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说课内容 改进方法不断进步 学生 情况 教材分析 教法学法 教师主导学生主体 教学过程 与评价 学情分析 选材

教材分析 教材分析 教 材 重 要 性

教材分析 教材分析 《外科护理学》 中国医药科技出版社出版的校本教材 第十九章第一节 教 材 重 要 性

教材分析 教材分析 急性阑尾炎是临床外科的常见病、多发病，居各种急腹症的首位。 教 材 重 要 性

教 学 目 标 知识目标 情感目标 能力目标 • 熟悉病因病理、特殊检 查及治疗 • 掌握临床表现、护理措 施及健康教育 教材分析 • 熟悉病因病理、特殊检 查及治疗 • 掌握临床表现、护理措 施及健康教育 • 了解解剖、生理概要及 辅助检查 知识目标 教 学 目 标 通过临床病例分析、讨论，激发学生的 学习兴趣。 情感目标 培养学生运用知识分析问题，解决临床实际问题的能力 Custom animation effects: object spins on end (Advanced) To reproduce the background effects on this slide, do the following: On the Home tab, in the Slides group, click Layout, and then click Blank. Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, and then select Solid fill in the Fill pane. Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). To reproduce the rectangle on this slide, do the following: On the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rounded Rectangle (second option from the left). On the slide, drag to draw a rounded rectangle. Select the rectangle. Drag the yellow diamond adjustment handle to the left to decrease the amount of rounding on the corners. With the rounded rectangle still selected, under Drawing Tools, on the Format tab, in the Size group, do the following: In the Shape Height box, enter 3.5”. In the Shape Width box, enter 0.25”. Under Drawing Tools, on the Format tab, in the bottom right corner of the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane. In the Fill pane, select Solid fill, click the button next to Color, and then under Theme Colors click White, Background 1, Darker 15% (third row, first option from the left). Also in the Format Shape dialog box, click Line Color in the left pane. In the Line Color pane, select No line. Also in the Format Shape dialog box, click Shadow in the left pane. In the Shadow pane, click the button next to Presets, under Outer select Offset Bottom (first row, second option from the left), and then do the following: In the Transparency box, enter 0%. In the Size box, enter 100%. In the Blur box, enter 8.5 pt. In the Angle box, enter 90°. In the Distance box, enter 1 pt. Also in the Format Shape dialog box, click 3-D Format in the left pane. In the 3-D Format pane, do the following: Under Bevel, click the button next to Top, and then under Bevel click Circle (first row, first option from the left). Next to Top, in the Width box, enter 5 pt, and in the Height box, enter 5 pt. Under Surface, click the button next to Material, and then under Standard click Matte (first row, first option from the left). Click the button next to Lighting, and then under Neutral click Soft (first row, third option from the left). On the slide, select the rounded rectangle. On the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate. Select the duplicate rectangle. On the Home tab, in the Drawing group, do the following: Click the arrow next to Shape Fill, and then click No Fill. Click the arrow next to Shape Outline, and then click No Outline. Drag the second rectangle above the first rectangle until the lower edge overlays the top edge of the first rectangle. (Note: When the spinning animation effect is created later for these rectangles, the spin will center where the edges of the rectangles meet.) Press and hold CTRL, and then select both rectangles. On the Home tab, in the Drawing group, click Arrange, and do the following: Point to Align, and then click Align Selected Objects. Point to Align, and then click Align Center. Click Group. On the slide, drag the group until it is centered horizontally on the left edge of the slide (straddling the edge). On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following: Click Align to Slide. Click Align Middle. To reproduce the dashed arc on this slide, do the following: On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Arc (third row, 12th option from the left). On the slide, drag to draw an arc. Select the arc. Under Drawing Tools, on the Format tab, in the Size group, do the following: In the Shape Height box, enter 7.5”. In the Shape Width box, enter 7.5”. With the arc still selected, on the Home tab, in the Drawing group, click the arrow next to Shape Outline, and then do the following: Under Theme Colors, click White, Background 1, Darker 15% (third row, first option from the left). Point to Dashes, and then click Dash (fourth option from the top). On the slide, drag the yellow diamond adjustment handle on the right side of the arc to the bottom of the arc to create a half circle. Drag the arc until the yellow diamond adjustment handles are on the left edge of the slide. With the arc still selected, on the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following: To reproduce the half circle on this slide, do the following: On the slide, select the arc. On the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate. Select the duplicate arc. Under Drawing Tools, on the Format tab, in the Size group, do the following: In the Shape Height box, enter 3.33”. In the Shape Width box, enter 3.33”. With the second arc still selected, under Drawing Tools, on the Format tab, in the Shape Styles group, click the arrow next to Shape Fill, and then under Theme Colors click White, Background 1, Darker 5% (second row, first option from the left). Under Drawing Tools, on the Format tab, in the Shape Styles group, click the arrow next to Shape Outline, and then click No Outline. Under Drawing Tools, on the Format tab, in the Shape Styles group, click Shape Effects, point to Shadow, and then click Shadow Options. In the Format Shape dialog box, click Shadow in the left pane. In the Shadow pane, click the button next to Presets, under Inner click Inside Right (second row, third option from the left), and then do the following: In the Transparency box, enter 86%. In the Blur box, enter 24 pt. In the Angle box, enter 315°. In the Distance box, enter 4 pt. On the slide, drag the second arc until the yellow diamond adjustment handles are on the left edge of the slide. On the Home tab, in the Drawing group, click Arrange, and then do the following: Point to Align, and then click Align to Slide. Point to Align, and then click Align Middle. Click Send to Back. To reproduce the button shapes on this slide, do the following: On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Oval (first row, second option from the left). On the slide, drag to draw an oval. Select the oval. Under Drawing Tools, on the Format tab, in the Size group, do the following: In the Shape Height box, enter 0.34”. In the Shape Width box, enter 0.34”. Under Drawing Tools, on the Format