”

Speciality - 060101 (65) – “Medical Care”

1. Patients are admitted into the admission room:

1. Routinely;

2. Urgently.

2. The sanitary inspection room is equipped with:

1. A sink, a lavatory;

2. A bathroom;

3. A safe;

4. A set of tools for tracheostomy, bleeding control;

5. Bedpans;

6. Means for sanitization.

3.The procedure room must be equipped with:

1. A domestic refrigerator;

2. An electrocardiograph;

3. An endoscope;

4. A stand for intravenous infusions;

5. A safe for storage of drugs;

6. Bactericidal lamps;

7. A centrifuge;

8. A washstand with hot and cold water.

4.Who directs the work of nurses and aid-women?

1.Head doctor’s deputy on surgery;

2. Head of the department of surgery;

3. Surgeons;

4.Head nurse of the department of surgery.

5. Which definition reflects the term "deontology" most fully?

1. A science about due and about norms of behaviour among medical workers;

2. A science about due and about norms of treatment;

3. A complex of rules and norms of contacts with patients and their relatives;

4. A science about due, that is about norms of behaviour of the medical worker in various situations of contacts with colleagues, patients and their relatives.

6. Enumerate the main deontological principles:

1. Responsibility;

2. Charity;

3. Do not damage;

4. Hearfulness;

5. Patient confidentiality;

6. Ethic behaviour of medical personnel and students in surgical clinic;

7. Observance of laws of the Russian Federation and principles of morals.

7. Euthanasia is...

1. A complex of unintentional actions or inactions, that caused the death of the patient or anabasis;

2. Deliberate damnification of the patient’s health or life;

3. Purposeful killing of the patient doomed by grave incurable disease;

4. No correct definition is given.

8. Patient confidentiality is...

1. All the information received from the patient;

2. Information received from patients and their relatives;

3. All the information received from the patient and not presenting a threat for people and society.

9. What percentage of the general daily calorie content should dinner include?

1. 30%-40 %;

2. 40%-50 %;

3. 60 %;

4. 70 %;

5. Any.

10. What conditions does the hygiene of medical personnel depend on?

1. Water supply;

2. Illumination;

3. Ventilation;

4. sewerage system;

5. Installation of telephones.

11. Enumerate the measures aimed at decreasing the number of cases of intestinal infections:

1. Hospitalization of patients with intestinal infections in the specialized hospital;

2. Neutralization and cleansing of sewage from hospital;

3. Isolation of patients that are suspected of having an intestinal infection in the surgical hospital.

12. What is understood as personal hygiene?

1. Hygienic maintenance of the body;

2. Hygienic maintenance of underwear, clothes, footwear;

3. Hygienic maintenance of bedding;

4. Hygienic maintenance of the surrounding objects.

13. Name the norm of the area allocated for one couch in multi-seater wards:

1. 12 mІ;

2. 9 mІ;

3. 7 mІ;

4. 5 mІ;

5. Such norm does not exist.

14. Enumerate the measures aimed at maintenance of an optimum sound mode in wards:

1. To not slam the doors;

2. To not talk in wards and corridors;

3. To talk only in wards;

4. To wear soft footwear;

5. To wear a doctor’s smock;

6. To talk quietly;

7. To not jingle utensils, inventory;

8. To exclude the visits of relatives.

15. Enumerate the requirements made to hospital furniture:

1. To be comfortable for the patient;

2. To be convenient for medical personnel when attending the patient;

3. Must not become spoilt after washing;4. Must be immovable;

5. If possible the furniture should be upholstered;

6. The furniture must be white.

16. General cleaning in the ward is done:

1. Once a week;

2. Once a month;

3. Once in 3 days;

4. Once in 10 days;

5. Such cleaning is not done in the wards.

17. Specify volume of physical activity of patients at a strict confinement to bed:

1. Position - sitting in bed;

2. Position - lying on the back;

3. Position - lateral, raise of the head;

4. Movements of limbs in dorsal position;

5. Walking in the ward.

18. Specify permissible volume of physical activity of patients at semi-strict bed rest:

1. It is allowed to lie only dorsal position;

2. It is allowed to go up to the canteen and to the toilet;

3. It is allowed to get up and walk unrestrictedly in the department;

4. It is allowed only to lie and sit;

5. It is allowed only to lie on the back and laterally, to move the limbs in bed.

19. Specify the kind of the patient’s regimen in cases of acute heavy gastrointestinal hemorrhage:

1. General regimen;

2. Semi-strict bed rest;

3. An inactive confinement to bed;

4. A strict confinement to bed.

20. Which of the following can be used clean the patient’s skin integuments?

1. Camphor spirit;

2. Soap “K”;

3. Sodium benzyl-benzoate;

4. A cleanser as "Novost";

5. 1% salicylic spirit.

