Theoretical foundations of nursing. harm to health as a result of emergency

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The role and importance of the nurse is growing along with the general development and improvement of medical science. Currently, nursing staff must have more and more complex medical, pedagogical, psychological, technical knowledge and skills. The training of nurses belongs to the applied section of general medicine.

The duties of a nurse are full-fledged patient care, accurate fulfillment of medical prescriptions, it is necessary that her human qualities be combined with high professional skills. It should be philanthropic, kind, distinguished by a sense of mercy and compassion, competence, be constantly ready to help, relieve pain and suffering.

The basic principles of nursing have remained unchanged over the past decades. Only individual details of the nursing process are changing, which are constantly being improved. The position "without good care there can be no high level of medical process" remains the rule. But the nurse is not a variant of the "simplified" doctor. The knowledge acquired during training is only updated at the stages of subsequent confirmation or professional development, therefore, during the training and improvement, nurses need to have simple and accessible educational materials at hand that can be a useful practical guide in their daily work. The main task of the handbook is to help them in this work.

The activity of a nurse is aimed at alleviating the condition of the patient, restoring his health. At the same time, each patient is considered not just as a certain variant of the manifestation of the disease, but also as a person. In some cases, the outcome of the disease is determined precisely by the stage of nursing the patient. Properly organized work of nurses contributes to a faster recovery without additional costs, increases the social status of nursing staff in society. There are ethical and legal aspects of activity in the work of paramedical personnel. Ethical aspects are reflected in society through the ideals of good, accepted at the level of approval or condemnation. Legal aspects are based on the requirements of morality, some of them have received the force of law and approved by various legal acts. Under the conditions of conducting medical activities, ethics can somewhat smooth out the callousness of existing laws, replace existing laws to some extent, and contribute to the settlement of many problems.

Nursing personnel bear moral, administrative, civil and criminal responsibility for their activities. Moral responsibility is considered by society itself. The moral concept is determined by the level of culture of each person, the ability to introspection. Condemnation by society is more effective than material methods of punishment (imposition of fines, deprivation of certain rights, even freedom). Administrative responsibility provides for punishment for non-fulfillment or abuse of one's duties, which can lead to adverse consequences for the patient's health. Civil liability is one of the varieties of legal liability. Penalties are used in accordance with the Civil Code of the legislation of the Russian Federation. The damage caused to the health of the patient can be compensated morally and financially. The main articles of the Civil Code related to the activities of paramedical workers provide for liability in the following cases:

1) causing harm to health;

2) causing harm to health as a result of extreme necessity;

3) infliction of harm to health, taking into account the fault of the victim;

4) liability of a legal entity for the activities of its employee;

5) and also provides for compensation for damages and damages caused by the loss of a breadwinner.

Criminal liability concerns crimes and is determined by the Criminal Code of the Russian Federation. Crimes in the field of medicine constitute certain actions or inaction in the course of the medical process. The deontological aspects of activity are related to improving the quality of patient care. The term "deontology" (Greek deon - "due" Greek logos - "teaching") was introduced by the English priest Bentham in the 18th century. In a narrow sense, the concept of "deontology" is a part of social psychology and combines moral, moral, ethical and legal aspects of activity. Deontology includes issues of relationships with patients, medical ethics and aesthetics, medical debt, medical confidentiality, medical law, as well as pedagogical issues. The concepts of ethics and deontology are closely related. The deontological approach, based on knowledge of the characteristics of psychological reactions, provides a certain moral comfort to the patient and is the key to successful cooperation. The perspective situation of communication consists in the direct perception of each other by both subjects. Depending on the chosen line of communication (pleasant or unpleasant, mutual understanding or its absence, etc.), the outcome of treatment may be different. Medical deontology contains the following areas: medical employee and patient; medical employee and society; relationship between medical employees; medical employee and relative patient; self-esteem medical worker.

Sick - Thisnotsimplyan objectholdingmedicalmanipulation,butsubject,activelyinteractingwithmedicalstaff!

Communication can be communicative and interactive. Communicative communication consists in the exchange of information through the receipt and transmission of information, various intonations, crying, laughter, facial expressions and gestures, since external paraphernalia sometimes speaks more about the disease than the patient himself. Interactive contact is the interaction of two subjects. Here, special attention is paid to the problem of conflicts, the search for ways out of such situations. Equally important is the treatment of the patients themselves with the nursing staff. Not all patients know how to be polite, sometimes you have to deal with manifestations of outright rudeness. The nurse must be able to remain calm and not transfer negative attitudes to all patients. Any medical professional should strive to combine the abilities of a high-quality craftsman, polymath and actor. He must be able to present information in the right light, convince him of the need to perform certain medical procedures. An experienced nurse will never allow the possibility of an unfavorable course of the disease associated with negative influences on her part ( seirogeny). The help of a nurse is necessary not only for the patient, but also for his relatives. For example, in severe cases, when the life of patients "hangs in the balance", it is necessary to conduct conversations with relatives, to prepare for a possible unfavorable outcome. A nurse can give advice to both the patient himself and his relatives. A number of diseases involve a change in lifestyle and lifestyle. A nurse can help with her advice to adapt to the changed conditions of life.

In the nursing process, there is such a thing as " sister diagnosis " . It is set only on the basis of the subjective data of the patient, the main complaints, since the disease is considered as an external manifestation of the pathological condition. The action of the nurse is aimed at adapting the patient to the conditions of the disease. Therefore, the nursing diagnosis can change many times during the course of the disease, depending on the change in the patient's condition. In relation to medical instructions, the manipulations of a nurse can be dependent, independent and interdependent. dependent activity implies the direct implementation of doctor's prescriptions, independent - independent participation of the nurse in the treatment process, interdependent - coordinated actions of a nurse and a doctor.

Nurses should monitor the patient's reaction in response to various medical manipulations, know the opinion of patients about the interventions. The response of the patient is evaluated by the nurse at each manipulation. The success of the work of a nurse is largely determined by the variety of methods that she owns, the ability to match them to a particular patient. She needs to know the physiological value of the manipulations performed and apply them differentially, in accordance with the nature and characteristics of the disease. The nursing process should be controlled primarily by the nurse herself. She herself should determine the degree of achievement of the goals. For example, in the case of pain after the use of an anesthetic drug, it must necessarily control the patient's condition, reduce the severity of the pain syndrome. The nurse must be able to take the initiative in the fight for the lives of patients. In her work negligence, negligence, non-compliance with the procedure are unacceptable. She must timely understand all the doctor's prescriptions, strictly measure the doses of medicines, observe the time of their issuance; in the event of a significant deterioration in the patient's state of health, she must be able to calm him down, inspire him with confidence in a favorable outcome, and take the necessary measures to stabilize the patient's condition. Of considerable importance is the appearance of the medical staff: a clean gown, hair pulled under a headdress, and neatness soothe the patient.

MedicalsisternotIt hasrightson themistake. slightestnegligence,inaccuracy,carelessnessmayleadtoirreparableconsequences!

Functional duties of a nurse

Medical sister - This face, past training on program nursing learning, having sufficient qualification and right fulfill responsible work on service sick. Tasks, entrusted on the medical sister extremely multilateral.

homemedicalsister

The head nurse must have organizational skills and high professionalism. A person with a higher medical education in the specialty "Nursing" or with a secondary medical education in the specialty "General Medicine" and having a certificate in "Organization of Nursing", confirmed by the highest qualification category, is appointed to this position. The chief nurse is directly subordinate to the deputy chief physician for medical work and the chief physician. It should ensure the rational work of nursing staff, conduct regular rounds of departments, checking the quality of work of nurses. Tours can be carried out during the daytime and in the evening. In addition, the duties include organizing control over the advanced training of nurses, the expenditure of medicines and dressings. Together with the epidemiologist, the chief nurse monitors the observance of the sanitary and epidemiological regime in the departments, the implementation of organizing orders.

Seniormedicalsister

A person with a secondary medical education who has a diploma in the specialty "Nursing" or "General Medicine" and a certificate in the specialty "Organization of Nursing", confirmed by the highest qualification category, is appointed to this position. The senior nurse is subordinate to the head of the department, deputy chief physician for medical work, chief nurse. The orders of the head nurse are obligatory for the middle and junior medical staff of the department. In the department, she is a financially responsible person. The head nurse should:

1) to carry out direct management of the activities of the middle and junior staff of the department;

2) carry out the placement of personnel in the department from among the middle and junior staff;

nursing

3) in a timely manner to replace nurses and nurses who did not come to work;

4) keep records and ensure the safety of property and medical equipment of the department, timely repair of equipment;

5) control the timeliness and quality of fulfillment of doctor's prescriptions by nurses;

6) control the quality of sanitation of newly admitted patients;

7) to compile information on the movement of patients, to control the timeliness of the delivery to the archive of case histories of discharged patients;

8) draw up a work schedule and maintain a time sheet for employees of the department;

9) to control the implementation of the internal labor regulations by the middle and junior medical personnel and the observance of anti-epidemic measures;

10) ensure and strictly monitor compliance with the rules of asepsis and antisepsis by the staff of the department;

11) write out requirements to the hospital pharmacy for the necessary medicines, materials, tools, control their correct use;

12) ensure the correct storage and accounting of potent, poisonous and psychotropic substances;

13) monitor the implementation of the advanced training plan by the nursing staff of the department;

14) maintain the necessary accounting and reporting documentation;

15) participate in the work of the council of nurses of the hospital, scientific and practical conferences for nurses;

16) draw up a vacation schedule for employees of the department for a year, draw up disability sheets for staff;

17) monitor compliance with the rules of ethics and deontology by middle and junior medical personnel;

18) control the implementation of hygiene education and education of the population, promote a healthy lifestyle;

19) ensure the proper organization of the nutrition of patients, draw up portion sheets for the nutrition of patients, control the receipt and quality of food;

20) ensure the organization and control of the timeliness of medical examinations by the employees of the department.

wardmedicalsister

A person with a secondary medical education in the specialty "Nursing" or "General Medicine" and having the appropriate certificate is appointed to this position. The duties of a ward nurse include:

1) care and observation of patients in accordance with the principles of medical deontology;

2) timely and accurate fulfillment of the appointments of the attending physician;

3) participation in rounds of attending physicians;

4) sanitary and hygienic service for physically weakened and seriously ill persons;

5) reception and accommodation of newly arriving patients, checking the quality of the sanitization performed, familiarization with the internal regulations;

6) checking transfers to patients, preventing the intake of contraindicated products, monitoring the storage of products in refrigerators, bedside tables;

7) duty in the wards at the bedside of the patient;

8) control over the receipt of food according to the number of the dietary table prescribed by the attending physician;

9) control over the timely intake of medicines;

10) timely and accurate execution of medical documentation;

11) ensuring the safety, serviceability and readiness for use of medical instruments, overalls;

12) professional development, participation in scientific and practical conferences for paramedical personnel;

13) promotion of a healthy lifestyle among patients and their relatives.

MedicalsisterproceduralCabinet

A person with a secondary medical education in the specialty "Nursing" or "General Medicine" and having the appropriate certificate is appointed to this position. The procedural sister organizes the work of the office, performs the prescribed procedures. The duties of a procedural nurse include:

1) preparation of the treatment room for work;

2) carrying out prescribed medical procedures authorized for performance by paramedical personnel;

3) assistance in performing medical manipulations;

4) taking blood from a vein for diagnostic studies;

5) strict accounting and storage of medicines of groups A and B, ensuring the availability of emergency medical aid;

6) compliance with the rules of asepsis and antisepsis in treatment rooms;

7) preparation of medical devices, underwear for sterilization;

8) control of the sanitary and hygienic content of the treatment room;

9) maintaining the necessary accounting and reporting documentation;

10) professional development;

11) promotion of a healthy lifestyle among patients and their relatives.

Medicalsisteroperationalblock

A person with a secondary medical education in the specialty "Nursing" or "General Medicine" and having the appropriate certificate is appointed to this position. The work of an operating nurse is complex and requires clarity and organization from her. Each nurse must:

1) observe the rules of asepsis and antisepsis in the operating room;

2) to master the technique of preparation of suture and dressing material, technique and technique of blood transfusions;

3) assist in conducting endoscopic examinations;

4) know the course of all typical operations;

5) be able to apply all typical bandages, transport tires and plaster splints;

6) monitor the safety and serviceability of equipment, repair faulty equipment;

7) systematically replenish the operating room with the necessary medicines, dressings, linen and equipment;

8) directly participate in the operation as an assistant to the surgeon, if necessary, perform the duties of an assistant.

Fundamentals of nursing care

Illness and physical suffering often give rise to increased irritability in the patient, a feeling of anxiety and dissatisfaction, sometimes even hopelessness, dissatisfaction with the people around him. Medical personnel should be able to protect the patient from the influence of negative factors, to distract from excessive focus on their painful condition.

During hospitalization in a hospital, it is necessary to resolve the issue of how the patient is transported. With the possibility of independent movement, the need to use a stretcher or wheelchair does not arise. After admission to the reception department, sanitization is carried out. Subsequently, it is repeated every 7 days with a change of underwear. Depending on the condition, the patient is assigned a certain mode - strict bed, in which it is not even allowed to sit; bed, when you can move in bed without leaving it; semi-bed, allowing walking around the room; general, not significantly limiting the patient's motor activity. The less motor activity is limited, the more the patient's ability to self-service is preserved. However, this does not relieve nursing staff from the need for appropriate care, providing the diet and diet recommended by the doctor, monitoring the condition and fulfilling medical prescriptions.

The temperature in hospital rooms should be constant (within 18-20°C), relative humidity should be 30-60%. Rooms must be well ventilated daily. There should be daylight in the ward, which affects the mood and condition of the patient. The intensity of light decreases only in certain diseases of the eyes and nervous system.

Rooms should be cleaned at least twice a day. Window frames, doors, furniture are wiped with a damp cloth, the floor is washed or wiped with a brush wrapped in a damp cloth. Carpets, curtains and other items where dust can accumulate should be removed from the room or frequently shaken out or vacuumed. The volume of the sound of radios, televisions must be reduced, the conversation should not be loud.

Care behind body : if the patient is on bed rest, he is wiped daily with a sponge or towel moistened with warm water or some disinfectant solution (camphor alcohol, table vinegar, etc.). An oilcloth is placed before wiping. The skin is wiped sequentially, special attention is paid to the treatment of folds behind the ears, under the mammary glands in women, in the gluteal-femoral folds, armpits, interdigital spaces of the legs, perineum. After wet rubbing, the skin is wiped dry. In the absence of contraindications, patients wash themselves in the shower or take a hygienic bath. Hygienic baths are contraindicated in case of hemorrhagic syndromes expressed general exhaustion heart attack myocardium, acute cardiovascular insufficiency, violation cerebral blood circulation. The bath must first be washed, treated with a disinfectant solution. After use, washcloths and brushes are dipped in a disinfectant solution, for example, bleach solutions clarified 0.5% or chloramine 2%, and then boiled. The temperature of the water in the bath should be warm (about 38°C). The patient is helped to carefully immerse himself in the water; it is not recommended to leave him alone in the bath. If necessary, the patient is helped to wash. Washing in the shower is easier for patients to tolerate. The temperature in the bathroom should be comfortable, drafts should be avoided. Patients with urinary and fecal incontinence, as well as those on bed rest, should be washed at least twice a day with warm water or a weak solution of potassium permanganate from an Esmarch mug with a rubber tube and a clamp or a jug. Additionally, you must have a vessel, oilcloth, forceps, cotton swabs. With diaper rash in the inguinal areas, the skin is lubricated with sunflower oil, petroleum jelly, and baby cream. In the presence of weeping surfaces, use talc, baby powder. Places of skin redness, especially in bedridden patients, are wiped with camphor alcohol, lemon pulp, brilliant green solution, irradiated with quartz. For the prevention of incipient bedsores, the patient is placed on a rubber circle covered with a cotton pad. In this case, the sacrum should be above the center of the circle. For incontinence of feces and urine, a rubber vessel is used instead of a circle. It is very important to ensure that the patient does not remain in one position for a long time. It needs to be rotated. Linen in such patients should be changed at least once a week, with incontinence of urine and feces - several times a day after appropriate washing.