tab, in the Shape Styles group, click More, and then click Light 1 Outline, Colored Fill – Dark 1 (third row, first option from the left). Under Drawing Tools, on the Format tab, in the bottom right corner of the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane. In the Fill pane, select Solid Fill. Click the button next to Color, and then under Theme Colors click Olive Green, Accent 3, Lighter 80° (second row, seventh option from the left). Also in the Format Shape dialog box, click Shadow in the left pane. In the Shadow pane, click the button next to Presets, under Outer click Offset Bottom (first row, second option from the left), and then do the following: Also in the Format Shape dialog box, click 3-D Format in the left pane, and then do the following in the 3-D Format pane: Under Bevel, click the button next to Top, and then under Bevel click Art Deco (third row, fourth option from the left). Next to Top, in the Width box, enter 5 pt, and in the Height box, enter 5 pt. Under Contour, click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). In the Size box, enter 3.5 pt. On the slide, select the oval. Under Drawing Tools, on the Format tab, in the bottom right corner of the Size group, click the Size and Position dialog box launcher. In the Size and Position dialog box, on the Position tab, do the following: In the Horizontal box, enter 2.98”. In the Vertical box, enter 1.5”. Select the oval. On the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate. Select the duplicate oval. Under Drawing Tools, on the Format tab, in the bottom right corner of the Size group, click the Size and Position dialog box launcher. In the Size and Position dialog box, on the Position tab, do the following: In the Horizontal box, enter 3.52”. In the Vertical box, enter 2.98”. Repeat step 9 two more times, for a total of four ovals. Under Drawing Tools, on the Format tab, in the bottom right corner of the Size group, click the Size and Position dialog box launcher. In the Size and Position dialog box, on the Position tab, do the following to position the third and fourth ovals: Select the third oval on the slide, and then enter 3.52” in the Horizontal box and 4.27” in the Vertical box. Select the fourth oval on the slide, and then enter 2.99” in the Horizontal box and 5.66” in the Vertical box. To reproduce the text on this slide, do the following: On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box. Enter text in the text box and select the text. On the Home tab, in the Font group, do the following: In the Font list, select Corbel. In the Font Size list, select 22. Click the arrow next to Font Color, and then under Theme Colors click White, Background 1, Darker 50% (sixth row, first option from the left). On the Home tab, in the Paragraph group, click Align Text Left to align the text left in the text box. On the slide, drag the text box to the right of the first oval. Select the text box. On the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate. Click in the text box and edit the text. Drag the second text box to the right of the second oval. Repeat steps 5-7 to create the third and fourth text boxes, dragging them to the right of the third and fourth ovals. To reproduce the animation effects on this slide, do the following: On the Animations tab, in the Animations group, click Custom Animation. On the Home tab, in the Editing group, click Select, and then click Selection Pane. In the Selection and Visibility pane, select the rectangle group. In the Custom Animation task pane, do the following: Click Add Effect, point to Emphasis, and then click More Effects. In the Add Emphasis Effect dialog box, under Basic, click Spin. Select the animation effect (spin effect for the rectangle group). Under Modify: Spin, do the following: In the Start list, select With Previous. In the Amount list, in the Custom box, enter 123°, and then press ENTER. Also in the Amount list, click Counterclockwise. In the Speed list, select Fast. On the slide, select the first oval. In the Custom Animation task pane, do the following: Click Add Effect, point to Emphasis, and then click More Effects. In the Add Emphasis Effect dialog box, under Basic, click Change Fill Color. Select the second animation effect (change fill color effect for the first oval). Under Modify: Change Fill Color, do the following: In the Start list, select After Previous. In the Fill Color list, click More Colors. In the Colors dialog box, on the Custom tab, enter values for Red: 130, Green: 153, Blue: 117. In the Speed list, select Very Fast. On the slide, select the first text box. In the Custom Animation task pane, do the following: Click Add Effect, point to Entrance, and then click More Effects. In the Add Entrance Effect dialog box, under Subtle, click Fade. Select the third animation effect (fade effect for the first text box). Under Modify: Fade, do the following: Select the fourth animation effect (spin effect for the rectangle group). Under Modify: Spin, do the following: In the Start list, select On Click. In the Amount list, in the Custom box, enter 22°, and then press ENTER. Also in the Amount list, click Clockwise. On the slide, select the second oval. In the Custom Animation task pane, do the following: Select the fifth animation effect (change fill color effect for the second oval). Under Modify: Change Fill Color, do the following: On the slide, select the second text box. In the Custom Animation task pane, do the following: Click Add Effect, point to Entrance and then click More Effects. In the Add Entrance Effect dialog box, under Subtle, click Fade. Select the sixth animation effect (fade effect for the second text box). Under Modify: Fade, do the following: On the slide, select the third oval. In the Custom Animation task pane, do the following: Select the seventh animation effect (change fill color effect for the third oval). Under Modify: Change Fill Color, do the following: On the slide, select the third text box. In the Custom Animation task pane, do the following: Select the eighth animation effect (fade effect for the third text box). Under Modify: Fade, do the following: On the slide, select the fourth oval. In the Custom Animation task pane, do the following: Select the ninth animation effect (change fill color effect for the fourth oval). Under Modify: Change Fill Color, do the following: On the slide, select the fourth text box. In the Custom Animation task pane, do the following: Select the 10th animation effect (fade effect for the fourth text box). Under Modify: Fade, do the following: 能力目标