21. Enumerate the measures aimed at prevention of bedsores:

1. Early activization of patients;

2. Changing bed linen;

3. Exclusion in of strict confinement to bed in hospital;

4. Extermination of folds of bed linen;

5. Putting rubber rings under patient.

22. Enumerate the measures necessary for taking care of the patients’ skin integuments:

1. Daily wiping the skin with a solution of boric spirit;

2. Daily cleaning the skin with sodium benzyl-benzoate;

3. The general hygienic baths in satisfactory condition;

4. Cleaning the acoustic meatus if there is sulfuric secretion;

5. To exclude cutting nails due to danger of infecting fingers;

6. To completely exclude the cleaning of genitals and perineum.

23.Specify, with what it is necessary to irrigate eyes in cases of purulent conjunctivitis?

1. 1% solution of brilliant green;

2. 0,5% solution of hydrogen peroxide;

3. Boiled water;

4. A weak solution of potassium permanganate;

5. A weak solution of boric acid;

6. Eyes must not be irrigated.

24. Specify the most optimal measures of taking care of nasal passages and head hair-covering:

1. Removing the scabs from nasal passages;

2. Instilling drops into the noses of all surgical patients;

3. Washing hair on the head once in 5-10 days;

4. Washing hair on the head according to the doctor’s prescription;

5. A cutting and combing hair according to the doctor’s prescription;

6. Daily combing of hair, and their cutting as well in case of long hospitalization.

25. Specify with what it is necessary for the nurse to clean the mouths of seriously ill patients?

1. A solution of soda;

2. A solution Furacillin;

3. A cleanser as "Novost";

4. A solution of a boric acid;

5. A solution of formalin;

6. A special disinfectant solution;

7. It is not reasonable to clean the mouths of seriously ill patients.

26. What is paid attention when attending respiratory system?

1. Excursion of the thorax;

2. Timed inspiratory capacity;

3. The colour of skin integuments and mucous membranes;

4. Movements of the diaphragm;

27. Enumerate the demands made of transportation of patients:

1. Transportation is carried out with the head forward;

2. Transportation is carried out with the side forward;

3. Transportation of all patients is carried out lying on the back;

4. Transportation in a semi-sitting position is allowed in cases of certain pathology;

5. The participants of transportation must operate simultaneously when moving the patient;

6. When moving the patient to the bed, the head and thorax are moved first, then the other part of the body.

28. Give the most exact definition of artificial feeding:

1. Introduction of nutrients intravenously or hypodermically;

2. Introduction of synthesized artificial nutrients;

3. Introduction of nutrients with the help of tubes, parenterally;

4. Absence of the possibility of intake of the main nutrients in the physiological way.

29. Specify the volume of measures at detecting a patient with lice:

1. Shaving;

2. Cleansing with soap "K";

3. Cleansing with sulfuric ointment;

4. Clothes, linen and the patient are sent to the sterilizer room;

5. Only the patient’s clothes are sent to the sterilizer room;

6. The patient is sent to the infectious disease ward;

7. Hygienic bathing of the patient in a bath.

30. What is it necessary to have for gastric lavage?

1. A gastric tube;

2. Levin tube;

3. Glycerin;

4. Water;

5. A reservoir for washwater;

6. Nothing specially is needed.

31. How can the ingress of vomiting matters into the respiratory tracts be noticed?

1. Through an attack of cough;

2. Through respiratory standstill;

3. Cyanosis of skin integuments and mucous membranes;

4. Disturbance of respiratory rhythm and character;

5. Rise of arterial pressure;

6. Fall of arterial pressure.

32. Specify the signs of respiratory standstill:

1. Absence of chest excursion;

2. Cough;

3. Crimson color of skin integuments and mucous membranes;

4. Cyanotic color of skin integuments and mucous membranes;

5. Hemoptysis;

6. Tachycardia;

7. Vomiting.

33.That should the nurse do in cases of the patient’s tongue-swallowing?