Needs attention care behind hair . Men should be cut short. Each patient should have an individual comb. Bedridden patients wash their heads in bed at least once a week. If hair lice are found, appropriate sanitization is carried out using insecticides. If the hair is short, then it is better to cut it and burn it. If pubic lice are found, the pubic hair is covered with abundant soapy foam and shaved off. The skin is washed with warm water and rubbed with sublimate vinegar (1: 300) or treated with ointments: sulfuric 33% or gray mercury 5-10%. After a few hours, the pubic area is washed with soap. Nail trimming is carried out with small scissors. After use, the scissors are wiped with alcohol, a 3% carbolic acid solution or a 0.5% chloramine solution.

Care behind eyes usually comes down to washing them with secretions that stick together eyelashes and form crusts on the eyelids. Washing is carried out with sterile gauze swabs moistened with a warm solution of boric acid 3%, in the direction from the outer corner of the eye to the inner one. Bedridden patients need to clean the nasal passages with a cotton turunda moistened with vaseline oil or glycerin.

Care behind cavity mouth : in seriously ill patients, after each meal, the oral cavity is treated with a cotton ball moistened with a weak solution of potassium permanganate, boric acid, soda or boiled water, food debris is removed from the oral mucosa and teeth. After that, the patient rinses his mouth. Treatment of the oral cavity is best done in a sitting or semi-sitting position. The neck and chest are covered with oilcloth, a tray or basin is placed under the chin. Bad breath is reduced by rinsing with a 2% soda solution. Removable dentures are removed at night, washed with soap.

Physiological departures : for bedridden patients, a vessel and a urinal are used. Before use, the vessel is rinsed with warm water, leaving a small amount of water in it. After the end of physiological administration, the perineal area is cared for, the vessel is washed, disinfected, for example, with a 3% chloramine solution or bleach and rinsed. In men, a urinal is more often used, which is located between the slightly spread hips with a tube towards the penis. Urine is poured out, and the urinal is washed and disinfected. To remove the ammonia smell, the urinal is periodically washed with a weak solution of hydrochloric acid.

Nutrition patients : you must follow a strict diet. At the same time, attention should be paid to the table setting or bedside table. For certain diseases, the corresponding treatment table is prescribed:

Zero table - the first days of the postoperative period during interventions on the stomach and intestines, semi-consciousness due to impaired cerebral circulation, craniocerebral injuries, and feverish conditions.

Table No. 1 - peptic ulcer of the stomach and duodenum in the stage of fading exacerbation and in remission; chronic gastritis with preserved and increased secretion in the stage of fading exacerbation; acute gastritis in the stage of remission.

Table No. 1a - exacerbation of peptic ulcer of the stomach and duodenum in the first 10-14 days, acute gastritis in the first days of the disease, exacerbation of chronic gastritis with preserved and increased secretion in the first days of the disease.

Table No. 1b - exacerbation of peptic ulcer of the stomach and duodenum in the next 10-14 days, acute gastritis in the next days of the disease, exacerbation of chronic gastritis with preserved and increased secretion in the next 10-14 days of the disease.

Table number 2 - acute gastritis, enteritis and colitis during the recovery period, chronic gastritis with secretory insufficiency, enteritis, colitis during remission without concomitant diseases of the liver, biliary tract, pancreas.

Table No. 2a - the diseases are the same as with table No. 2, characterized by a restriction of table salt to 8-10 g.

Table number 3 - chronic bowel disease, accompanied by persistent constipation during a period of mild exacerbation and remission, as well as accompanied by lesions of the stomach, liver, biliary tract, pancreas.

Table No. 4 - acute and chronic bowel diseases during profuse diarrhea and pronounced dyspeptic disorders, condition after intestinal surgery.

Table number 4a - chronic enterocolitis with a predominance of fermentation processes in the intestine. Compared to table number 4, carbohydrates and protein foods are more limited.

Table No. 4b - acute and chronic bowel diseases during an exacerbation, as well as when they are combined with damage to the stomach, liver, biliary tract, pancreas.

Table number 4c - acute bowel disease during the recovery period, the transition to a general diet, chronic bowel disease during remission.

Table No. 5 - chronic hepatitis of a progressive and benign course with signs of mild functional liver failure, chronic cholecystitis, cholelithiasis, acute hepatitis during the recovery period (when switching to a general diet).

Table No. 5a - the diseases are the same as with table No. 5, characterized by the restriction of salt and fat.

Table number 5shch (sparing) - postcholecystectomy syndrome with concomitant duodenitis, exacerbation of chronic gastritis, hepatitis.

Table No. 5g - condition after cholecystectomy with the presence of biliary stasis and hypomotor biliary dyskinesia.

Table No. 5p - acute pancreatitis in the stage of sharp exacerbation (energy value 1300-1800 kcal).

Table No. 5p - acute pancreatitis in the stage of subsiding acute phenomena and reducing pain (energy value 2300-2500 kcal).

Table number 6 - gout, uric acid diathesis.

Table number 7 (low-protein) - acute nephritis (after sodium-free days), exacerbation of chronic nephritis with edematous syndrome.

Table number 8 - varying degrees of obesity.

Table number 9 - diabetes mellitus (as a trial diet, with the exception of pre - and post-comatose conditions).

Table number 9a - diabetes mellitus (in overweight patients).

Table number 9b - diabetes mellitus (in patients receiving insulin).

Table number 10 - heart disease, cardiosclerosis, hypertension I and II degree with not pronounced signs of circulatory failure.

Table number 10a - diseases of the cardiovascular system, accompanied by circulatory failure II and III degree.

Table No. 10c (anti-atherosclerotic) - atherosclerosis of the coronary, cerebral and peripheral vessels, aortic atherosclerosis, atherosclerotic cardiosclerosis.

Table number 10i - myocardial infarction.

Table number 11 - pulmonary tuberculosis, the period of recovery after a severe long-term illness (with exhaustion, anemia, etc.).

Table number 12 - diseases of the nervous system.

Table number 13 - acute infectious diseases, a condition after extensive diseases (but not in the gastrointestinal tract).

Table number 14 - phosphaturia.

Table number 15 - a common table, is prescribed for diseases that do not require a diet.

The nurse monitors the patient's condition. She must inform the doctor about all changes in his condition. Patients of elderly and senile age require special attention. Many diseases in them proceed atypically, without a pronounced temperature reaction, with the addition of severe complications. This group of patients is characterized by increased irritability, which requires special attention and patience on the part of nurses. The prescribed drugs must be given within a strictly defined time frame, all prescribed procedures must be performed.

Technique for basic medical manipulations

Autohemotherapy

Autohemotherapy - application own blood sick for therapeutic goals. Blood is taken with a syringe from the cubital vein and immediately injected intramuscularly (or subcutaneously), usually in the buttock. The initial dose of the taken blood is 2 ml. Every 2-4 days (depending on the reaction), the injections are repeated, the dose of blood taken is increased by 1-2 ml with each subsequent session. The maximum dose of blood taken is 10 ml. After that, the amount of blood taken is gradually reduced, also by 1-2 ml every 2-4 days. At the administered dose of 2 ml, the autohemotherapy procedure ends. The general course of treatment ranges from 5 to 10 injections.

Banksdry

Banks dry apply usually on the region back, lateral departments chest cells, lower back. The skin is wiped with alcohol and lubricated with petroleum jelly. Negative pressure in the jar is created by inserting and withdrawing a lighted cotton swab dipped in denatured alcohol, after which the jar is quickly applied to the skin. Banks are left for 10-20 minutes. In order to remove the jar, the skin is pulled from one end, and the jar is deflected to the other side. After removing the jars, the skin is wiped with a towel.

Bougienage

Bougienage - extension constricted lumen tubular bodies (esophagus, urethra) through metal or soft elastic bougie.

Bathswatersimple

Baths water simple - treatment water. Baths are common, local, semi-baths.

At general baths, the patient is immersed in water to the level of the nipples. Depending on the temperature of the water, shared baths are cold ( 24-27°C), cool ( 28-32°C), lukewarm ( 33-35°C), warm ( 36-38°C) and hot ( 39-40°C). At semi-baths the patient is immersed in water up to the waist. Half baths are often combined with dousing and rubbing. Local baths are manual, foot, sedentary in form cold ( 10-15°C), hot ( 40-45°C), variables with alternating action of cold and hot water. The duration of water baths ranges from 5-10 to 45 minutes.

Bathsmedicinal

Baths medicinal in dependencies from added medicinal drugs share on the salty, coniferous and other kinds baths. With salt baths, 2-5 kg of table salt is added to 300 liters of water. In coniferous baths, 25-100 g of powder containing coniferous extract is poured into warm fresh or salt water, or 2 tablespoons of liquid extract are poured.

Venipuncture

Venipuncture - puncture veins, held with diagnostic goal (fence blood for research), for transfusions blood, introductions various medicinal substances. The puncture is more often carried out in the elbow bend or the rear of the hand and foot. Before the procedure, the skin is treated with alcohol. For better identification of the vein, the limb above the puncture site is pulled with a tourniquet. When taking blood, the tourniquet is left until the end of the procedure, when infusing, the tourniquet is removed after the needle enters the vein. It is better to use needles with a short cut.

intravenousinfusion

intravenous infusion - introduction big quantities liquids or medicinal solutions intravenously.

Rubbing

Rubbing - way introductions medicinal substances through skin. A small amount of the medicinal substance is applied to the skin after preliminary washing it with hot water and soap and the agent used is rubbed in the direction of the lymph flow. This procedure is carried out daily or every other day.

Gas outlet

Gas outlet - way removal gases from intestines. A thick rubber tube, lubricated with fat, is inserted into the anus to a depth of 25-30 cm, leaving 10-15 cm outside. The end of the tube is lowered into a bedpan. The patient lies on his back. The tube is left in the rectum for 1-2 hours, after which it is removed. Before the introduction of the gas outlet tube, a siphon enema should be made.

mustard plasters

mustard plasters superimposed usually on the region chest cells, back, neck. Dry mustard plaster is moistened with water and applied to the skin for 10-30 minutes. To prepare mustard plaster (fresh), dry mustard is mixed with a small amount of water. The resulting slurry is smeared on a cloth or paper, applied to the corresponding area of the skin and a piece of compress paper is applied on top. Mustard plaster is left for 5-30 minutes, depending on the sensitivity of the skin.

Mud treatment

Mud treatment - usage mud various origin with medical goal. Silt, peat and volcanic muds are used. The mud is heated according to the principle of a water bath, as well as with the help of steam, electric current, and sunlight. For mud therapy, the application method is usually used at a mud temperature of 40-50°C. The duration of the procedure is 15-30 minutes. At the end of the procedure, a shower is taken, rest is assigned. Mud baths (liquid, medium, thick), mud medallions, rubbing the body with mud in combination with sunbathing are used.

Injections

The introduction of drugs into the patient's body with the help of syringes. Having collected a syringe with a needle, they draw up a solution for injection, having previously made sure that the administered drug is in accordance with the intended purpose. For each injection, two needles are required: one with a wide lumen for drawing the solution into the syringe, the other - directly for the injection. Changing needles ensures sterility is maintained. Before taking the material, the neck of the ampoule or the rubber stopper of the vial with the medicinal substance is pre-treated with alcohol or iodine. The opened ampoule is taken in the left hand, a needle is inserted into it with the right hand, put on a syringe. By pulling the piston, the required amount of medicinal content is gradually drawn into the syringe. Then, by pressing on the piston, air is gradually pushed out of the syringe until drops appear from the lumen of the needle. If an oily liquid is introduced, the ampoule is preheated by lowering it into warm water. The patient's skin before the injection is wiped with a sterile swab dipped in alcohol.

Depending on the method of injection and the injected substance, syringes of various volumes (from 0.1 to 20 ml and more) are used with a division scale and needles with a length of 3-4 to 8-10 cm and a lumen width of 0.3 to 1, 5 mm. Currently, mostly disposable sterile syringes are used, which are assembled as follows: with tweezers in the right hand, take the needle by the sleeve, put it on the nipple of the cylinder and rub it well. After that, the patency of the needle is checked by passing air or a sterile solution through it, holding the sleeve with the index finger.

Intradermal injections

For the injection, a short needle 2-3 cm long with a small lumen is required. Basically, the palmar surface of the forearm is used, and with novocaine blockades, other parts of the body are also used. The site of the intended injection is wiped with alcohol. The needle is injected into the skin with the cut up, then advanced 3-4 mm, releasing a small amount of the drug. Tubercles appear on the skin, which, with further administration of the drug, turn into a "lemon peel".

Subcutaneous injections

The injection sites are the outer surface of the shoulder, the subscapular region, the lateral surface of the abdominal wall, the anterolateral surface of the thigh. The skin at the injection site is wiped with alcohol, grasped with the fingers of the left hand in the fold, and the needle is inserted at an angle of 45 °. After the needle has passed through the skin, the syringe is held with the left hand and the thumb of the right hand is slowly pressed against the plunger. At the end of the introduction of the solution, the needle is removed with a quick movement. The puncture site is treated with a new swab moistened with alcohol.

Intramuscular injections

The injection sites are the gluteus maximus, abdominal muscles and thighs. A needle 7–10 cm long is used. Visually, the buttock is divided into four squares by two perpendicular lines. The site of the intended injection is wiped with alcohol. The syringe is held perpendicularly, then with a quick, clear movement, the needle is inserted into the muscle into the upper outer square to a depth of 7-8 cm. Make sure that the needle does not enter the blood vessel, for which the piston is pulled towards itself and look at the color of the drug solution. If a characteristic color of blood appears, the needle should be removed quickly and tried again. After a successful puncture, the medicine is slowly injected. When introducing oil solutions, they are preheated. The injection site is lubricated again with alcohol.

Intravenous injections

The injection site is most often the veins of the cubital fossa. Medicines are injected directly into a vein. The patient's hand is placed on a special rubber pad and unbent as much as possible, then pulled with a tourniquet above the injection site. For better filling of the vein with blood, the patient is offered to vigorously clench and unclench his fist. The injection site is treated with alcohol. The needle is inserted into the skin with the cut up at an angle of 30-45°. After the puncture, the angle is reduced to 5-10°. When a feeling of some resistance appears, the wall of the vein is pierced and the needle is advanced a little more along the course of the vein. Then pull the plunger of the syringe towards you. The flow of blood into the syringe indicates entry into the vein. The tourniquet is removed and the drug solution is slowly injected. After the injection of the drug, the needle is slowly removed, a cotton swab moistened with alcohol is placed at the puncture site, the patient's arm is bent at the elbow.

catheterization

catheterization - introduction catheter in uric bubble with goal receiving urine for research, breeding urine at her delay and with medical goal. Soft rubber catheters, semi-solid (made from silk fabric impregnated with a special mastic) and solid metal catheters are used.

Insertion of a soft catheter

Sterilization of the catheter is carried out by boiling. After preliminary washing of the external opening of the urethra, the catheter, lubricated with vaseline or sterile vegetable oil, glycerin, anatomical tweezers, is inserted into the urethra. Intercepting it with tweezers, it is injected to the bladder.

Semi-solid catheters

They are usually sterilized with formalin in special vessels. Catheters are inserted in such a way that their bend is directed towards the pubic joint, pulling the penis with the left hand on the catheter. The catheter is brought to the pubic symphysis, then descends, after which it passes into the bladder.

Metal catheters

Sterilization of metal catheters is carried out by boiling. They are inserted in the same way as semi-solid catheters.

Catheterization in women is carried out in compliance with all the rules of asepsis. The patient lies on a gynecological chair or on a bed with legs slightly bent at the knee joints, which are brought to the stomach and spread apart. The nurse spreads the labia with her left hand, and with her right hand from top to bottom (towards the anus) carefully wipes the vulva with a swab dipped in a 1: 1000 sublimate solution. Then, with the same hand, she takes a soft catheter or a female metal catheter doused with vaseline or sterile vegetable oil with tweezers. Finds the external opening of the urethra, carefully inserts the catheter. The catheter is inserted only with the right hand, gradually moving deeper with tweezers; in this case, the tweezers must be held with the thumb and forefinger. The outer end of the catheter is clamped between the IV and V fingers. When urine ceases to come out on its own, you can lightly press through the abdominal wall on the lower abdomen in the projection of the bladder to remove residual urine, and then the catheter is slowly removed.