重 点 难 点 • 急性阑尾炎 的临床表现 的护理措施 • 急性阑尾炎 的病因病理 的临床表现 教材分析 Placeholder 难 点 重 点 • 急性阑尾炎 的病因病理 的临床表现 Placeholder The text you type keeps the same style and formatting as the placeholder text. This text can be replaced with your own text. This is a placeholder text.

学情分析 心理 知识结构 学生学习积极性较高，但学习主动性欠佳 在教学过程中进行积极地引导，不断激发学生的学习兴趣 教材分析 Text 学生学习积极性较高，但学习主动性欠佳 在教学过程中进行积极地引导，不断激发学生的学习兴趣 学生已学过相关基础课程的知识，对本节课程的学习起到了铺垫的作用 确定了教学过程中案例教学法的可行性；明确了教学重点 心理 知识结构

说教法 学生为主 讲授法 探究讨论法 案例教学法 分组讨论激发 学生对病例问 题的兴趣,在讨 论、探究中学 习知识 通过多媒体课 教法学法 说教法 学生为主 学情分析 教材分析 讲授法 探究讨论法 案例教学法 分组讨论激发 学生对病例问 题的兴趣,在讨 论、探究中学 习知识 通过多媒体课 件，形象具体 的讲解重点难 点知识 通过临床病 例，引导学 生进入本节 课内容 三位一体 相互支撑

说学法 合作探究法 知识迁移法 课前预习 病例学习 分析研讨病例 •联想记忆 •鉴别诊断 •相关护理 •课后自学 自主学习法 联想记忆法 教法学法 说学法 学情分析 教材分析 合作探究法 知识迁移法 课前预习 病例学习 分析研讨病例 •联想记忆 •鉴别诊断 •相关护理 •课后自学 自主学习法 联想记忆法

教法学法 教学设计 学情分析 教材分析 巩固知识 课后练习 解决问题 重点讲解 研究问题 分组 讨论法 发现问题 案例 导入法

教法学法 时间安排 学情分析 教材分析 5’ 复习 35’ 小组讨论 5’ 课后练习 t 5’ 案例导入 35’ 讲解 5’ 小结、阅读

教学程序与评估 案 例 导 入 案例教学法 问：⑴ 医疗诊断及依据 分组讨论法 ⑵ 进一步检查 ⑶ 治疗原则 教法学法 案 例 导 入 问：⑴ 医疗诊断及依据 ⑵ 进一步检查 ⑶ 治疗原则 案例教学法 分组讨论法 学情分析 男性，33岁，转移性右下腹疼痛8小时。     患者8小时前进食后突然发生上腹部阵发性隐痛，伴恶心、呕吐，自服消炎药物后症状无明显缓解，约2小时前腹痛转移至右下腹部，伴发热、腹胀，排便有里急后重感。     既往体健。查体：T 39℃，P 98次／分，R 20次／分，Bp 110／70mmHg，下腹部压痛、反跳痛及肌紧张，尤以右下腹为重。移动性浊音阴性，肠鸣音减弱。     腹腔穿刺抽出少量脓性液体，血白细胞16.0×109／L，中性粒细胞90%。 教材分析 ⑸ 请制定相应的护理措施 ⑷ 针对该患者提出主要的护理诊断