1. To push the upper jaw a bit forward;

2. To push the lower jaw a bit forward;

3. To perform tracheostomy;

4. To perform intubation of trachea;

5. To call surgeon on duty;

6. To call the pulmonologist on duty.

34. Specify the functional duties of the nurse:

1. Periodic taking of the pressure and pulse;

2. Performing venesection;

3. Subclavian cathertization;

4. Observing the color of a skin and mucous membranes;

5. Not to let air pass into the infusion system;

6. To change the bottle with infusion medium opportunely;

7. To prescribe intravenous injections.

35. Specify the signs of acute cardiovascular insufficiency:

1. Sudden paleness of skin and mucous membranes;

2. Cyanosis of lips;

3. Cold sweat;

4. Rise of temperature;

5. Shallow breathing;

6. Fall of pressure;

7. Rise of pressure;

8. Blackout.

36. What is it necessary for the nurse to do when revealing the signs of acute cardiovascular insufficiency?

1. To cause the doctor on duty immediately;

2. To immediately prescribe infusion therapy and to introduce cardiotropic drugs;

3. To take an electrocardiogram immediately;

4. To carry out all orders of the doctor on duty.

37. Enumerate the possible symptoms of hemorrhage into the lumen of gastrointestinal tract:

1. Excretion of blood through Levin tube;

2. Vomiting with scarlet blood;

3. Vomiting with masses such as «coffee ground»;

4. Acholic stool;

5. Melanorrhagia.

38. Choose correct demands made of performing respiratory gymnastics:

1. When breathing in the hands are moved sideways;

2. When breathing in the hands are lifted upwards and one stands on the toes;

3. When breathing out one squats, bends the head forward, hands are lowered;

4. When breathing out hands are crossed in front touching lateral surfaces of the thorax;

5. 20 forced inhalations and exhalations are performed several times a day;

6. 20 respiratory movements are performed once in 24 hours (after sleep);

7. Respiratory movements are carried out till coughing starts.

39. Enumerate the duties of the nurse:

1. Introduction of antibiotics;

2. Giving sulfanilamides, expectorants;

3. Performing tracheostomy;

4. Performing intubation of trachea;

5. Control of carrying out the physiotherapeutic procedures;

6. Introduction of narcotic analgesics.

40. That must the nurse do if the patient has retrosternal pains?

1. Inform the doctor in charge of the case;

2. Prescribe an electrocardiogram;

3. Take an electrocardiogram and prescribe cardiac drugs;

4. To perform a rontgenoscopy of the thorax.

41. In which cases is a permanent urinous catheter installed?

1. At impossibility of independent urination;

2. At operations on organs of digestion;

3. At operations on the urinary bladder;

4. Only to men;

5. Only to women;

6. All patients after any operation.

42. In which cases is a permanent metal urinous catheter installed into the urinary bladder?

1. It is installed to all patients at impossibility of independent urination;

2. It is installed to men only;

3. It is installed to women only;

4. It is not installed at all;

5. It is installed only after operations on the urinary bladder;

6. It is installed only at children's age.

43. How and with what exactly is Levin tube washed out?

1. With the help of Esmarch's irrigator;

2. With the help of Janet's syringe;

3. With the help of a bucket;

4. Water;

5. A solution of Furacillin;

6. 3% solution of hydrogen peroxide;

7. Soda solution;

8. Solution of Iоdopironum.

44. Enumerate the states in which tympania is observed most often:

1. Enteroplegia;

2. Paralysis of urinary bladder;

3. Collapse;

4. Pulmonary collapses;

5. Acute iliac passion;

6. Hemorrhoidal bleeding.

45. Who installs the colonic tube?

1. The hospital attendant;

2. The nurse;

3. The doctor.

46. For how long is the colonic tube installed?

1. For 2 o'clock;

2. For 10 mines;

3. For 6-7 hours.

47. Enumerate the kinds of enemas according to their purpose:

1. Cleansing;

2. Analeptic;

3. High;

4. Medicinal;

5. Nutrient;

6. Oil;

7. Saline.

48. Enumerate the possible components of analeptic enema that stimulates peristalsis:

1. 10% solution of NaCl;

2. 0,9% solution of NaCl;

3. Soap water;

4. 3% solution of hydrogen peroxide;

5. 0,25% solution of Novocaine;

6. 3% solution of cholaramine.