Catheterization in men is carried out subject to all the rules of asepsis. The nurse takes the penis in her left hand, opens its head and carefully wipes it with a swab moistened with a solution of sublimate or boric acid. The catheter should be watered with sterile vegetable oil or petroleum jelly.

Enemas

Enemas applied to introductions in intestines through direct intestine liquid substances.

Enema cleansing

Boiled water is introduced into the large intestine through the rectum in the amount of 500-1500 ml, the water temperature is 20-35°C. Esmarch's mug is used with a rubber tube ending in a tip, which is lubricated with fat before insertion. The patient is laid on the right side with legs pulled up to the stomach.

Siphon enema

It is done using a rubber probe connected to a funnel. The patient lies on his back, legs bent at the knees. The probe is inserted into the rectum, liquid is poured into the funnel. When the funnel is raised up, the liquid enters the intestines. With the subsequent lowering of the funnel, the liquid, together with gases and pieces of feces, is released outside. Performing alternately such manipulations for 10-20 minutes, it is possible to clear the intestines from feces.

Medicinal enemas

The introduction of small amounts of drugs into the intestinal cavity. Before setting up a medicinal enema, a cleansing enema is done. It is used to reduce inflammation and irritation in the large intestine.

Suction enemas

The patient is given a cleansing enema, and after 30 minutes, 200-250 ml of the medicinal solution is injected in a heated form.

Drip enemas

The introduction of large quantities of medicinal solutions (up to 6 liters) through Esmarch's mug with a rubber tube and a catheter, which is inserted into the rectum. A dropper is installed throughout the tube, the flow of liquid is regulated dropwise by Mohr's clamp. A cleansing enema is done first.

Fundamentals of Nursing

Security tests with response patterns

1. Class A waste includes:

non-toxic, not in contact with biological fluids
potentially infectious waste, materials and secretions contaminated with blood
organic operating rooms, post-mortem waste
extremely hazardous waste

2. The period of use of solutions used in the chemical method of disinfection

7 days
1 day
once
until the color of the solution changes

3. Duration of boiling in 2% sodium bicarbonate solution during disinfection of medical instruments (in minutes)

4. Temperature of the washing solution during pre-sterilization cleaning of medical instruments (in º C)

5. Optimal mode of air sterilization of glass and metal products

1. temperature 180ºС, time 120 min.

2. temperature 180ºС, time 60 min.

3. temperature 160ºС, time 60 min.

4. temperature 120ºС, time 45 min.

6. The optimal mode of using 6% hydrogen peroxide to sterilize medical instruments (temperature in degrees, time in minutes)

1. temperature - 40, time - 250

2. temperature - 18, time -240

3. temperature - 50, time - 180

4. temperature - 50, time - 120

Fundamentals of Nursing

Choose the number of the correct answer

The foundation of patient care is:

1. Daria Sevastopolskaya

2. Ekaterina Bakunina

3. Florence Nightingale

4. Virginia Henderson

Contraindications for the use of heating pads:
1. local warming of individual parts of the body
2. bleeding
3. renal colic
4. infiltrate
Document regulating the processing of medical supplies:

1. Order No. 720

2. Order of the Ministry of Health No. 408

3. Order of the Ministry of Health No. 288

4. OST 42-21-2-85

Fowler's position:

1. reclining, half sitting

2. on the side

3. on the stomach

4. on the back

Non-existent method of processing hands:

1. hygienic

2. therapeutic

3. surgical

4. social

Prevention of spinal injuries is important to deal with:

1. when moving goods

2. at home and at work

3. 12 hours a day

4. 24 hours a day

To treat the oral cavity, napkins are used:

1. clean

2. boiled

3. disinfected

4. sterile

Pulse count time for arrhythmia:

1. 60 sec

4. 15 sec

Specify one of the optional stages of processing a reusable tool according to OST 42-21-2-85

1. disinfection

2. pre-disinfection washing

3. pre-sterilization cleaning

4. sterilization

The site of subcutaneous injection is not:

1. outer surface of the shoulder

2. subscapular region

3. inner surface of the forearm

4. anterior-lateral surface of the abdominal wall

During a period of high temperature, the patient must observe:

1. common mode

2. ward regime

3. bed rest

4. strict bed rest

For urinary incontinence in women at night, it is advisable to use:

1. diapers

2. rubber vessel

3. metal vessel

4. removable urinal

Laboratory that performs blood tests for antibodies and HIV:

1. bacteriological

2. clinical

3. biochemical

4. immunological

The gas outlet tube is placed on a maximum of:

1. 1 hour

2. 30 minutes

4. 10 minutes

The outer part of the tracheostomy tube can be removed:

1. nurse

3. patient

4. relatives of the patient

A concept that includes the generalization of medical knowledge and human values:

1. nursing process

2. deontology

3. bioethics

4. competence

Medicines included in the list "A" and "B" are stored in:

1. refrigerator

3. treatment room

4. at the post, in the closet

Medicinal substances can be administered by inhalation:

1. liquid

2. gaseous

3. powdered

4. suspension

Intradermally administered:

1. tuberculin

2. clonidine

3. ampicillin

4. cordiamine

The main routes of transmission of HIV infection that are of epidemiological significance are:

1. parenteral, sexual, vertical

2. airborne, parenteral, vertical

3. alimentary, transmissible, sexual

4. transmissible, parenteral, sexual

Tissue death is:

1. hematoma

2. infiltrate

3. necrosis

4. abscess

The number of levels in Maslow's hierarchy of basic vital needs:

1. fourteen

2. ten

Fear of death is a problem:

1. psychological

2. physical

3. social

4. spiritual

The subjective method of nursing examination includes:

1. definition of edema

2. questioning the patient

4. Familiarity with medical records s

When examining the victim, first of all, determine:

1. breath

2. consciousness

4. airway patency

The irreversible stage of the death of an organism is:

1. clinical death

2. agony

3. biological death

4. preagony

Survival needs, according to Maslow's hierarchy, include the need to:

1. breathe

2. avoid danger

3. maintain body temperature

4. communicate

The first stage of the nursing process:

4. setting goals for nursing care

Risk factors for falling patients do not include:

1. imbalance

2. hypothermia

3. age over 65

4. visual impairment

In order to remove crusts from the nasal cavity, use:

1. vaseline oil

2. 3% solution of hydrogen peroxide

3. 10% solution of camphor alcohol

4. 70% solution of ethyl alcohol

For the second layer of warm compress, take:

1. bandage

2. 6 layers of gauze pad

3. wax paper

4. cotton wool

The size of the personal comfort zone in most people:

1. 40 cm

4. 13.6 m

The most important in the development of nosocomial infection is:

1. virus carrier, bacteria carrier

3. care items

4. food

The issue of the volume of sanitization of the patient decides:

1. nurse

3. senior nurse

4. procedural sister

To prevent bedsores, the patient's position is changed every:

1. 24 hours

2. 12 hours

3. 6 hours

4. 2 hours

In case of an acute infectious disease, a feverish state, a diet No. is prescribed:

1. 13

To avoid the harmful effects of drugs on the body of a nurse, it is necessary:

1. wear a robe and cap

2. wear a long-sleeved robe

3. wear a full set of protective clothing

4. wear gloves

An increase in blood pressure is called:

1. hypotension

2. hypertension

3. hypertension

4. hyperthermia

The substance secreted by a medical leech when biting through:

1. hirudin

2. heparin

3. histamine

4. hyaline

An ice pack should be applied topically for:

1. an attack of renal colic

2. arthritis

3. pneumonia

4. bleeding

With a critical drop in body temperature, blood pressure:

1. declining

2. drops sharply

3. rising

4. rises sharply

When catheterizing the bladder, the nurse has the right to use a catheter:

1. any

2. soft

3. semi-rigid

4. hard

The ratio of the amount of liquid drunk and allocated by me is called:

1. daily diuresis

2. water balance

3. anuresis

4. diurnal diuresis

Indications for gastric lavage:

1. acute appendicitis

2. acute poisoning

4. stomach bleeding

The effect of an oil enema comes:

1. after 5-10 minutes

2. 20-30 minutes

3. after 8-10 hours

4. immediately

The number of servings of bile obtained by duodenal sounding:

1. 9

The composition of the first aid kit, according to the order of the DOZN to No. 545 "On the prevention of occupational infections of HIV infection and other blood-borne infections":

1.10% albucid, 96% ethyl alcohol, adhesive plaster

2. 5% alcohol solution of iodine, 96% ethyl alcohol, adhesive plaster

3. 5% alcohol solution of iodine, 70% ethyl alcohol, adhesive plaster

4. potassium permanganate (a sample, 70% ethyl alcohol, adhesive plaster)

Enteral should be called the method of administering drugs:

1. intramuscularly

2. intravenously

3. subcutaneously

4. orally (through the mouth)

The concentration of alcohol to treat the injection site (in degrees):

1. 96

Antibiotics are most often administered:

1. subcutaneously

2. intradermally

3. intramuscularly

4. intravenously

When air enters the vessel, a complication develops:

1. air embolism

2. thrombophlebitis

3. necrosis

4. infiltrate

The program document "Philosophy of Nursing in Russia" was adopted in:

1. Kamensk-Podolsk in 1995

2. Moscow in 1993

3. St. Petersburg in 1991

4. Golitsino in 1993

The AIDS virus infects:

1. nervous system

2. reproductive system

3. immune system

4. gastrointestinal tract

Number of stages of the nursing process:

1. two

3. four

4. five

Independent type of nursing intervention:

1. teaching the patient about personal hygiene

2. gastric lavage

3. instillation of drops in the eyes

4. duodenal sounding

If the airway is patent, then the following is checked:

1. consciousness

2. pulse

3. breathing

4. pain syndrome

Nursing activities include:

1. diagnosis of diseases

2. treatment of diseases

3. disease prevention

4. trauma treatment

Step two of the nursing process:

1. planning the scope of nursing interventions

2. identification of patient problems

3. collection of information about the patient

4. defining the goals of the nursing process

The objective methods of nursing examination include:

1. conversation with the patient's relatives

2. questioning the patient

3. measurement of blood pressure

4. Familiarity with the data of the medical record

The Sims position is called:

1. intermediate between lying on the stomach and lying on the side

2. lying on your back

3. lying on the stomach

4. reclining and half sitting

When cracks appear on the lips, the nurse treats them:

1. Vaseline

2. 3% solution of hydrogen peroxide

3. 5% solution of potassium permanganate

4. 70% solution of ethyl alcohol

Pink staining of instruments when wiping them with cotton wool soaked in 1% phenolphthalein solution (a positive phenolphthalein test indicates that:

1. there was blood on the instruments

2. oven sterilization was sufficient

3. Sterilization with saturated water steam (in an autoclave) was sufficient

4. the instruments are not sufficiently washed from the cleaning solution

Purpose of the nursing process:

1. prioritization of care activities

2. establishing the nature of morbidity

3. meeting the basic needs of the body

4. prescription of treatment

Social needs include:

1. sleep

2. respect

4. food

A perceived psychological or physiological deficiency of something, reflected in the perception of a person:
1. addiction
2. alienation
3. need
4. motivation
Temperature of the washing solution during pre-sterilization cleaning (in º C):

1. 18 – 20

4. 50 –55

The goals of nursing care are:

1. general

2. personal

3. non-specific

4. short term

The number of respiratory movements per minute in an adult is normal:

1. 10 – 12

4. 20 –24

One of the properties of the pulse:

1. hypotension

2. frequency

3. tachypnea

4. atony

According to the rhythm, the pulse is distinguished:
1. frequent
2. solid
3. rhythmic
4. rare

Clinical picture of viral hepatitis B and C:
1. swelling of the extremities
2. shortness of breath, acrocyanosis
3. jaundice, dark urine, discolored stools
4. increased blood pressure, increased body temperature
Carrying out the first stage of the nursing process requires:

1. consent of the attending physician

2. older sister's consent

3. consent of the head of the department

4. the ability to conduct a conversation with the patient

The final stage of the nursing process includes:

1. choice of priorities

2. identifying the patient's problems

3. setting goals

4. Determining the effectiveness of ongoing nursing care

All of the following are included in a person's daily activities except:

1. walks

2. washing

3. normal breathing

4. watching TV

The complete destruction of microorganisms, spores and viruses is called:

1. disinfection

2. sterilization

3. pest control

4. deratization

The thermal disinfection method includes:

1. UVI - ultraviolet irradiation

2. full immersion in disinfectant

3. boiling

4. 2-fold wiping with disinfectant

When handling powdered chemicals, medical staff should only wear gloves:
1. rubber

2. cotton

3. latex

4. silicone

With a planned pregnancy, the midwife should be exempted from working with cytostatics:

before and throughout pregnancy
in the first weeks of pregnancy
throughout pregnancy
in the second half of pregnancy

CSO is:

1. central sterilization department

2. centralized sterilization department

3. centralized specialized department

4. centralized sterile department

The CSO includes:

1. doctor's office

2. sterile block

3. treatment room

4. insulator

General cleaning of the wards is carried out:

1. 1 time per week

2. 1 time in 10 days

3. 1 time per quarter

4. 1 time per month

The method of transporting a patient from the emergency room to the department determines:

1. Receptionist Nurse

2. head nurse of the admission department

3. head of the admission department

4. doctor

Bed linen for a seriously ill patient is changed:

1. 1 time in 10 days

2. 1 time in 7 days

3. 1 time per day

4. as it gets dirty

The most common area for pressure sores in the supine position is:

1. sacrum

2. popliteal fossa

4. lower leg

Care item used in artificial feeding:

1. duodenal probe

2. thick stomach tube

3. cup

4. nasogastric tube

In case of bruising in the first hours, apply:

1. warm compress

2. hot compress

3. heating pad

4. ice pack

A warm compress is contraindicated in:

1. otitis media

2. infiltrate

3. tonsillitis

4. injury in the first hours

The number of periods allocated in the development of fever:

1. one

4. four

In the first period of fever, it is possible to use:

1. wet rubdown

2. cold compress

3. heating pads

4. ice pack

The ultimate goal of palliative care:

1. Improving the patient's quality of life

2. full rehabilitation

3. patient recovery

4. help friends and family members

Professional care is provided by:

1. relatives of the patient

2. friends and acquaintances

3. medical workers

4. social workers

The site for intradermal injection is chosen more often:

1. on the inner surface of the forearm

2. on the anterior surface of the abdominal wall

3. on the anterior-outer surface of the thigh

4. in the subscapular region

When 10% calcium chloride enters the tissue, a complication develops:

1. thrombophlebitis

2. infiltrate

3. necrosis

4. abscess

After setting a cleansing enema, bowel movement, as a rule, occurs after (in hours):

1. 8 –10

4. 1 –1,5

To set up a siphon enema, you need to prepare clean water (in liters):

1. 8 – 10

Janet's syringe is used for:
1. rinse cavities

2. subcutaneous injection

3. intramuscular injection

4. intravenous injection

In case of hypertension, the position of the patient should be:

1. lying down without a pillow

2. lying down with legs raised

3. Lying with your head up

4. sitting

Specify the drug that is used sublingually for an attack of angina pectoris (pain in the heart):

1. chloral hydrate

2. drugs

3. nitroglycerin

4. festal

One of the first signs of an unconscious patient is the absence of:

1. breath

2. pulse

3.pressure

4. reactions to the environment

Blood pressure with a critical drop in body temperature:

