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患儿,男,1岁1个月,生后42天体检发现心脏杂音,1年内共患肺炎3次。本次因2天前开始咳嗽伴发热,1天来加重入院。查体T37.8℃,生长发育落后,两肺布满中、小水泡音及痰鸣音。心率152次/分,胸骨左缘3~4肋间可闻Ⅲ~Ⅳ级粗糙收缩期杂音,伴有震颤,肺动脉第二音亢进,肝肋下2cm。请根据以上资料回答:

(1)该患儿患有哪种先天性心脏病?

(2)本次合并何种疾病?

(3)该患儿主要的护理措施。

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正确答案:

(1)这个患儿所患的先心病是室间隔缺损,判断依据是胸骨左缘3~4肋间可闻Ⅲ~Ⅳ级粗糙收缩期杂音,伴有震颤,肺动脉第二音亢进。(2)本次合并的疾病是支气管肺炎,判断依据是2天前开始咳嗽伴发热,查体T37.8℃,两肺布满中、小水泡音及痰鸣音。(3)该患儿的主要护理措施:①评估患儿病情变化、生长发育状况、记录生命体征和出入量、监测体液平衡。②建立合理的生活制度,保证休息睡眠,根据病情合理安排适当活动量。③注意营养搭配,供给充足能量、蛋白质和维生素,增强体质。④遵医嘱使用抗生素控制感染,注意体温变化,及时增减衣物。⑤观察有无心率加快、呼吸困难、端坐呼吸等心力衰竭表现,如出现及时通知医生并进行处理。⑥做好心理护理,对患儿关心爱护、态度和蔼,建立良好的护患关系。⑦进行健康教育,使家长掌握先心病的日常护理措施。

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患儿,男,1岁1个月,生后42天体检发现心脏杂音,1年内共患肺炎3次。本次因2天前开始咳嗽伴发热,1天来加重入院。查体T37.8℃,生长发育落后,两肺布满中、小水泡音及痰鸣音。心率152次/分,胸骨左缘3~4肋间可闻Ⅲ~Ⅳ级粗糙收缩期杂音,伴有震颤,肺动脉第二音亢进,肝肋下2cm。请根据以上资料回答:

(1)该患儿患有哪种先天性心脏病?

(2)本次合并何种疾病?

(3)该患儿主要的护理措施。

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