49. Define hiccup:

1. The hiccup is an energetic and fast exhalation through the nose;

2. The hiccup is an energetic and fast inhalation through the nose;

3. The hiccup is a clinical display of twitching of the diaphragm as a result of irritation of the phrenic nerve, and causing a short inhalation when the fissure of glottis is narrow;

4. The hiccup is a vomiting with little masses due to irritation of the phrenic nerve, overfull stomach;

5. The hiccup is a clinical display of twitching of the diaphragm after irritation of the phrenic nerve, with full absence of breathing.

50. Enumerate the reasonable measures of fighting with hiccup:

1. Evacuation of the stomach through Levin tube;

2. Intubation of trachea;

3. Liquidation of stomach atony;

4. Fighting with intoxication;

5. Fundoplication;

6. Tracheostomy.

51. Choose the measures used to fight with hiccup:

1. Breath-holding;

2. Deep breaths;

3. Eating;

4. Drinking in small gulps;

5. Drinking in large gulps;

6. There are no special measures.

52. Enumerate the measures necessary for taking care of the patients’ skin integuments:

1. Daily wiping the skin with a solution of boric spirit;

2. Daily cleaning the skin with sodium benzyl-benzoate;

3. The general hygienic baths in satisfactory condition;

4. Cleaning the acoustic meatus if there is sulfuric secretion;

5. To exclude cutting nails due to danger of infecting fingers;

6. To completely exclude the cleaning of genitals and perineum.

53. Enumerate the actions aimed at prevention of inflammatory complications in the mouth cavity:

1. Rinsing the mouth with a soda solution;

2. Rinsing the mouth with a solution of Furacillin;

3. Rinsing the mouth with a solution of hydrogen peroxide;

4. Chewing lemon with peel;

5. Chewing elastic chewing rubber;

6. Cleaning teeth with tooth-paste;

7. Cleaning teeth with zinc paste.

54. Which of the following can be used clean the patient’s skin integuments?

1. Camphor spirit;

2. Soap “K”;

3. Sodium benzyl-benzoate;

4. A cleanser as "Novost";

5. 1% salicylic spirit.

55. Specify with what it is necessary for the nurse to clean the mouths of seriously ill patients?

1. A solution of soda;

2. A solution Furacillin;

3. A cleanser as "Novost";

4. A solution of a boric acid;

5. A solution of formalin;

6. A special disinfectant solution;

7. It is not reasonable to clean the mouths of seriously ill patients.

56. Specify the kind of the patient’s regimen in cases of acute heavy gastrointestinal hemorrhage:

1. General regimen;

2. Semi-strict bed rest;

3. An inactive confinement to bed;

4. A strict confinement to bed.

57. Enumerate the demands made of performing closed-chest cardiac massage:

1. It is performed at the speed of 60 pushes a minute;

2. It is performed at the speed of 100 pushes a minute;

3. It is performed at the speed of up to 30 pushes a minute;

4. The patient lies on a hard surface;

5. The patient must be on a soft bed;

6. Pushes are given in area of the lower third of the sternum;

7. Pushes are given 7 cm left of the sternum in 3-6 intercosts;

8. Pushes are given in area of the upper third of the sternum.

58. Enumerate the signs of biological death:

1. Absence of pulse only on radial arteries;

2. Absence of pulse on carotid and femoral arteries;

3. Absence of heart contraction;

4. Absence of breath;

5. Fall of body temperature.

59.Who was the first organizer of nursing service in Russia?

1) G.A. Zakharyin.

2) S.S.Zimnitsky.

3) N.I.Pirogov.

4) S.V. Kurashov.

5) M.Ya.Mudrov.

60. What does medical ethics study?

1. Interrelations between the doctor and the patient.

2. Problems of the duty, morals and professional ethics.

3. Iatrogenic diseases.

4. Interrelations between medical staff and the patient’s relatives.

5. All the above mentioned is correct.

61. What is iatrogenic disease?
1) The disease that developed as a result of a careless pronouncement of a medical worker about the patient or his illness or as a result of wrong treatment.

2) Nosocomial disease.

3) Complication of the main disease.

4) The disease transmitted from patient to patient.

5) Inherited disease.

62. The duties of the junior nurse of the admission room are:

1) Supervision over the sanitary regimen;

2) Accompanying the patient to the doctor’s consulting room and performing the patient’s cleansing;

3) Transportation and accompanying the patient to the necessary department;

4) All the above listed;

5) None of the above listed.