1. does not change

2. declining

3. drops sharply

4. rising

Therapy

Choose the number of the correct answer

1. Etiotropic treatment of pneumonia is the use of:

1. bronchodilators

2. expectorants

3. Antibiotics

4. antipyretic

2. The main symptom of emphysema:

1. chest pain

2. wet cough

3. hemoptysis

4. shortness of breath

3. For pleural puncture it is necessary to prepare:

1. needle length 10-15cm

2. Dufo needle

3. Cashier's needle

4. trocar

4. Prevention of exacerbation of bronchial asthma contributes to:

1. power amplification

2. elimination of hypodynamia

3. Refusal of alcohol

4. stop contact with the allergen

5. Disease characterized by the development of purulent inflammation in dilated bronchi:

1. lung abscess

2. bronchiectasis

3. lobar pneumonia

4. exudative pleurisy

6. Individual pocket spittoon should be ¼ full:

1. boiled water

2. saline

3. 25% sodium bicarbonate solution

4. chloramine solution

7. Peak flowmetry is the definition of:

1. tidal volume

2. lung capacity

3. Residual lung volume

4. peak expiratory flow

8. The patient should rinse their mouth thoroughly after using the inhaler:

1. ventolina

2. becotida

3. berotek

4. Asthmopenta

9. Patient's priority problem during an asthma attack:

1. headache

2. cough with phlegm

3. sharp weakness

4. suffocation

10. Psychological problem of a patient with lung cancer:

1. expiratory dyspnea

2. paroxysmal unproductive cough

3. anxiety about the outcome of the disease

4. sleep disturbance

11. Physiological problem of the patient with respiratory diseases:

1. dry cough

2. stitching pain in the region of the heart

3. anxiety about the outcome of the disease

4. inability to use a pocket inhaler

12. Risk factor for diseases of the respiratory system:

1. obesity

2. violation of the diet

3. hypothermia

4. hard physical labor

13. To stop pulmonary bleeding, apply:

1. hemostatics, vitamins C, K

2. anticoagulants, vitamin C

3. hemostatics, antihistamines

4. vitamins C, K, antihistamines

14. Normal number of breaths per minute:

15. In croupous pneumonia, the inflammatory process captures:

1. acinus

3. segment

4. slice

16. Clinic of dry pleurisy:

increasing dyspnea, cyanosis
shortness of breath with difficulty exhaling, dry wheezing
chest pain that worsens with coughing and breathing
shortness of breath with difficulty breathing, wet rales

17. With lung abscess, sputum:

"rusty"
three-layer
two-layer
foamy pink

18. The method of prevention of congestive pneumonia is:

strict bed rest
breathing exercises
use of bronchodilators
use of expectorants

19. Sputum for culture is collected:

in a pocket spittoon
in a dry clean jar
in a sterile jar
into a sterile tube

20. Reduced oxygen content in the blood is called:

hypercapnia
hypoxemia
hypoxia
asphyxia

21. A patient has shortness of breath during an attack of bronchial asthma:

mixed
inspiratory
is absent
expiratory

22. Potential problem of a patient with pulmonary tuberculosis:

cough with phlegm
pulmonary hemorrhage
dyspnea
weight loss

23. Pregnancy causes the following changes in the respiratory system:

dryness of mucous membranes
shortness of breath
cough
the appearance of wheezing

24. In the second half of pregnancy, pulmonary tuberculosis occurs:

with a pronounced clinical picture
oligosymptomatically
with intoxication
without intoxication

25. To stop an attack of bronchial asthma, use:

salbutamol, berotek
analgin, prednisone
aspirin, diphenhydramine
etazol, enap

26. Signs of incipient pulmonary hemorrhage:

vomit of the color of "coffee grounds"
scarlet frothy blood when coughing
dark clots in large quantities
suffocation with hemoptysis

27. The main method for diagnosing pneumonia:

bronchoscopy;
radiography
bronchography
spirography

28. Pneumosclerosis is:

airless lung
inflammation of the lung tissue
increased airiness of lung tissue

29. To clarify the diagnosis of bronchiectasis, use:

bronchography
tomography
radiography
fluorography

30. Pleural puncture is performed for:

separation of pleural adhesions;
suction of sputum from the bronchi;
bronchial lavage
removal of fluid for diagnostic and therapeutic purposes

31. Leading symptoms of bronchial asthma:

shortness of breath, cough with mucous sputum
cough with hemoptysis, shortness of breath;
suffocation with difficulty breathing, dry whistling rales;
shortness of breath, dry wheezing

32. Sputum during exacerbation of bronchiectasis:

mucopurulent;
viscous vitreous;
"rusty"
scarlet foamy

33. To stop an attack of bronchial asthma in pregnant women, the following should not be used:

1. eufillin 2.4% - 10.0 ml per physical. solution in/in

2. atropine 0.1% - 05 ml s.c.

3. Berotek inhalation

4. intermittent inhalation of humidified oxygen

34. During auscultation of the lungs in patients with bronchial asthma, the following are heard:

vesicular breathing
moist rales
dry, wheezing wheezing
pleural rub

35. The main role in the development of an infectious form of bronchial asthma is played by:

enzymes and bacteria
bacteria and viruses
viruses and antibiotics
antibiotics and wood dust

39. Contrast agent used in bronchography:

bigignost
iodolipol
verografin
barium sulfate

40. Atelectasis is:

increased airiness of lung tissue
inflammation of the lung tissue
collapse of lung tissue
development of connective tissue in the lungs

41. An infectious-allergic disease characterized by bronchospasm is called:

acute bronchitis
bronchiectasis
bronchial asthma
cardiac asthma

42. The cause of the formation of bronchiectasis are:

chronic bronchitis, pneumosclerosis
frequent acute respiratory infections, chronic tonsillitis
bronchial asthma, emphysema
lungs' cancer

43. With croupous pneumonia, sputum:

mucopurulent
purulent
"rusty"
viscous, glassy

44. Symptoms of exudative pleurisy:

increasing dyspnea, cyanosis
severe chest pain
fever, cough with "rusty" sputum
asthma attacks, cough with scanty sputum

45. Sputum for research is collected three times at:

lung cancer
pulmonary tuberculosis
lobar pneumonia
acute bronchitis

46. Rules for taking furosemide:

after breakfast with potassium supplements
before meals 3 times a day
in the morning, on an empty stomach
in the morning on an empty stomach, with potassium supplements

47. To confirm the diagnosis of myocardial infarction, use:

examination of the pulse and measurement of blood pressure
ECG, biochemical blood test
Ultrasound, chest x-ray
percussion and auscultation of the heart

48. In order to prevent hypertension, it is necessary to:

do not smoke, avoid hypothermia, do not overeat
limit salt intake, avoid stress
do not smoke, sanitize foci of chronic infection
limit physical activity, do not abuse alcohol

49. A patient with a hypertensive crisis complains of:

headache, back pain, dysuria
general weakness, dizziness, dry mouth
severe headache, tinnitus, flickering
weakness, cold sweat, abdominal pain

50. A cough with foamy sputum appeared in a hypertensive crisis - these are:

lobar pneumonia
pulmonary hemorrhage
pulmonary edema
bronchial asthma

51. Cat "purring" is observed when:

mitral valve stenosis
mitral valve insufficiency
insufficiency of the aortic valve;
aortic valve stenosis

52. When diet number 10 limit:

fried and spicy foods
sweets, confectionery
salt and liquid
canned meat and fish

53. Early complication of myocardial infarction:

angina attack
cardiosclerosis
cardiogenic shock
recurrent myocardial infarction

54. First aid for fainting:

put a heating pad and mustard plasters
give nitroglycerin, seat the patient
lay down with a raised foot end
apply defoaming

55. Drug treatment for hypertension:

seasonal
continuous
only in crises
is absent

56. Rheumatism is a disease in which:

damage to the connective tissue of the joints
the connective tissue of the whole organism, mainly the cardiovascular system, is affected
the connective tissue of the heart is affected;
connective tissue of the skin is damaged

57. Stenosis of the left atrioventricular orifice is characterized by:

systolic murmur
diastolic murmur
no noise
pericardial rub

58. The most dangerous rhythm disorder for a pregnant woman:

extrasystole
paroxysmal tachycardia
atrial fibrillation
conduction disorder

59. During pregnancy, the volume of circulating blood:

does not change
decreases
increases
increases in the first trimester of pregnancy and decreases in the II-III

60. Atherosclerosis in the blood increases the content of:

carbohydrates
cholesterol
electrolytes
transaminases

61. In angina pectoris pain is localized:

behind the sternum, in the region of the heart
in the region of the heart, in the right hypochondrium
in the right hypochondrium, in the lumbar region
in the lumbar region

62. Typical clinical form of myocardial infarction:

asthmatic
abdominal
painful
cerebral

63. Clinical manifestations of cardiac asthma:

vomiting and liver enlargement
liver enlargement and suffocation
choking and cough with frothy sputum
cough with frothy sputum and ascites

64. Before injecting heparin, it is necessary to do a blood test for:

bilirubin
cholesterol
clotting
transaminases

65. To clarify the diagnosis of "hypertension" it is necessary:

blood pressure measurement, oculist consultation, ECG recording
spirography, blood pressure measurement
blood pressure measurement, dopplerography
pulse counting, blood and urine tests

66. First aid for myocardial infarction:

administer a narcotic analgesic, call a doctor
soothe, give oxygen therapy
put to bed, give nitroglycerin, call a doctor
apply defoaming, apply venous tourniquets

67. Insufficient amount of hemoglobin in the blood:

ischemia
anemia
hypoxia
hypoxemia

68. The main problem of the patient with angina pectoris:

1. tachycardia

2. shortness of breath

3. retrosternal pain radiating to the left arm

4. decrease in blood pressure

69. Pregnancy is contraindicated in:

1. hypertension 1 degree

2. neurocirculatory dystonia

3. mitral stenosis with NK stage II - III

4. mitral valve insufficiency

70. Prevention of early complications of myocardial infarction is:

strict bed rest
doing light exercise
conducting vitamin therapy
no prophylaxis required

71. Pain in myocardial infarction is relieved:

nitroglycerin
analgesics and nitroglycerin
narcotic analgesics
antispasmodics

72. The main cause of myocardial infarction:

hypertonic disease
atherosclerosis of the coronary arteries
increase in blood sugar

73. Clinical manifestations of collapse:

pallor, cold sweat, tinnitus
flushing of the face, tinnitus, flickering "flies"
pallor, sweat, a sharp feeling of hunger
dry hyperemic skin, intense thirst

74. Late complication of myocardial infarction:

cardiac asthma
recurrence of myocardial infarction
cardiogenic shock
atrial fibrillation

75. Method of oxygen supply in case of pulmonary edema:

oxygen is passed through water
oxygen is administered subcutaneously
oxygen is passed through alcohol
oxygen is administered enterally

76. When planning a conversation about nutritional habits in patients with hypertension, the midwife will offer to limit/exclude:

vegetables
fruits
milk products

77. Cutaneous form of rheumatism manifests itself as:

papules
bubbles
vesicle
annular erythema

78. Diet prescribed for patients in the active phase of rheumatism:

79. Heart disease, the most dangerous for a pregnant woman:

mitral valve insufficiency
stenosis of the left atrioventricular orifice
aortic stenosis
aortic valve insufficiency

80. Lactation in a healthy woman:

does not affect the functioning of the heart
reduces stress on the heart
increases the workload on the heart
effect on the heart depends on the frequency of feeding

81. Diet therapy for atherosclerosis provides for restriction of:

animal fats
vegetable fats
proteins
mineral salts

82. An attack of angina is stopped:

tincture of valerian
diphenhydramine
nitroglycerin
anaprilin

83. Priority psychological problem of a patient with acute myocardial infarction:

fear of death
apathy
memory loss
irritability

84. Clinical manifestations of cardiogenic shock:

cold clammy sweat, lethargy
cold clammy sweat, sudden drop in blood pressure
cold clammy sweat, sudden drop in blood pressure, thready pulse
cold clammy sweat, sudden drop in blood pressure, thready pulse, lethargy

85. Accumulation of fluid in the abdominal cavity is:

anasarka
hydrothorax
ascites
hydropericardium

86. Widespread edema of subcutaneous tissue throughout the body is:

ascites
hydropericardium
hydrothorax
anasarka

87. Position of a patient in bed with chronic heart failure:

horizontal (without cushion)
with raised head
on the right side
on the left side

88. The symptom of "intermittent claudication" develops as a result of:

1. atherosclerosis of the vessels of the lower extremities

2. varicose veins of the lower extremities

3. thrombophlebitis of the lower extremities

4. phlebothrombosis of vessels of the lower extremities

89. Dose of bicillin-5 in the prevention of rheumatism:

1. 600 thousand action points once a week

2. 1 million units 2 times a month

3. 1 million 500 thousand units once a month

4. 1 million 200 thousand units 2 times a month

90. Midwife tactics in myocardial infarction:

provide rest, nitroglycerin under the tongue, mustard plasters on the heart area
give drops of corvalol
3.narcotic analgesics, followed by hospitalization on a stretcher
leeches on the mastoid region

91. First aid for cardiac asthma:

mustard plasters on the heart
lay down, warm the patient
seat, legs hanging from the bed, tourniquets alternately on the lower limbs for 20 minutes, defoaming
lay down with the head end down

92. Etiology of rheumatism:

1. beta-hemolytic streptococcus

2. Staphylococcus aureus

3. herpes virus

4. rickettsia

1. for 10min. before meals

2. in 20 min. before meals

3. 30 min. before meals

4 after meals

94. Potential problem when taking acetylsalicylic acid:

2. loss of appetite

3. stomach bleeding

4. intestinal obstruction

95. Possible complications when taking prednisolone:

1. shortness of breath, pulmonary bleeding

2. headache, decrease in blood pressure

3. increased blood pressure, hyperglycemia, obesity

4. fever, hearing loss

96. Symptom of atherosclerosis of mesenteric arteries:

1. fever

2. weakness

3. abdominal pain

4. decrease in blood pressure

97. A large amount of cholesterol contains:

1. cereals, legumes

2. fruits, berries

3. fish, vegetables

4. eggs, caviar

98. Functional class of stable angina characterizes:

1. condition of the heart muscle

2. cardiac output

3. exercise tolerance

4. Presence of risk factors

99. Aerosol form of nitroglycerin:

1. nitrong

2. nitrosorbide

3. nitrogranulong

4. nitromint

100. The effect of nitroglycerin comes through (min):

101. In case of blood stagnation in the pulmonary circulation, the patient should be provided with the following position:

1. horizontal without cushion

2. horizontal with raised legs

3. sitting, with legs down

4. position does not matter

102. Main symptom of gastralgic form of myocardial infarction:

1. abdominal pain

2. headache

3. retrosternal pain

4. asthma attack

103. A patient with myocardial infarction needs hospitalization:

1. in the first hours of the disease

2. on the 2nd day of the disease

3. on the 3rd day of the disease

4. on the 4th day of the disease

104. Edema of cardiac origin appears:

1. in the morning on the face

2. on my feet in the morning

3. in the evening on the face

4. in the evening on your feet

105. bluish coloration of the lips and fingertips is:

1. hyperemia

2. icterus

3. acrocyanosis

4. diffuse cyanosis

106. Preparing a patient for fecal occult blood analysis:

eliminate carbohydrates, fats
eliminate fats, liquid
exclude black bread, milk, cabbage
exclude meat, fish, greens, eggs

107. The most effective stimulant of gastric secretion:

magnesium sulfate
meat broth
pentagastrin
cabbage decoction

108. Preparation of a patient for cholecystography includes:

strict protein diet
gastric lavage
taking a contrast agent
no special training

109. Contrast agent used in intravenous cholecystography:

iodolipol
bigignost
verografin
barium sulfate

110. Irrigoscopy is a study:

endoscopic
X-ray
radioisotope
laboratory

111. In cholecystography, the organ under examination is:

liver
stomach
gallbladder
duodenum 12

112. Diet No. 1 is prescribed for:

exacerbation of peptic ulcer
acute cholecystitis
acute enterocolitis;
liver cirrhosis

113. Complications of peptic ulcer do not include:

ulcer bleeding
pyloric stenosis
ulcer malignancy
development of gastritis

114. Chronic hepatitis is characterized by:

violation of the structure of the liver
hepatic dysfunction
development of arterial hypertension
development of portal hypertension

115. Patients suffering from cirrhosis of the liver are prescribed a diet:

116. Development of cholestasis during pregnancy is promoted by:

arterial hypertension
arterial hypotension
increased intra-abdominal pressure
decrease in intra-abdominal pressure

117. The following symptoms are typical for chronic gastritis type "A":

1. loss of appetite, pain in the epigastric region, nausea, vomiting of food, diarrhea