病因 最常见原因 管腔阻塞 管腔阻塞 粘液继续分泌 腔内压力上升 血运障碍 淋巴小结增生：60%；年轻人多见 粪石：35% 异物、肿瘤、食物残渣 管腔细、开口小、系膜短 腔内压力上升 血运障碍

视频欣赏

病理 慢性阑尾炎 单纯性阑尾炎 化脓性阑尾炎 阑尾周围脓肿 弥漫性腹膜炎 坏疽性/穿孔性阑尾炎 治愈 炎症消退 抗炎治疗 治愈 阑尾腔梗阻 细菌入侵 胃肠道疾病 肿胀充血 加重 局限 治愈 化脓性阑尾炎 不局限 阑尾周围脓肿 管壁缺血坏死穿孔 弥漫性腹膜炎 坏疽性/穿孔性阑尾炎 扩散

临床表现 转移性右下腹痛 症状 70%~80%始于上腹或脐部，疼痛位置不固定 数小时后疼痛转移并局限于右下腹

男性，33岁，转移性右下腹疼痛8小时。     患者8小时前进食后突然发生上腹部阵发性隐痛，伴恶心、呕吐，自服消炎药物后症状无明显缓解，约2小时前腹痛转移至右下腹部，伴发热、腹胀，排便有里急后重感。     既往体健。查体：T 39℃，P 98次／分，R 20次／分，Bp 110／70mmHg，下腹部压痛、反跳痛及肌紧张，尤以右下腹为重。移动性浊音阴性，肠鸣音减弱。     腹腔穿刺抽出少量脓性液体，血白细胞16.0×109／L，中性粒细胞90%。

问：⑴ 医疗诊断及依据 ⑵ 进一步检查 ⑶ 治疗原则 ⑷ 针对该患者提出主要的护理诊断 ⑸ 请制定相应的护理措施 病例再现 强化自主学习与后续学习 问：⑴ 医疗诊断及依据 ⑵ 进一步检查 ⑶ 治疗原则 ⑷ 针对该患者提出主要的护理诊断 ⑸ 请制定相应的护理措施

护理诊断 是什么？

护理诊断 疼痛：与急性阑尾炎的炎性刺激及手术创伤有关 体温过高：与急性阑尾炎有关 体液不足：与突然发病、术前准备不充分等有关 潜在并发症：出血、切口感染、腹膜炎等

引导学生 自主学习 知识迁移 请针对护理诊断提出护理目标

护理措施 术前护理 ⑴ 生命体征 ⑵ 腹部症状和体征，有无腹痛 ⑶ 禁用镇静止 痛剂，如吗啡 ⑷ 疼痛加剧、发热及时通知医生 病情观察

急性阑尾炎最常见的病因是 1 阑尾腔梗阻 A 阑尾损伤 B 自身感染 C 胃肠功能紊乱 D 神经反射 E

2 急性阑尾炎最主要的症状 转移性右下腹痛 A 畏寒、发热 B 恶心、呕吐 C 食欲下降 D 腹泻和便秘 E

小结 阑尾细又长 根在麦氏点 血运单循环 腹内扁桃腺 病因梗阻是第一 临表转移性压痛 治疗一般行手术 术后护理多注意

教学手段评价 自主学习、合作探究、知识迁移等方法 设计临床案例，通过积极讨论，引发学生思索，调动学生学习积极性，发挥其学习的主观能动性，改变了长期被动填鸭式的学习，取得较好的效果。 案例教学法、合作探究法等 以参与式探究为主，以实际临床病例为引导，并用多媒体辅助演示，力求结构严谨性、条理性、丰富性 多媒体演示 多方法教学 多引导自学 图片、视频、示意图等促进自主学习 增加素材，提高课件质量，全方位调动学生学习热情，开阔其视野，提高教学效果。

板书设计 急性阑尾炎病人的护理 提纲式板书 一、病例导入 二、分组讨论 三、重点讲解 四、小结

教学反思 ⒈在教学过程中，以参与式探究教学法为主，以实际临床病例为引导，并用多媒体辅助演示，提高了教学效率。 ⒉课堂上采用合作探讨、知识迁移的方法，促进学生自主学习，开动脑筋、参与课堂，收到了较好的效果。 3.在以后的教学过程中还要不断的吸取好的教学方法，努力提高自己的教学水平。

教材及参考书籍

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