63. Work of the admission room must be done in the following order:

1) Registration of patients, sanitary-and-hygienic cleansing, medical examination;

2) Registration of patients, medical examination, sanitary-and-hygienic cleansing;

3) Sanitary-and-hygienic cleansing, medical examination, registration of patients;

4) Depending on the particular situation;

5) Ad arbitrium.

64. The temperature of water for a hygienic bath must be:

1) 27-29 °С;

2) 30-33 °С;

3) close to the body temperature (34-36 °С) or a little higher (37-39 °С);

4) 40-43 °С;

5) 44-46 °С.

65. The nurse’s post is organized on each:

1) 15-20 couches;

2) 20-25 couches;

3) 25-30 couches;

4) 30-35 couches;

5) 35-40 couches.

66. Cleaning wards is carried out:

1) In the damp way not less than 2 times a day;

2) In the damp way once a day;

3) In the dry way once a day;

4) In the dry way not less than 2 times a day;

5) In the dry and damp ways.

67. For preparation of 0,1% of working solution of bleaching powder:

1) 100 ml of 10% solution of bleaching powder is added to 9,9 l of water;

2) 200 ml of 10% solution of bleaching powder is added to 9,8 l of water;

3) 500 ml of 10% solution of bleaching powder is added to 9,5 л waters;

4) 1 l of 10% solution of bleaching powder is added to 9 l of water;

5) 1,5 l 10% solution of bleaching powder is added to 8,5 l of water.

68. Change of bed linen is carried out:

1) Not less than once a week;

2) Not less than once in 2 weeks;

3) At the request of the patient;

4) Every 3 days;

5) At the nurse’s discretion.

69. Occurrence of bedsores is a sign of:

1) Incorrectly prescribed treatment by the doctor;

2) Insufficient care of the patient;

3) Non-observance of the hospital regimen by the patient;

4) Wrong nutrition of the patient;

5) None of the above listed.

70. For bedsore prevention it is necessary:

1) To change the patient’s position every 2 hours;

2) To stretch bed sheets and bed linen;

3) To wipe the skin with disinfectant solution;

4) All of the above listed;

5) None of the above listed.

71. It is necessary to clean the patient’s ears:

1) Once a week;

2) 2-3 times a week;

3) Once a month;

4) 2-3 times a month;

5) Every day.

72. When there appear skin reddening in the sacrum area it is necessary:

1) To wipe the skin with a 10 % solution of camphor;

2) To wipe the skin with a damp towel;

3) To irradiate the skin with a quartz lamp;

4) To use all the enumerated;

5) None of the above listed.

73. In cases of duodenal ulcer with an increased secretion function of the stomach the following diet is prescribed:

1) №1;

2) №2;

3) №8;

4) №9;

5) №10.

74. Diet №15 is prescribed to patients with:

1) Diabetes;

2) Acute nephritis;

3) Chronic hepatites;

4) When there are no indications for prescription of a special diet;

5) Everything is incorrect.

75. Subfebrile temperature is a rise of temperature:

1) Up to 38°С;

2) From 38 up to 39°С;

3) From 39 up to 41°С;

4) More than 41°С;

5) From 40 up to 41°С.

76. The first period of fever is the period of:

1) Rise of body temperature;

2) Constant high body temperature;

3) Body temperature drop;

4) Normal body temperature;

5) Subnormal body temperature.

77. During the second period of fever it is necessary:

1) To wrap up the patient;

2) To put hot-water bottles on the limbs;

3) To hang an ice-bag above the head;

4) To apply mustard plaster;

5) To apply leeches.

78. The active substance of mustard plaster is:

1) Turpentines;

2) Hot water;

3) Allylic oil;

4) Ichthyol;

5) All of the above listed.

79. The time for which the burning tampon is placed inside the cupping-glass is:

1) 5 sec;

2) 1 sec;

3) 1 min;

4) 10 sec;

5) Till the edges of the cupping-glass are hot.

80. For emergency removal of leeches it is necessary to use:

1) Tweezers;

2) Alcohol;

3) Scissors;

4) Liquid nitrogen;

5) Chloroform.

81. The duration of applying damp compress should not exceed:

1) 24 hours;

2) 6-8 hours;

3) 12 hours;

4) 3 hours;

5) 5 minutes.

82. Cold water in balneotherapy:

1) Decreases the pressure;

2) Increases heart rate;

3) Has a tonic effect;

4) Has a sedative relaxing effect;

5) Causes distension of skin vessels.