2. loss of appetite, girdle pain in the abdomen, heartburn, bitter taste in the mouth, constipation

3. Appetite preserved, epigastric pain late, nocturnal, nausea, sour vomiting, constipation

118. Type B gastritis is characterized by the following symptoms:

1. loss of appetite, feeling of drinking in the epigastrium, diarrhea, nausea, vomiting

2. Appetite preserved, epigastric pain late, nocturnal, nausea, vomiting, sour constipation

3. loss of appetite, sharp pains in the epigastric region early, nausea, vomiting of food, diarrhea

4. pain in the right hypochondrium, nausea, bitterness in the mouth, alternating diarrhea and constipation

119. A characteristic symptom of gastric ulcer perforation:

coffee grounds vomit
vomiting of bile
tarry stool
"dagger pain" in the epigastric region

120. Before the Gregersen reaction, the following products should be excluded:

containing protein;
containing iron;
containing carbohydrates;
no special training

121. Preparation of a patient for radiography of the stomach includes:

setting a siphon enema
taking laxatives
no food intake before the study
test for sensitivity to a contrast agent

122. Contrast agent used in radiography of the stomach:

bigignost
barium sulfate
iodolipol
verografin

123. To prepare for irrigoscopy, you will need:

Castor oil
Esmarch's irrigator
20 gram syringe
glassware

124. Colonoscopy examines:

small intestine
colon
gallbladder
rectum

125. The purpose of diet #2 is to:

decreased secretion of the stomach
increased secretion of the stomach
increased motility of the stomach
decreased motility of the stomach

126. Signs of gastric bleeding:

vomiting "coffee grounds"
dagger pain
increase in blood pressure
constipation

127. Changes in the physicochemical properties of bile during pregnancy occur:

in 1-2 trimester;
in 2-3 trimester;
throughout the entire period of pregnancy;
do not change

128. Preparing a patient for FGDS:

1. 3 days before the study - a non-slag diet

2. on the eve of 2-3 cleansing enemas

3. in the morning 2 hours before the examination - cleansing enema

4. in the morning do not drink, do not eat, do not take medicine, do not smoke

129. The main cause of acute gastritis:

1. overeating

2. Helicobacter pylori

3. eating poor quality and infected food

4. long intervals between meals

130. Tyubazh is prescribed for the purpose of:

1. improve gastric motility

2. preparation for cholecystography

3. improve the outflow of bile from the bladder

4. improve the outflow of pancreatic juice

131. Bile contains:

1. bile acids, pepsin, amylase

2. bile acids, cholesterol, lipase

3. bile acids, cholesterol, bile pigments

4. cholesterol, bile pigments, chemotrypsin

132. The most informative method for diagnosing diseases of the stomach:

1. radiography

2. endoscopy

4. scan

133. To suspect gastric bleeding allows:

1. vomiting of unchanged blood

2. dagger abdominal pain

3. vomiting "coffee grounds"

4. weakness, aversion to meat food

134. One of the causes of liver cirrhosis:

1. viral hepatitis

2. enterocolitis

3. chronic gastritis

4. duodenal ulcer

135. Tubeless study of the secretory function of the stomach:

1. acid test

2. glucotest;

3. laparoscopy

4. tomography

136. The main complaint in duodenal ulcer is:

1. early pain

2. late hungry, night pain

3. girdle pain

4. "dagger" pain

137. Gregersen's reaction is based on the determination in feces:

2. iron

4. magnesium

138. Tactics of a midwife when a patient vomits "coffee grounds" outside a medical institution:

1. outpatient observation

3. administration of analgesics

4. urgent hospitalization

139. Probiotic preparations include:

1. tetracycline

2. festal

3. smecta

4. bactisubtil

140. In chronic enteritis, feces are noted:

1. tarry

2. with an admixture of unchanged blood

3. plentiful, liquid

4. plentiful, discolored

1. milk, kefir

2. rye bread, crackers

3. vegetables, fruits

4. plentiful drink, rice water

142. Chronic colitis usually reveals:

1. heartburn

2. belching

3. bitterness in the mouth

4. tendency to constipation

143. To determine the etiology of liver disease in a patient, it is necessary to take blood for:

1. general analysis

2. Wassermann reaction

3. markers of viral hepatitis

4. determination of the immune status

144. A midwife should teach a patient with chronic non-calculous cholecystitis:

1. measure blood pressure and t body

2. do tubage;

3. calculate water balance

4. prevent constipation

145. During duodenal sounding, magnesium sulfate is used to obtain the contents of:

1. stomach

2. duodenum

3. gallbladder

4. hepatic ducts

146. Essentiale, karsil, vitamins of group B are used to treat diseases:

1. stomach

2. intestines

3. Liver

4. pancreas

147. After abdominal puncture, the patient's stomach is left with a tight towel to prevent:

1. hypertensive crisis

2. internal bleeding

3. collapse

4. pulmonary edema

148. In case of gastric cancer of stage I-II, the patient undergoes:

1. conservative treatment

2. palliative care

3. physiotherapy

4. surgical treatment

149. Priority in the treatment of peptic ulcer belongs to:

1. blockers of H 2 -histamine receptors

2. antispasmodics

3. enzymes

4. analgesics

150. Symptom of chronic gastritis with preserved secretion:

2. bitterness in the mouth

3. fever

4. epigastric pain

151. Complication of chronic gastritis with sharply reduced secretory activity:

1. stomach cancer

2. cholecystitis

3. pancreatitis

4. cirrhosis

152. When taking diuretics in the diet, it is necessary to increase the amount of:

confectionery
dried apricots, raisins
milk, cottage cheese

153. The main symptom of an attack of renal colic:

temperature increase
intense abdominal pain radiating to the groin
cloudy urine
vomiting of bile

154. The ratio between daytime and nighttime diuresis is determined by the sample:

Nechiporenko
Zimnitsky
Reberga
Addis-Kakovsky

155. Acute glomerulonephritis is characterized by:

leg swelling, cyanosis
facial edema, hematuria
fever, lowering blood pressure
back pain, pyuria

lime blossom, coltsfoot, thermopsis
sage, chamomile, St. John's wort
lingonberry leaf, cranberry juice, bearberry
marshmallow root, mukaltin, plantain leaf

157. Density of urine - 1005 in Zimnitsky's test is called:

hyperstenuria
isosthenuria
hypostenuria
normosthenuria

158. A contrast agent is used for intravenous urography:

bigignost
verografin
iodolipol
barium sulfate

159. In case of chronic renal failure, the following should be excluded from the diet:

sugar, reduce salt and liquid
meat, fish, increase the amount of sweet foods
fermented milk products, prescribe a plant-based diet
fatty and fried foods, limit salt

160. Pyelonephritis affects:

glomeruli
tubules
pelvis
ureters

161. In acute glomerulonephritis, the following changes are noted in the urine:

bacteriuria
glycosuria
hematuria
pyuria

162. Pain in renal colic radiates to:

shoulder blade
shoulder
groin
to the left hand

163. First aid to a patient with renal colic:

cold in the lumbar region
inject baralgin intramuscularly
dry heat on the lumbar region
bladder catheterization

164. Changes in the urinary system during pregnancy are characterized by:

glomerular expansion
narrowing of the ureters
a decrease in the volume of the pelvis
an increase in the volume of the pelvis

165. Preferred method of delivery in pregnant women with pyelonephritis:

1. Vaginally (natural birth canal)

2. caesarean section

3. forceps

4. vacuum - extraction

166. Side effects of diuretics:

fever
cardiac arrhythmia
diarrhea
dyspnea

167. The numbers correspond to the normal specific gravity of urine:

10000 – 1010
1026 – 1035
1012 – 1024
1036 – 1042

168. Urinalysis according to Nechiporenko is prescribed for the purpose of:

determine daily diuresis
count the elements
detect the presence of a protein
detect the presence of salts

169. In acute glomerulonephritis, the following is prescribed:

bed rest, diet number 7
bed rest, diet number 10
bed rest, diet number 5
ward regimen, diet No. 7

170. Monotonous specific gravity of urine is called:

isosthenuria
hylostenuria
hyperstenuria
normosthenuria

171. Method of preparing a patient for urography:

gastric lavage
within 3 days before the study, exclude meat, apples, greens;
test sensitivity to iodine;
no special training

172. In chronic renal failure in the blood:

increased creatinine levels
cholesterol level rises
increased levels of bilirubin
increased amylase levels

173. In renal pathology, edema occurs more often:

in the evening on the lower limbs
in the morning, on the lower part of the neck, torso
in the morning on the face, neck
in the evening on the face, torso

174. Urolithiasis refers to diseases:

allergic
infectious
exchange
immuno-complex

175. Patients with kidney disease are prescribed a diet:

176. Change in urinalysis in pyelonephritis:

hematuria
leukocyturia
hemoglobinuria
acetonuria

177. A healthy person excretes the following amount of urine per day:

2. 1.5 liters

3. 50% of the drunk

4. 75% of the drunk

178. The cause of acute glomerulonephritis is:

Staphylococcus aureus
hemolytic streptococcus
coli
enterococcus

179. Nocturia is:

1. decrease in the daily amount of urine less than 500 ml;

2. increase in the daily amount of urine more than 2 liters

3. predominance of nighttime diuresis over daytime

4. frequent urination

180. A patient excreted 50 ml of urine per day - this is:

1. anuria

2. oliguria

3. strangury

4. nocturia

181. Frequent urination is:

1. polydipsia

2. polyuria

3. dysuria

4. Pollakiuria

182. Difficulty urinating is:

1. ischuria

2. strangury

3. polyuria

4. anuria

183. Method of treatment of chronic renal failure:

1. pararenal blockade

2. cystostomy

3. hemodialysis

4. whole blood transfusion

184. In case of acute glomerulonephritis, the following is prescribed:

1. bed rest, diet number 10

2. bed rest, diet number 7

3. bed rest, diet number 5

4. ward regime, diet number 7

185. Pale skin, dense swelling around the eyes is detected with:

1. chronic pyelonephritis

2. acute pyelonephritis

3. acute glomerulonephritis

4. urolithiasis

186. Chronic renal failure develops:

1. glomerular atrophy

2. extension of the cups

3. expansion of the tubules

4. deformation of the pelvis

187. In renal pathology, edema occurs more often:

1. in the evening on the lower limbs

2. in the morning on the neck and torso

3. in the morning on the face and neck

4. in the evening on the face and torso

188. Reducing the daily amount of urine excreted is called:

1. pollakiuria

2. nocturia

3. oliguria

4. dysuria

189. Problem of a patient with kidney disease:

1. dysarthria

2. dysphagia

3. dysuria

4. dystrophy

190. When examining according to Zimnitsky, urine is collected:

1. every 2 hours during the day

2. every 3 hours during the day

3. every 3 hours during the day

4. every 3 hours for 2 days

191. A patient with acute glomerulonephritis has:

1. anuria

2. oliguria

3. polyuria

4. nocturia

192. In uremic coma, the exhaled air smells:

1. acetone

2. alcohol

3. ammonia

4. rotten eggs

193. Nitrogenous slags are formed in the body during the decay of:

1. proteins

3. carbohydrates

4. vitamins

194. Dispensary observation of persons who have had acute pyelonephritis is carried out during:

195. Dispensary observation of persons who have had acute glomerulonephritis is carried out during:

196. Preparing a patient for a contrast x-ray examination of the kidneys:

1. the night before - a test for the tolerance of the radiopaque drug

2. enema the night before and the morning of the study

3. enema the night before and in the morning on the day of the study, a test for the tolerance of the radiopaque preparation for 15 minutes. before research

4. no preparation required

197. An early sign of the appearance of latent edema is:

1. hydrothorax

2. hydropericardium

3. belly enlargement

4. increase in body weight and decrease in daily diuresis

198. The amount of urine that the midwife will send to the laboratory for a general analysis:

3. 100-200 ml

4. 300-400 ml

199. To conduct a urine test according to Nechiporenko, the midwife will send to the laboratory:

1. 50 ml of fresh urine

2. 100-200 ml of the daily amount

3. 9 hour portion

4. 3-5 ml from a medium serving

200. In acute glomerulonephritis, bed rest is prescribed:

1. before normalization of body temperature

2. until the pain in the lumbar region disappears

3. before the normalization of urine tests

4. until blood pressure normalizes and edema disappears

201. Priority problems of the patient in acute glomerulonephritis:

1. weakness, malaise

2. fever, fatigue

3. headache, swelling

4. decreased appetite and performance

202. In order to prevent and treat endemic goiter, a diet rich in:

vitamins
calcium
iodine
potassium

203. Complications typical for pregnancy with hypothyroidism:

threatened miscarriage
premature birth
weakness of the ancestral forces
insufficient lactation

204. Clinical symptoms of thyrotoxicosis:

bradycardia, constipation, dry skin
tachycardia, diarrhea, sweating
bradycardia, thirst, pruritus
tachycardia, hunger, tinnitus

205. For the prevention of endemic goiter prescribe:

Mercazolil
triiodothyronine
thyroxine
antistrumine

206. Mercazolil and tyrosol are used to treat:

diffuse toxic goiter
diabetes
hypothyroidism
endemic goiter

207. Tachycardia, fever, hand trembling are typical for:

hypothyroidism
endemic goiter
diffuse toxic goiter
diabetes

208. For the diagnosis of thyroid diseases, the following are used:

chest x-ray, thyroid ultrasound
radioisotope study and ultrasound of the thyroid gland
spirography, palpation of the thyroid gland
ECG, auscultation of the thyroid gland

209. The thyroid gland secretes the hormone:

thyroxine
glucagon
adrenalin
vasopressin

210. Rules for the introduction of simple insulin:

30 minutes before meals
1 hour after eating
2 hours before meals
while eating

211. Treatment of diabetes mellitus type 1:

butamide, maninil
insulin, protafan
prednisone, glucose
korglukon, adrenaline

212. Changes in the cardiovascular system in thyrotoxicosis:

bradycardia, lowering blood pressure
tachycardia, increased blood pressure
functional systolic murmur, lowering blood pressure
normosistolia, increased blood pressure

213. Main symptoms of endemic goiter:

irritability, exophthalmos, goiter
goiter, swelling of the subcutaneous tissue
irritability, swelling of the subcutaneous tissue

214. Providing emergency care in hyperglycemic coma, enter:

glucose solution 40%
glucose solution 5%
short acting insulin
long acting insulin

215. Duration of diabetes mellitus:

all life
2-3 months
2 weeks
1 year

216. Risk factor for diabetes mellitus for women:

1. underweight

2. early gestosis transferred during pregnancy

3. the birth of a child weighing more than 4500g

4. smoking, alcohol abuse

217. The problem of patients with diffuse toxic goiter:

obesity
exophthalmos
dry skin
constipation

218. Complications characteristic of diffuse toxic goiter during pregnancy:

Iron-deficiency anemia
weakness of the ancestral forces
fetal anomaly
intrauterine fetal death

219. Complication of thyrotoxicosis:

hypoglycemic coma
adrenal crisis
ketoacidotic coma
thyrotoxic crisis

220. The main reason for the development of hypoglycemic coma:

insulin withdrawal
acute infections
insulin overdose
errors in the diet

221. "Intent frightened" look occurs when:

adrenal insufficiency
obesity
diffuse toxic goiter
acromegaly

222. Thyroidin is used to treat diseases:

hyperthyroidism
hypothyroidism
Itsenko-Cushing's disease
diabetes

223. Weight gain, dry, cold skin, constipation are characteristic of:

thyrotoxicosis
hypothyroidism
endemic goiter
diabetes

224. Dry mouth, thirst, weight loss, polyuria are typical for:

diffuse toxic goiter
hypothyroidism
diabetes
endemic goiter

225. Apathy, lethargy, drowsiness, depression are typical for:

hypothyroidism
diffuse toxic goiter
endemic goiter
diabetes

226. Endocrine glands include:

salivary
dairy
thyroid
sweat

227. Treatment of diabetes mellitus type 2:

insulin, actrapid
butamide, maninil
etazol, sulfadimethoxine
corglicon, adrenaline

228. Changes in the cardiovascular system in hypothyroidism:

tachycardia, increased blood pressure
bradycardia, lowering blood pressure
extrasystole, blood pressure normal
missing

229. Tremor of hands and trembling of the whole body are characteristic of the disease:

endemic goiter
hypothyroidism
thyrotoxicosis
diabetes

230. Normal blood sugar levels:

4.8 - 7.9 mmol/l
2.6 - 4.6 mmol/l
2.7-5.9 mmol/l
3.3 - 5.5 mmol/l

231. Providing emergency care in hyperglycemic coma, enter:

1. glucose solution 40%

2. glucose solution 5%

3. short-acting insulin

4. long-acting insulin

232. Direct cause of diabetes mellitus:

excess insulin in the body
lack of insulin in the body
lack of glycogen in the body
excess cholesterol in the body

233. Cretinism develops in case of a disease:

diffuse toxic goiter
hypothyroidism
endemic goiter
diabetes

234. Complications of diabetes mellitus include:

1. microangiopathy

2. fainting

4. collapse

235. Patients suffering from diabetes are prescribed a diet:

236. Daily requirement of iodine in pregnant women:

237. The thyroid gland of the fetus begins to function with:

1. 6-7 weeks pregnant

2. 8-9 weeks

3. 10-11 weeks

4. 12-17 weeks

238. The degree of obesity, at which there is an excess of weight by 40% of the due:

239. Potential patient problem in obesity:

1. heartburn

2. fainting

3. heart failure

4. dyspepsia

240. The following drugs are used in the treatment of obesity:

1. antimicrobial

2. anorexigenic

3. anti-inflammatory

4. cytostatics

241. High relative density of urine in diabetes mellitus is due to the appearance of:

2.glucose

3. bilirubin

4. leukocytes

242. Potential problem of a patient with diabetes mellitus:

1. loss of vision

2. osteoarthritis

3. internal bleeding

4. hepatic coma

243. Red "varnished" tongue, atrophy of the esophagus, glossitis - this is a clinic:

aplastic anemia
megaloblastic anemia
iron deficiency anemia
posthemorrhagic anemia

244. Acute leukemias include:

myeloma
erythremia
erythromyelosis
myelofibrosis

245. Anemia with diarrhea and stomatitis, without CNS damage is:

posthemorrhagic anemia
hemolytic anemia
folate deficiency anemia
megaloblastic anemia

246. Platelets normally live:

8-24 hours
1-2 days
12-14 days
6-8 days

247. Chronic lymphocytic leukemia is a lesion:

platelet germ
lymphocytic germ
leukocyte germ
erythrocyte germ

248. Perversion of taste and smell is typical for:

hypoplastic anemia
iron deficiency anemia
megaloblastic anemia
aplastic anemia

249. Clinical manifestations of B12 deficiency anemia:

perverted taste
hair loss
brittle nails
enlargement of the liver and spleen

250. Hyperchromic anemia, with the presence of megablasts in the bone marrow, is:

B 12 - folate deficiency anemia
hypoplastic anemia
hemolytic anemia
posthemorrhagic anemia

251. Early sign of acute lymphocytic leukemia:

swollen lymph nodes
enlargement of the spleen
thymus enlargement
kidney enlargement

252. Change in the size of an erythrocyte:

poikilocytosis
anisocytosis
erythrocytosis
anisochromia

253. Clinical manifestations of iron deficiency anemia:

yellowness of the skin
perverted taste
burning tongue
haemorrhoids

254. The course of iron deficiency anemia during pregnancy:

is improving;
worsens;
no change

255. Normal amount of hemoglobin in women (g/l):

256. Iron preparation for parenteral use:

1. hemostimulin

2. ferrocal

3. ferroplex

4. ferum-lek

257. To improve the absorption of iron preparations, use:

1. retinol

2. cyanocobalamin

3. ascorbic acid

4. ergocalciferol

258. Patient to complete blood count:

1. in the morning - exclusion of food intake

2. in the morning - a rich breakfast

3. in the evening - the exclusion of food intake

4. no special training required

259. Physiological leukocytosis is observed:

1. fasting

2. after eating

3. after drinking a lot of fluids

4. when hypothermia

260. Sternal puncture is performed to diagnose:

1. pleurisy

2. ascites

3. cirrhosis of the liver

4. leukemia

261. Syndromes observed in leukemia:

1. painful, dysuric

2. nephrotic, hemorrhagic

3. hemorrhagic, hyperplastic

4. painful, dyspeptic

262. In the assimilation of vitamin B 12, the following matters:

1. Castle factor

2. XI clotting factor

3. vitamin C

4. high protein intake

263. The most dangerous localization of angioedema:

gastric mucosa
larynx
oral cavity

264. Serum sickness develops after administration of:

penicillin
urographine
globulin
heterogeneous serum

265. The most dangerous allergic reaction is:

angioedema
anaphylactic shock
hives
serum sickness

266. Duration of acute period in urticaria:

from several hours to several days;
from 3 days to 30 days;
from 2 to 6 months;
from 5 minutes to 10 hours

267. In anaphylactic shock, the reaction develops:

cytotoxic type
immediate type
immunocomplex type
delayed type

268. For relief of Quincke's edema, the following are used:

chlorpromazine, diphenhydramine, analgin
suprastin, papaverine, ampicillin
novocaine, lidocaine, adrenaline
prednisolone, methyltestosterone, pipolfen

269. The average duration of the incubation period for serum sickness:

7-12 days
8-12 hours
15-20 days
2 or more months

270. Tracheostomy is performed in case of:

pulmonary edema
hives
laryngeal edema
serum sickness

271. The most common cause of urticaria:

insect bite
introduction of horse serum
stress
administration of antibiotics

272. An allergic reaction of an immediate type develops through:

5-6 hours
1-2 weeks
15-20 minutes
15-20 days

273. A patient after taking analgin in tablets noticed severe swelling of the eyelids, lips, nose, these are:

1. serum sickness

2. angioedema

3. urticaria

4. Lyell's syndrome

274. Polysymptomatic clinic: swollen lymph nodes, fever, urticaria, Quincke's edema, muscle asthenia are typical for:

1. angioedema

2. serum sickness

3. Lyell syndrome

4. anaphylactic shock

275. An antibiotic that often causes an allergic reaction:

1. lincomycin

2. erythromycin

3. penicillin

4. tetracycline

276. If the patient is allergic to sulfonamides, the following are contraindicated:

1. bicillin

2. biseptol

3. furadonin

4. erythromycin

277. Localization of rash in urticaria:

1. face

2. torso

3. limbs

4. any parts of the body

278. Tactics of a midwife with a threat of laryngeal edema outside a medical institution:

1. outpatient observation

2. referral to a polyclinic at the place of residence

3. urgent hospitalization

4. planned hospitalization

279. In rheumatoid arthritis, joints are mainly affected:

1. knee

2. elbow

3. hip

4. metacarpophalangeal

280. Typical symptom of rheumatoid arthritis:

weakness
dyspnea
morning stiffness in the shoulder girdle
pain in the lower extremities

281. Potential problem of a patient with rheumatoid arthritis:

jaundice
moist cough
joint deformity
inability to walk independently

282. In deforming osteoarthritis, the joints are primarily affected:

1. hip

2. ankle

3. interphalangeal

4. metacarpophalangeal

283. Priority problem of a patient with deforming osteoarthritis:

swelling in the joint area

2. joint pain when moving

3. fever

4. lameness

284. In the treatment of rheumatoid arthritis, the following are used:

1. chondroprotectors

2. steroidal anti-inflammatory drugs

3. cardiotonic drugs

4. bronchodilators

285. What disease is indicated for joint prosthetics:

1. rheumatoid arthritis

2. deforming osteoarthritis

3. gout

4. bursitis

286. Rheumatoid arthritis often suffers from:

1. older people, regardless of gender

2. young men

3. young women

4. children

287. Types of percussion:

comparative
superficial
deep
intermittent

288. Subjective research methods are:

percussion
palpation
auscultation
questioning the patient

289. Model 3. Hendersen provides nursing care for:

self-care deficit
violations of physiological needs
age problems
behavioral disorders

290. When examining the chest, determine:

breath sounds
soreness of the chest
character of percussion sound
chest shape

291. Percussion of the lungs determines:

number of breaths
crepitus
areas of blunting
chest shape.

292. On palpation of the region of the heart, determine:

heart sounds
blood pressure
apex beat
heart border

293. The most informative method for diagnosing the gestational age and date of presumptive delivery:

1. by the date of the last menstruation

2. Ultrasound of the uterus

3. according to the level of standing of the fundus of the uterus

4. according to the degree of engorgement of the mammary glands

294. Additional examination methods include:

auscultation
blood pressure measurement
pulse counting

295. The method of palpation of the chest determines:

borders of the lungs
soreness of the chest
character of percussion tone
pericardial rub

296. During auscultation of the lungs, one normally hears:

vesicular breathing
hard breathing
dry rales
moist rales

297. The apex beat in a healthy person is localized in the intercostal space: 298. The pulse in case of rhythm disturbances should be counted for:

1. 10 sec

2. 15 sec

3. 30 sec

4. 1 min

299. Orthopnea is a position:

1. lying on your side with your legs brought to your stomach

2. sitting with emphasis on the edge of the chair and leaning forward

3. lying down with the head end down

4. sitting facing the back of a chair

300. Restriction of caloric intake in pregnant women with obesity:

1. 2000 kcal

2. 1200 kcal

3. 1300 kcal

4. 1400 kcal

Introduction. 4

Criteria for evaluation of test control. 4

List of disciplines for test tasks. 4

Regulations on a specialist with a secondary medical and pharmaceutical education. Specialty 0401 "Medicine" 5

Fundamentals of nursing. ten

Tasks in the test form on safety. eleven

Nursing process. fifteen

Infection safety, infection control. 22

manipulation technique. 35

Propaedeutics of clinical disciplines. 74

Requirements of the state educational standard for the level of training of specialists in the field of propaedeutics of clinical disciplines. 74

Propaedeutics in therapy. 74

Propaedeutics in surgery. 86

Instructional and methodological documents.. 93

Introduction

The final state certification is carried out in order to assess the quality and level of knowledge and skills of graduates of secondary medical educational institutions, their compliance with the requirements of the state educational standard for the content and level of training of a paramedic in the specialty 0401 "General Medicine".

The proposed collection consists of 6 books and contains test tasks in all special disciplines.

The mandatory minimum of knowledge in the specialty is reflected in the security tests. In the absence of knowledge on these issues, the paramedic can commit actions leading to the death of the patient. In the collection they are separated into separate sections. If at least one task from the security tests section is incorrectly solved, the graduate receives an unsatisfactory grade and is not allowed to complete the following tasks.

In total, 2368 tests are offered to graduates for preparation. There are 200 tasks randomly selected by the computer for the exam. Of these, 30 of the first tasks are security tests.

Test Control Evaluation Criteria

Security Tests- 100% correct answers

5 "excellent" - 91-100% correct answers from 170 tests

4 "good" - 81-90% correct answers from 170 tests

3 "satisfactory" - 71-80% correct answers from 170 tests

2 "unsatisfactory" – 70% or less correct answers from 170 tests

The tasks were drawn up taking into account the requirements of the state educational standard for the content and level of training of a paramedic in the specialty 0401 "General Medicine", training programs in disciplines, order No. and instructive documents of the Ministry of Health of the Russian Federation.

List of disciplines for test tasks

Name of the discipline	Number of tests
1. Fundamentals of nursing
2. Propaedeutics of clinical disciplines: - therapy - surgery - pediatrics
3. Therapy with a course of primary health care
4. Pediatrics with childhood infections
5. Surgery
6. Traumatology
7. Oncology
8. Resuscitation
9. Life safety and disaster medicine
10. Obstetrics
11. Gynecology
12. Syndromic pathology, differential diagnosis with pharmacotherapy
13. Infectious diseases with a course of HIV infection and epidemiology
14. Geriatrics
15. Nervous diseases
16. Mental illness with a course of narcology
17. Skin and venereal diseases
18. Diseases of the ear, throat, nose
19. Eye diseases
20. Diseases of the teeth and oral cavity
21. Fundamentals of rehabilitation
22. Economics and health management
Total:

Regulations on a specialist with a secondary medical
and pharmaceutical education.
Specialty 0401 "Medicine"

(From order No. 249 of the Ministry of Health of the Russian Federation of August 19, 1997 "On the nomenclature of specialties of nursing and pharmaceutical personnel")

General Knowledge

The paramedic must know:

Fundamentals of legislation and law in healthcare;

Fundamentals of health insurance;

Organization of the work of a medical institution in the new economic conditions;

Organization of medical care to the population;

Organization of medical and social assistance to the population, the basics of gerontology and geriatrics;

Theoretical foundations of nursing;

Medical ethics and deontology; psychology of professional communication;

population health statistics;

The role of nursing staff in federal, territorial programs for the protection of public health; fundamentals of valeology and sanology; methods and means of health education;

Regional pathology; basics of occupational pathology;

Causes, mechanisms of development, clinical manifestations, diagnostic methods, complications, principles of treatment and prevention of diseases and injuries;

Fundamentals of organization of medical and social rehabilitation, forms and methods of rehabilitation;

Pharmacokinetics and pharmacodynamics of the main groups of drugs, indications and contraindications for use, the nature of the interaction, complications of the use of drugs; organization of drug supply, regulatory documents regulating the pharmaceutical order in a medical institution;

Basic and additional methods of examination;

Fundamentals of clinical examination, social significance of diseases;

Fundamentals of dietetics;

The system of infection control, infection safety of patients and medical personnel of a medical institution; a system of interaction between a medical institution and institutions of a sanitary and epidemiological profile; anti-epidemic measures in the event of a focus of infection; immunoprophylaxis;

Occupational health and safety in a medical institution;

Functional duties, rights and responsibilities of middle and junior medical personnel;

Fundamentals of disaster medicine.

General Skills

Analyze the current situation and make decisions within their professional competence and authority;

Possess communication skills;

Rational use of resource support for activities;

Perform diagnostic, therapeutic, resuscitation, rehabilitation, preventive, health-improving, sanitary-hygienic, sanitary-educational measures in accordance with their professional competence and authority;

Implement and document the main steps of the nursing process in patient care;

Master the technique of nursing manipulation;

Assess the condition and highlight the leading syndromes and symptoms in patients and victims who are in serious and terminal condition, provide emergency first aid in case of emergencies, injuries, poisoning; perform cardiopulmonary resuscitation;

Assess the effect of drugs in a particular patient, provide emergency first aid in case of drug etching;

Conduct laboratory, functional, instrumental studies;

Perform the main types of physiotherapy procedures, conduct classes in therapeutic exercises, master massage techniques, monitor the implementation of recommendations for occupational therapy, use elements of psychotherapy, recommend therapeutic and dietary nutrition; evaluate the effectiveness of ongoing activities;

Comply with the pharmaceutical procedure for obtaining, storing and using medicines;

Prescribe medications using prescription reference books;

Comply with the requirements of infection control, infection safety of patients and medical personnel;

Carry out planned and emergency hospitalization of patients;

Carry out measures to protect the population, sick, injured and personnel of the disaster medicine service, the civil defense medical service; provide first aid in emergency situations;

To increase the professional level of knowledge, skills and abilities.

Special knowledge

Demographic and medical and social characteristics of the attached population;

Organization of preventive work among the population of the site; methods of planning, conducting and evaluating comprehensive prevention programs aimed at maintaining and strengthening the health of individuals, families, population groups;

Organization and material support of the medical assistant's outpatient reception;

The main causes, clinical manifestations, diagnostic methods;

Complications, principles of treatment and prevention of diseases, organization of nursing care and rehabilitation in therapy, pediatrics, surgery, oncology, urology, dermatovenereology, obstetrics and gynecology, clinic of infectious diseases, neurology, psychiatry, ophthalmology, otorhinolaryngology, geriatrics;

Pharmacological action of the most common drugs, their compatibility, dosage, methods and methods of introduction into the body;

Fundamentals of rational and balanced nutrition, the basics of therapeutic and dietary nutrition; basics of baby food;

Rules for the examination of disability;

Methods of examination of children and pregnant women;

Screening programs for monitoring the health of children;

Organization of work on the upbringing of the child in the family, on the preparation of children in preschool and school institutions.