83. How many layers should there be in the warming damp compress?

1)1 layer.

2)4 layers.

3)3 layers.

4) The more, the better.

5)5 layers.

84. The most suitable area for hypodermic injections is:

1) External surface of the shoulder;

2) Upper external quadrant of buttock;

3) Places where vessels are most close to the surface;

4) Internal surface of the forearm;

5) Forward surface of the hip.

85. How often is the current cleaning of the procedure room carried out?

1) Weekly.

2) 2 times day.

3) Once a day.

4) After each manipulation.

5) Every 8 hours.

86. What amount of water solution is in one table-spoon?

1) 20 gr.

2) 15 gr.

3) 25 gr.

4) 10 gr.

5) 5 gr.

87. What amount of solution is introduced intracutaneously?

1)3-5 ml.

2)5~10 ml.

3) Up to 1 l.

4)0,5-1 ml.

5)250 ml.

88. Under what angle to the skin surface is the needle introduced during intramuscular injections?

1) Almost in parallel.

2) 15°.

3) 45°.

4) 90° (perpendicularly).

5) 30°.

89. What concentration of alcohol is used for disinfection of medical instruments?

1)90 % solution.

2) 100 % solution.

3)96 % solution.

4) 40 % solution.

5) 70 % solution.

90. In cases of pulmonary hemorrhage all measures are prescribed except for:

1) Providing the patient with absolute rest;

2) Giving a semi-sitting position with an inclination to the sick side;

3) Putting a hot-water bottle to the sick party{side} of a thorax;

4) Applying a bubble with ice to the sick side of the thorax;

5) Introduction of haemostatics.

91. For the general analysis goes:

1) Daily sputum;

2) Sputum, collected during 3 days with the help of the flotation method;

3) Fresh morning sputum collected in a clean spittoon;

4) Fresh morning sputum collected into the Petri dish with a nutrient medium;

5) Evening sputum.

92. The pulse rate of healthy people in rest is:

1)50-80 a minute;

2)60-90 a minute;

3)80-100 a minute;

4)40-60 a minute;

5)100-120 a minute.

93. For a typical attack of stenocardia everything is most typical except for:

1) Retrosternal localization of pain;

2) Shooting-pain;

3) Appearance of pain at the peak of physical training;

4) Effect from taking nitroglycerine sublingually after 1-3 min;

5) Compressing character of pain.

94. The list of first aid actions in cases of pulmonary oedema includes all measures except for:

1) Giving the patient of a horizontal position;

2) Prescription of nitroglycerine (when the level of systolic pressure is not less than 100 mm of mercury);

3) Applying venous tourniquets on the lower limbs;

4) Carrying out oxygen therapy with antifoaming agent;

5) Introduction of diuretics.

95.Enumerate the measures that improve lung ventilation after operation:

1. Use of therapeutic physical training;

2. Early activation of patients;

3. Absolute bed rest;

4. Inflating balloons;

5. Use of respiratory gymnastics.

96. How many times is it necessary to repeat the procedure of gastric lavage with the siphon method?

1) 3 times.

2) Till running out of the water prepared for the procedure.

3) Till the water is clean.

4)10 times.

5)5 times.

97. If the patient coughs during introduction of thick gastric tube:

1) The tube is moved more deeply;

2) The tube is removed;

3) The patient is asked to make a deep breath;

4) An oxygen mix is served to the tube;

5) The patient is asked to hold breath.

98. To what depth is gastric tube introduced during gastric lavage?

1) 25 cm.

2) To the depth equal to the distance from the patient’s end of the nose up to the umbilicus.

3) 40 cm.

4) On the maximum possible depth.

5) 60 cm.

99. What is typical of gastrointestinal hemorrhage?

1) Frequent vomiting with stripes of hematochezia.

2) Vomiting with coffee ground.

3) Melanorrhagia.

4) Rare pulse.

5) Arterial hypertension.

100. In which cases faeces are not sent for examination on concealed blood?

1) Stomach ulcer.

2) Duodenal ulcer.

3) Cancer of the stomach, intestines.

4) Ulcer process in intestines in cases of typhoid fever and tuberculosis.

5 ) Haemorrhoids.

Answers.

1. 1,2 2. 1,2,5,6 3. 1,4,5,6, 7,8 4. 4 5. 4 6. 1,2,3,5,6 7. 3 8. 3 9. 1 10. 1,2,3,4 11. 1,2,3 12. 1,2,3,4 13. 3 14. 1,4,6,7 15. 1,2,3 16. 1 17. 2 18. 2 19. 4 20. 1,2,3,5 21. 1,2,4,5 22. 1,3,4 23. 4,5 24. 1,3,6 25. 1,2,4 26. 1,3,5 27. 1,4,5 28. 3 29. 1,2,5,7 30. 1,3,4,5

31. 1,3,4 32. 1,4,6 33. 2,5 34. 1,4,5,6 35. 1,2,3, 5,6,8 36. 1,4 37. 1,2,3,5 38. 1,4,5 39. 1,2,5 40. 1 41. 1,3 42. 4 43. 2,4,7 44. 1,5 45. 2 46. 1 47. 1,2,4,5 48. 1,3,4 49. 3 50. 1,3,4 51. 1,2,4 52. 2,3,4,7 53. 1,2,4, 5,7 54. 2,3 55. 4 56. 4 57. 1,4,6 58. 2,3,4,5 59. 3 60. 5 61. 1

62. 4 63. 2 64. 3 65. 3 66. 1 67. 1 68. 1 69. 2 70. 4 71. 2 72. 4 73. 1 74. 4 75. 1 76. 1 77. 3 78. 3 79. 2 80. 2 81. 3 82. 3 83. 3 84. 1 85. 2 86. 2 87. 4 88. 4 89. 5 90. 3 91. 3 92. 2

93. 2 94. 1 95.1,2, 4,5 96. 3 97. 2 98. 3 99. 3 100. 4

Literature fundamentally

1. Grebenev A.L., Sheptulin A.A., Chochlov A.M. The basics of general attending patients. – M.: Medicine, 1999. – 256 p.

2.Murashco V.V. Shuganov E.V., Panchenko A.V. General medical attendance. – M.: Medicine, 1989. - 224 p.

3. Oslopov V.N. Bogoyavlenskaya O.V. General medical attendance in therapeutic clinic. Manual М., 2008. – 464 p.

Literature complementary

1. Andreeva T.A. General medical attendance. M.: RIOR, 2005. – 79 p.

2. Bashmacov A.I., Chernov V.K. First aid – Alma-Ata: Kazahstan, 1990. – 190 p.

3. Buyanov V.M. First medical aid – M.: Medicine, 1981. – 250 p.

4. Davlicarova K.E. The basics of attending patients. First medical aid. M.: Forum, Infra-M, 2004/ - 368 p.

5. .Zalikina S.L. General medical attendance. – M.: Medicine, 1984. – 244 p.

6. Kolygin A.N. General medical attendance in therapeutic clinic. Manual for students, GOU VUNMC: 2006. - 223c.

7. Kosticina V.V., Menkov N.V. General medical attendance in therapeutic clinic. N.Novgorod: NGMA, 2000. – 48 p.

8. Muchina S.A., Tarnovscaya I.I. General medical attendance: Manual. – M.: Medicine, 1989. – 254 p.

9. Muchina S.A., Tarnovscaya I.I. A nurse manipulation technique atlas. – M.: «Anmi», 1995. – 256 p.

10. Pautcin Y.F. The elements of general medical attendance. M.: RUDN, 2003. –150 p.

11. Kuznecov I.M. First aid. – M.: RUDN, 2007. – 163р.

12. Nursing: Manual. / Yaroling I.V. - 6-edition, revised – M.: ONIKS, 2007. – 464 p.

13. Sumin S.A. Emergency medical service: Manual. M.: Moscow, «Liter», 1997. – 464 p.

14. Turcina N.V., Filenko A.B. General medical attendance: Manual, “KMK”, 2007. – 550c.

Назифуллин Виль Лутфиевич

Майорова Ольга Анатольевна

Шамсутдинов Альберт Рашитович

Терегулова Эльвира Назировна

Нуртдинова Гузель Масхутовна

Аглямова Дина Вилевна

Nasiphullin Vil Lutphievich

Majorova Olga Anatolievna

Shamsutdinov Albert Rashitovich

Teregulova Elvira Nazirovna

Nurtdinova Guzel Mashutovna

Aglyamova Dina Vilevna

Общий уход и наблюдение
за больными в терапевтической клинике

Учебное пособие

General medical attendance
and observation in therapeutic clinic

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Редактор Н.А. Брагина

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