Organization and structure of the ambulance service in urban and rural areas;

Medical, ethical and legal aspects of the provision of emergency and emergency medical care;

Functional duties, rights and responsibilities of members of the emergency and emergency care team;

Ambulance equipment;

General principles of intensive care for emergency and terminal conditions;

Fundamentals of anesthesia used in the prehospital stage;

Fundamentals of diagnostics and emergency medical care in emergency conditions in the clinic of internal diseases; acute diseases and injuries of the abdominal organs, injuries of the musculoskeletal system; acute diseases and injuries of the organ of vision; ENT organs; injuries and diseases of the nervous system; obstetric and gynecological pathology; mental illness; acute exogenous poisoning; thermal lesions; infectious diseases, acute diseases and injuries in urology.

In the field of narcology:

Organization of narcological service;

Medical, ethical and legal aspects of emergency care;

Clinic and emergency conditions for alcoholism, alcoholic psychosis, drug addiction, substance abuse, psychosis caused by drug addiction and substance abuse;

Methods of prevention, treatment, examination and rehabilitation in narcology;

Organization of hygienic education in the field of narcology.

In the field of occupational pathology:

The main causes, clinical manifestations, methods of examination, principles of treatment and prevention of occupational diseases and injuries;

Assessment of the health status of the working population;

Issues of examination of disability in case of occupational diseases and injuries;

Organization of hygiene education at the site.

Special Skills

Carry out personal registration, collection of demographic and medical and social information about the assigned population; analyze the health status of the attached population;

Identify population groups with early and latent forms of diseases, risk factors; assist in reducing the impact of risk factors on the health of the population;

Collect and evaluate operational information on the epidemiological situation, changes in the environmental situation; carry out immunoprophylaxis; together with the sanitary and epidemiological service, to carry out anti-epidemic measures in the focus of infection;

Organize and conduct sanitary and educational work at the site, including the promotion of medical knowledge, hygienic education and training of the population in a healthy lifestyle;

Provide advice on medical and social aspects of family life, family planning; organize medical and psychological support for family members, taking into account the state of health and age characteristics;

Keep records of citizens in need of medical and social assistance; participate in the organization of assistance to the lonely and the elderly, the disabled, patients with chronic diseases, including home care;

Conduct medical outpatient appointments;

Perform preventive, therapeutic, diagnostic measures in a medical institution and at home, perform simple outpatient surgical operations;

To prepare patients for diagnostic studies;

Carry out work on drug and material support for the activities of a medical institution, monitor the serviceability of medical equipment and equipment, timely repairs and write-offs; comply with the requirements of safety and labor protection;

Conduct training of the sanitary asset of the site, including classes on providing self-help and mutual assistance in case of injuries, poisoning, emergency conditions; education of the population in methods of care, first aid;

Maintain approved medical records.

In the field of emergency and emergency medical care:

Get information about the disease;

Apply basic and additional methods of examination;

Assess the severity of the patient's condition;

Determine the volume and sequence of resuscitation measures; provide emergency first aid;

Determine the plan and tactics of patient management, indications for hospitalization, ensure transportation to the hospital;

Complete the necessary medical documentation.

In the field of narcology:

Identify the characteristic signs of alcoholism, drug addiction, substance abuse;

Identify clinical indications for hospitalization, determine the profile of the hospital;

Carry out planned preventive work among the serviced contingent;

Provide first aid in case of emergencies in narcology.

In the field of occupational pathology:

Conduct an analysis of general and occupational morbidity and injuries of the serviced contingent;

Plan and carry out preventive and health-improving work at an industrial site, aimed at reducing general and occupational morbidity;

Carry out activities for the medical and social rehabilitation of patients;

Provide first aid in emergency conditions in occupational pathology and injuries.

manipulation

Technique of nursing manipulations;

Drainage position of the patient with pulmonary pathology;

Determining the presence of edema;

The technique of taking blood from a finger to determine the ESR, hemoglobin, leukocytes;

Preparation of a thick drop;

Determination of protein in urine (boiling method, albu-test with acetic acid);

Determination of sugar in urine (glucotest);

The introduction of heparin;

Determination of blood clotting time;

Determination of bleeding time;

Collection of urine for the determination of sugar;

A set of insulin in a syringe;

Prevention and treatment of bedsores;

Breeding antibiotics;

Opening of superficial abscesses and phlegmon;

Extraction of foreign bodies, which does not require the use of complex techniques;

The imposition of skin sutures for a superficial wound;

Stop external bleeding from superficially located vessels;

Transport immobilization;

vaginal examinations;

Taking swabs from the genitals;

Determining the size of the female pelvis;

Determining the position of the fetus;

Listening to the heart sounds of the fetus;

Determining the height of the fundus of the uterus;

Examination of the cervix on the mirrors;

Examination of the mammary glands;

douching;

Carrying out a Mantoux test;

Inspection of the rectum with a rectal mirror;

Ability to work with the simplest physiotherapy equipment;

Introduction of vaccines;

Measurement of intraocular pressure.

Fundamentals of Nursing

Tasks in a test form for security

1. Colibacterin is intended for administration

a) intravenously

b) subcutaneous

c) oral

d) intramuscular

2. The BCG vaccine is administered for the purpose of immunization

a) intramuscularly

b) intramuscularly or subcutaneously

c) strictly subcutaneously

d) strictly intradermally

3. In the early postoperative period after abdominal gynecological surgery, the task of the nurse

a) give the patient hot sweet tea to drink

b) feed the sick

c) monitor hemodynamics and the condition of the postoperative suture

d) give painkillers, at the request of the patient

4. The patient after spinal puncture must be laid down

a) on the stomach without a pillow

b) on the back with a raised head end

c) on the side with the knees brought to the stomach

d) half sitting

5. Crystalloid solutions before intravenous administration

a) warm to room temperature

b) heated up to 500

c) heated up to 37-380

d) administered cold in case of hyperthermia

6. A patient with typhoid fever with stool retention is indicated

a) foods high in fiber

b) saline laxatives

c) belly massage

d) cleansing enema

7. Bite wounds inflicted by animals (possible sources of rabies) must be

a) treated with iodine

b) rinse with hydrogen peroxide

c) rinse with a solution of furacilin

d) wash with soapy water

8. Method A.M. Often provides

a) taking a daily dose of drugs against the background of antihistamines

b) the introduction of drugs in minimal dosages

c) the introduction of a small dose of the drug at first, and in the absence of a reaction - a full dose

d) the introduction of a daily dose of drugs with the largest possible intervals

9. The maximum volume of drugs administered intramuscularly in one place does not exceed

10. Follow-up of the patient after antibiotic tolerance testing continues

a) within 2-3 minutes

b) within 5-10 minutes

c) up to 30 minutes

d) at least 2 hours

11. Emergency care for anaphylactic shock begins to be provided

a) in the treatment room

b) in the intensive care unit

c) in the intensive care unit

d) at the site of development

12. In anaphylactic shock caused by intravenous drip of drugs, the main thing is

a) remove the drip

b) close the dropper, while maintaining access to the vein

c) creating mental peace

d) oral antihistamines

13. The carotid artery, when bleeding from it, is pressed against

a) corner of the lower jaw

b) transverse process of the 7th cervical vertebra

c) to the collarbone

d) to the sternocleidomastoid muscle

14. When using cardiac glycosides, you should monitor:

a) body temperature

b) pulse rate

c) urine color

15. Jet can be injected

a) blood components

b) reopoliglyukin

c) hemodez

d) trisol

16. Enzymatic preparations (mezim, festal) are taken

a) regardless of food intake

b) strictly on an empty stomach

c) while eating

d) 2-3 hours after eating

17. A sharp drop in temperature, tachycardia, pallor of the skin in typhoid fever may indicate

a) early recovery

b) intestinal bleeding

c) reduced immunity

d) hypovitaminosis

18. The sharp smell of ozone in the air after quartzization indicates

a) reliable air disinfection

b) creating a favorable atmosphere for a person

c) insufficient time for air disinfection

d) the need to ventilate the room and the poor performance of the bactericidal lamp

19. It is not necessary to protect the respiratory organs with a mask when

a) taking blood from a vein

b) taking a smear from the pharynx and nose

c) caring for a cholera patient

d) preparation of chloramine solutions

20. In order to improve blood circulation in bronchopulmonary diseases, children are contraindicated

a) put mustard plasters

b) put banks

c) massage

d) apply a warm compress

21. Rags for general cleaning of the operating room should be

b) clean

c) disinfected

d) sterile

22. Store insulin

a) at room temperature

b) at a temperature of +1 - + 10 degrees. With

c) at -1-+10 С

d) frozen

23. The type of patient transportation determines

a) a nurse in accordance with the condition of the patient

b) a nurse in accordance with the well-being of the patient

c) a doctor in accordance with the well-being of the patient

d) a doctor in accordance with the patient's condition

24. When transporting a patient in a wheelchair, it is dangerous to find hands

a) on the stomach

b) in a crossed position

c) on the armrests

d) outside the armrests

25. With a critical drop in temperature, one should not

a) report the incident to the doctor

b) remove the pillow from under the head and raise the patient's legs

c) leave one patient to create maximum rest

d) give the patient hot tea

26. Safety precautions for the storage of oxygen cylinders include everything except

a) no smoking in the room where the cylinders are stored

b) storage of cylinders near heat sources

c) storage of cylinders in a well-ventilated area

d) contact of oxygen with fats and oils

27. Taking material for bacteriological culture from the rectum is prohibited

a) rubber catheter

b) rectal loop

c) rectal swab

d) rectal glass tube

28. The main sign of shortness of breath in a child:

a) pale skin

b) inflation and tension of the wings of the nose

c) bulging fontanelles

d) loud crying

29. Working solutions of chloramine are used

a) once

b) during the shift

c) during the working day

d) before changing the color of the solution

30. After sublingual administration of clonidine in hypertensive crisis, the patient should remain in the supine position for at least

a) 10-15 minutes

b) 20-30 minutes

c) 1.5-2 hours

d) 12 hours

31. When oil solutions and suspensions get into a blood vessel, the development of

a) embolism

b) phlegmon

c) bleeding

d) vasospasm

32. In case of intramuscular administration of chlorpromazine, the patient needs

a) lie down for 1.5-2 hours

b) take antihistamines

c) put a heating pad on the injection site

d) eat

33. If bright bloody discharge from the vagina appears in a pregnant woman at a period of 10 weeks, it is necessary

a) refer the pregnant woman to the antenatal clinic doctor

b) urgently send the pregnant woman to the hospital by any passing transport

c) call an ambulance

d) put the pregnant woman to bed at home and administer hemostatic drugs

34. Protection against HIV infection and other sexually transmitted diseases is

a) condoms

b) intrauterine devices

c) hormonal contraceptives

d) local contraceptives

35. On the first day after childbirth, the puerperal should be washed

a) on the gynecological chair

b) on the couch in the treatment room

c) in bed

d) in the toilet room, teaching her to independently perform the procedure

36. Vaginal swabs are taken by a nurse.

a) sterile instruments in sterile gloves

b) sterile instruments without gloves

c) sterile instruments in clean gloves

d) disinfected instruments in sterile gloves

37. Measurement of blood pressure in a pregnant woman with severe preeclampsia is performed by a nurse

a) in the treatment room, with the patient lying down

b) at the post, in the position of the patient sitting

c) in bed, in the position of the patient lying down

d) in the ward, with the patient in a sitting position

Sample answers

1 in	2 g	3 in	4 a	5 in	6 g	7 g	8 in	9 b	10 in
11 g	12 b	13 b	14 b	15 g	16 in	17 b	18 g	19 in	20 b
21 g	22 b	23 g	24 g	25 in	26 in	27 g	28 b	29 a	30 in
31 a	32 a	33 in	34 a	35 in	36 a	37 in

Nursing Process

1. The policy document "Philosophy of Nursing in Russia" was adopted in

a) Kamensk-Podolsk, January 1995

b) Moscow, October 1993

c) St. Petersburg, May 1991

d) Golitsino, August 1993

2. Physiological problem of the patient

a) loneliness

b) the risk of a suicide attempt

c) anxiety about losing a job

d) sleep disturbance

3. Purpose of the nursing process

a) diagnosis and treatment of the disease

b) ensuring an acceptable quality of life during the period of illness

c) deciding the order of care measures

d) active cooperation with the patient

4. The subject of study of bioethics

a) moral and moral aspects of the relationship between people

b) professional duty of a nurse

c) history of nursing

d) professional knowledge and skills of a nurse

5. The first level in the pyramid of human values (needs) of psychologist A. Maslow

a) belonging

b) physiological needs

c) success

d) safety

6. The physiological need, according to A. Maslow's hierarchy, includes

a) respect

b) knowledge

c) breathing

d) communication

7. Fear of death is a problem

a) psychological

b) physical

c) social

d) spiritual

8. The number of levels in the hierarchy of basic vital needs, according to A. Maslow

a) fourteen

b) ten

9. The top of the hierarchy of human needs, according to A. Maslow, is

a) social need

b) the need for self-respect and respect for others

c) the need for self-realization of the individual

d) the need for security

10. The first theorist of nursing is

a) Yu. Vrevskaya

b) E. Bakunina

c) D. Sevastopolskaya

d) F. Nightingale

11. The concept of a vital human need means

a) the ability to function independently

b) lack of what is essential for human health and well-being

c) any conscious desire

d) human need for self-actualization

a) Ekaterina Mikhailovna Bakunina

b) Pirogov Nikolay Ivanovich

c) Florence Nightingale

d) Virginia Henderson

13. The goals of nursing care are

a) short term

b) general

c) personal

d) not specific

14. Number of steps in the nursing process

15. The third stage of the nursing process includes

b) urgent emergency care

c) identifying the patient's problems

d) gathering information

16. The second stage of the nursing process includes

a) planning the scope of nursing interventions

b) identifying the patient's problems

c) collecting information about the patient

d) defining the goals of nursing care

17. The word "diagnosis" in Greek means

a) illness

b) sign

c) state

d) recognition

18. Verbal communication includes communication with the help of

a) facial expressions

d) look

19. An example of independent nursing intervention

a) using a gas outlet tube

b) organization of mutual assistance in the patient's family

c) the appointment of mustard plasters

d) appointment of a treatment table and a mode of physical activity

20. Nursing diagnosis (patient problems)

a) urinary incontinence

b) angina

c) cyanosis

a) Dorothea Orem

b) Julia Vrevskaya

c) Abraham Maslow

d) Nikolai Pirogov

22. The problem of stool retention

a) secondary

b) potential

c) emotional

d) real

23. Social needs of the patient

c) recognition

24. The first stage of the nursing process includes

a) predicting care outcomes

b) a conversation with the patient's relatives

c) identification of existing and potential problems of the patient

d) prevention of complications

25. Definition of a nursing problem

a) identification of the clinical syndrome

b) identifying a specific disease

c) identifying the cause of the disease

d) description of the patient's problems associated with reactions to the disease

26. The subjective method of nursing examination includes

a) definition of edema

b) questioning the patient

c) measurement of blood pressure

d) familiarization with the data of the medical record

27. Nursing problem

a) can change during the day

b) does not differ from medical

c) determines the disease

d) aims to cure

28. Specialized facility for palliative care

a) hospice

b) polyclinic

c) medical unit

d) ambulance station

29. The hierarchy of basic human needs was proposed by an American psychologist

b) Maslow

30. The number of heartbeats per minute in an adult is normal

31. The properties of breathing include

c) filling

d) tension

32. The number of breaths per minute in an adult is normal

33. One of the properties of the pulse

a) voltage

b) hypotension

c) tachypnea

d) atony

34. Choose a nursing problem from the proposed list

a) satisfaction of the need for security is violated

b) the staff avoids contact with the patient

c) heart failure

d) lack of knowledge about stoma care

35. By filling the pulse is distinguished

a) rhythmic, arrhythmic

b) fast, slow

c) full, empty

d) hard, soft

36. The most interconnected properties of the pulse

a) tension and filling

b) tension and rhythm

c) frequency and rhythm

d) speed and frequency

37. Blood pressure measurement is an intervention

a) dependent

b) independent

c) interdependent

d) depending on the situation

38. The difference between systolic and diastolic blood pressure is called

a) maximum blood pressure

b) minimum blood pressure

c) pulse pressure

d) pulse deficit

39. Maximum pressure is

a) diastolic

b) systolic

c) arrhythmic

d) pulse

40. Anthropometry includes measurement

b) pulse

c) temperature

d) blood pressure

41. Invasive manipulations include

a) change of bed linen

b) examination of the skin

c) setting mustard plasters

d) gastric lavage

42. Brief loss of consciousness is

b) collapse

to faint

43. The pulse of an adult at rest is 98 beats per minute.

b) tachycardia

c) bradycardia

d) arrhythmia

44. The properties of the pulse include

a) depth

c) frequency

45. Pulse is distinguished by voltage

a) rhythmic, arrhythmic

b) fast, slow

c) full, empty

d) hard, soft

46. Pulse count time for arrhythmia (in sec.)

47. Pulse is not determined on

a) carotid artery

b) temporal artery

c) radial artery

d) abdominal artery

48. Correctly formulated goal of nursing intervention

a) the patient will not be short of breath

b) the patient will receive enough liquid

c) the patient will quit smoking after talking with the sister

d) the patient will be able to dress himself by the end of the week

49. Normal figures for diastolic blood pressure in an adult (mm Hg)

50. According to the frequency, the pulse is distinguished

a) normal

b) hard

c) complete

d) arrhythmic

51. The value of the pulse depends on

a) tension and filling

b) voltage and frequency

c) filling and frequency

d) frequency and rhythm

52. The first step in the nursing process requires

a) the ability to communicate with the patient and his relatives

b) the consent of the attending physician

c) the consent of the head nurse

d) consent of the head of the department

53. The fourth stage of the nursing process is

a) implementation of the nursing intervention plan

b) examination-collection of information about the patient

c) assessment of the effectiveness of actions, causes, errors and complications

d) making a nursing diagnosis

54. The fifth stage of the nursing process is

a) drawing up a nursing care plan

b) collecting information about the patient

c) evaluation of the effectiveness of actions, causes of errors and complications

d) identification of violated needs, existing and potential human problems in connection with health

55. Classification of nursing diagnoses (patient problems)

a) short term and long term

b) present and potential

d) technical, spiritual, social

Sample answers

1 g	2 g	3 b	4 a	5 B	6 in	7 a	8 in	9 in	10 g
11 b	12 g	13 a	14 g	15 a	16 b	17 g	18 b	19 b	20 a
21 a	22 g	23 in	24 b	25 g	26 b	27 a	28 a	29 b
30 in	31 a	32 in	33 a	34 g	35 in	36 a	37 g	38 in	39 b
40 a	41 g	42 in	43 b	44 in	45 g	46 a	47 g	48 g	49 in
50 a	51 a	52 a	53 a	54 in	55 b


Chapter 1. Nursing examination ............................................... ................................................. ...............................
Examination of the pulse on the radial artery .............................................. ................................................. ...............
Measurement of body temperature in the axillary region (in a hospital) .............................................................. ......
Measurement of blood pressure .............................................................. ................................................. ....................
Measuring the patient's height .................................................................. ................................................. ....................................
Weighing and determination of body weight .............................................. ................................................. ...............
Chapter 2. Infection safety. Infection control .................................................................. .........................
Disinfection and pre-sterilization cleaning of medical devices
appointments in one step manually .............................................................. ................................................. .............
Chapter 3. Patient reception .............................................. ................................................. ...............................................
Treatment of a patient with head lice .............................................................. ................................................. ......................
Chapter 4. Safe hospital environment. Therapeutic-protective regime .............................................................. ...............
Turning the patient and placing him in the position on the right side		......................................................
Transferring the patient from the supine position to the Sims position .............................................................. .........................
Transferring a hemiplegic patient to the prone position .............................................................. ...............................
Placement of a hemiplegic patient in Fowler's position.................................................................. .................................
Placement of the patient in the supine position .............................................................. .................................................
Chapter 5. Personal hygiene of the patient .............................................. ................................................. ...............................
Change of bed linen in the transverse way .............................................. ................................................. .
Change of bed linen in the longitudinal way .............................................. ..................................................
Changing the shirt of a seriously ill person .............................................. ................................................. .........................
Assisting the patient in using a vessel or urinal .............................................................................. ...............................
Care of the external genital organs of men ..............................	". .........	: .....................................................
Care of the external genitalia and perineum of women .............................................................. ......................
Morning toilet of a seriously ill patient: washing ....................................................... ................................................. .....
Morning toilet of a seriously ill patient: toilet of the oral cavity .............................................. ............................................
Application - drug effect on the oral mucosa ..............................................................
Morning toilet of a seriously ill patient: eye toilet .............................................. ................................................. .....
Morning toilet of a seriously ill patient: toilet of the nose .............................................. ................................................. .....
Morning toilet of a seriously ill patient: toilet of the ears .............................................. ................................................. ...
Chapter 6 Feeding the Patient............................................... ................................................. ....................................
Feeding a patient in bed with a sippy bowl .............................................................. .........................................
Feeding a patient in bed with a spoon .............................................................. .................................................
Feeding the patient through a nasogastric tube .............................................................. ................................................
Caring for your nasogastric tube.............................................................. ................................................. .........................
Feeding a patient through a gastrostomy .............................................................. ................................................. ..............
Chapter 7. Methods of the simplest physiotherapy. Hirudotherapy .............................................................. ...............................
The use of mustard plasters .................................................. ................................................. ...................................
Heating pad application .............................................................. ................................................. ...............................................
Using an ice pack .................................................................. ................................................. ...............................
Applying a warm compress .................................................................. ................................................. .................
Applying a cold compress ............................................................... ................................................. .......................

Setting up cans................................................... ................................................. ................................................
Setting leeches (hirudotherapy).................................................. ................................................. ...................
Delivering humidified oxygen through a nasal catheter .............................................................. ......................................
Chapter 8 ................................................. ...........
Instillation of oil drops into the nose .............................................. ................................................. ....................
Instillation of vasoconstrictor drops into the nose .............................................................. ................................................. ...
Teaching the patient how to use the pocket inhaler .............................................................. ...................................
Introduction to the patient of a suppository with a laxative effect .............................................................. ......................
A set of medicine from an ampoule .............................................. ................................................. .........
Dilution of antibiotics .................................................................. ................................................. ...................................
Performing an intradermal injection .............................................................. ................................................. ...............
Performing a subcutaneous injection ............................................................... ................................................. ...................
Performing an intramuscular injection ............................................................... ................................................. ..........
Performing an intravenous injection ............................................................... ................................................. ................
Filling the infusion set............................................................... ................................................. ...................
Infusion .................................................................................. ................................................. ............................................
Chapter 9 Gas tube. Colon ................................................................. ................................................
Cleansing enema .................................................................. ................................................. ................................................
Siphon enema .................................................................. ................................................. ..................................................
Laxative oil enema .............................................................. ................................................. .........................
Enema hypertonic laxative .............................................................. ................................................. ...........
Medicinal microclyster .............................................................. ................................................. ...............................
Drip enema .............................................................. ................................................. ................................................
Installation of the gas outlet pipe .............................................. ................................................. .......................
Algorithm of the patient's actions when replacing an adhesive (adhesive) colostomy bag ..................................................................
Chapter 10 ................................................. ................
Catheterization of the bladder of a woman with a rubber catheter .............................................................. ......................
Catheterization of the bladder of a man with a rubber catheter .......................
Placement and fixation of an indwelling catheter ..............................................	: ...................................................
Washing the bladder .................................................................. ................................................. .........................
Chapter 11 ................................................. ................................................. .
Participation of the nurse in the pleural puncture .............................................................. ....................................
Participation of a nurse in a lumbar puncture .............................................................. ....................................
Involvement of a nurse in a sternal puncture .............................................................. ....................................
Involvement of a nurse in an abdominal puncture .............................................................. ...............................
Chapter 12 ...................................
Guidelines "Rules and techniques for obtaining samples of clinical material
for research in the laboratory of clinical microbiology" .............................................................. .......................
Throat smear .............................................................. ................................................. ................................................. ....
Nose swab ............................................................... ................................................. ................................................. ....
Blood sampling from a peripheral vein .............................................. ................................................. ................
Taking blood from a vein into vacuum containers .............................................. ................................................. .
Collection of sputum for clinical analysis .............................................. ................................................. ...............
Collection of sputum for bacteriological examination .............................................. .........................................
Collection of sputum for Mycobacterium tuberculosis .................................................................. ................................................. ....
Collection of sputum for tumor cells (atypical) .............................................. ................................................
Stool collection for scatological examination .............................................. ...............................................
Collection of feces for bacteriological examination .............................................. .........................................
Stool collection for occult blood testing .............................................................. ..................................................
Taking feces to detect protozoa .................................................................. ................................................. .......

Taking feces for analysis for helminth eggs .............................................. ................................................. .......
Collection of urine for general clinical analysis .............................................. ................................................. ..........
Collection of urine for sugar in the daily amount .............................................. ................................................. .........
Collection of urine for diastasis .............................................. ................................................. ................................................
Urine collection according to Nechiporenko .............................................. ................................................. ................................
Collection of urine according to Zimnitsky .............................................. ................................................. .................................
Preparing the patient for fibroesophagogastroduodenoscopy .............................................................. ...............................
Chapter 13 ................................................. ...............................
Gastric lavage with a thick probe .............................................. ................................................. .............
Gastric lavage with a thin tube .............................................................. ................................................. ...............
Taking gastric contents to study the secretory function of the stomach
Duodenal sounding (fractional method) .............................................. ............................................
Chapter 14 .......................
Cardiopulmonary resuscitation performed by one rescuer .............................................................. .........................
Cardiopulmonary resuscitation by two rescuers .............................................................. .........................
Chapter 15 Handling the tracheostomy tube .............................................................. ..................................................
Caring for a plastic tracheostomy tube with a non-deflated cuff .............................................................. .
Teaching the patient how to care for the tracheostomy tube .............................................................. .................................

		Rationale

I. Preparation for the procedure
1. Collect information about the patient. Kindly and



2. Explain to the patient the purpose and sequence of the procedure	Psychological preparation of the patient

3. Obtain patient consent for the procedure	Respect for patient rights

4. Prepare the necessary equipment	Carrying out the procedure and documentation
	its results

5. Wash and dry your hands

P. Performing a procedure
1. Invite the patient to sit or lie down. In this case, the hands should
be relaxed, the hand and forearm should not be “on


2. Press the II, III, IV fingers on the radial arteries on both hands	Determination of pulse synchronism. If a
patient at the base of the thumb (I finger	the pulse is synchronous, then in the future
be on the back of the hand), feel	the study is carried out on one hand
pulsation and slightly compress the arteries

3. Determine the rhythm of the pulse. If the pulse wave follows one	Peripheral pulse rhythm
after another at regular intervals, then	match the rhythm of the heartbeat.
rhythmic, if not - arrhythmic. When expressed			cardiac
arrhythmias conduct additional research on the subject	cuts			frequency
detecting a pulse deficit	peripheral pulse at the same minute
	called a pulse deficit

4. Determine the pulse rate per minute: take a watch or	Ensuring Frequency Accuracy
	pulse. Normal heart rate:
30 s. Multiply the result by two (if the pulse is rhythmic) and	from 2 to 5 years - about 100 beats / min; 5 to 10
get heart rate. If the pulse is irregular, then	years - about 90 beats / min; grown men
count the number of pulse beats within 60 s.	65-80 bpm;		adults	women -
Heart rate varies by age, gender, physical	75-85 bpm; pulse more than 80 beats / min -
activity	tachycardia; pulse less than 60 beats / min -
	bradycardia

5. Determine the filling of the pulse: if the pulse wave is clear,	Filling	heart rate dependent			from volume
then the pulse is full, if weak - empty, if the pulse wave	circulating				quantities
very faintly palpable, the pulse is thready	cardiac output

6. Determine the voltage of the pulse. To do this, press	Security	accuracy			definitions
artery stronger than before to the radius. If a	pulse tension.		It depends on the tone.
the pulsation stops completely, the voltage is weak,	arterial vessels. The higher the scores
pulse soft; if it weakens, the tension is moderate;	BP, the more intense the pulse
if the pulsation does not weaken - the pulse is tense, hard

7. Tell the patient the result of the study	The patient's right to information

III. End of procedure	Ensuring infectious safety
1. Wash and dry your hands

2. Make a record, reflecting the results obtained in it and	Ensuring the continuity of nursing
patient reaction

		Rationale

I. Preparation for the procedure		Establishing contact with the patient
	Collect patient information. Kindly and
introduce yourself respectfully, clarify how to address him,
if the nurse sees the patient for the first time

	When the patient does not know the purpose and sequence	Psychological preparation of the patient for
procedures explain them to him		procedure

	Obtain patient consent for the procedure	Respect for patient rights

4. Wash and dry your hands	Prevention of nosocomial infection

5. Prepare the necessary equipment. Make sure	Ensuring patient safety and
the integrity of the thermometer and that the readings on the scale are not	credibility		result		measurements
exceed 35 °C. Otherwise, shake the thermometer	temperature
so that the mercury column drops below 35 "C

P. Performing a procedure	Ensuring the reliability of the result
1. Examine the armpit, if necessary
wipe it dry with a tissue or ask the patient
do it.
Attention! In the presence of hyperemia, local inflammatory
processes, temperature measurement cannot be carried out

2. Place the thermometer reservoir in the armpit so that	Security				receiving
so that it is in close contact with the body from all sides	reliable result
patient (press shoulder to chest)

3. Leave the thermometer for at least 10 minutes. The patient must	Ensuring the validity of results
lie in bed or sit

4. Remove thermometer. Assess indicators while holding a thermometer	Evaluation of measurement results
horizontally at eye level

5. Inform the patient of the results of thermometry

III. End of procedure	Training	thermometer		to the next
1. Shake the thermometer so that the mercury column falls into	body temperature measurement
storage tank

2. Immerse the thermometer in the disinfectant solution	Ensuring infectious safety

3. Wash and dry your hands	Ensuring infectious safety

4. Make a mark of the temperature indicators in the temperature	Security	continuity			observations
sheet. Report patients with fever to the doctor on duty	for the patient

4. Close the valve on the "pear", turning it to the right, and pump			Exception	discomfort	associated with
air into the cuff under the control of a phonendoscope until			excessive	clamping
while the pressure in the cuff (according to indications	manometer) not		Ensuring the reliability of the result
will exceed by 30 mm Hg. the level at which it disappeared
ripple

5. Turn the valve to the left and start releasing		air out	Ensuring the reliability of the result
cuff at a rate of 2-3 mmHg/s, maintaining position
phonendoscope. At the same time listen to tones on the shoulder
arteries and monitor the pressure gauge

6. When the first sounds (Korotkov tones) appear, “mark” on			Security	credibility	result.
pressure gauge scale numbers and remember them - they correspond			The systolic pressure values should
systolic blood pressure			match the readings on the manometer.
			which the pulsation disappeared in the process
			cuff inflation

7. Continuing to release air, note		indicators	Ensuring the reliability of the result
diastolic pressure, corresponding to a weakening or
complete disappearance of Korotkov's loud tones.
Continue auscultation until cuff pressure is relieved
by 15-20 mm Hg. relative to the last tone

8. Round measurement data to 0 or 5,	fix		Security	reliable	result
result as a fraction (in the numerator -	systolic		blood pressure measurements
pressure; in the denominator - diastolic), for example 120/75
mmHg. Deflate the cuff completely.
Repeat blood pressure measurement procedure
two or three times with an interval of 2-3 minutes. Fix averages
indicators

9. Inform the patient of the measurement result.			Ensuring the patient's right to information
Attention! In the interests of the patient is not always reported
reliable data obtained in the study

III. End of procedure			Ensuring infectious safety
1. Treat the phonendoscope membrane with alcohol

2. Wash and dry your hands			Ensuring infectious safety

3. Make a record reflecting the received	results and		Ensuring continuity of observation
patient reaction