[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-106-2-medical-surgical-004":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":63},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-106-2-內外科護理學-004","nurse-106-2-medical-surgical-004",106,2,4,"有關出血性腦中風病人的護理措施，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"於中風發生 3 小時內給與血栓溶解劑","給與 MgO 以避免便秘引起顱內壓升高","給與 Aspirin 以避免頭痛及發燒","維持平躺姿勢以增加腦部血流","B",null,[],"本題考點為出血性腦中風的護理措施。出血性中風應避免任何增加顱內壓或加重出血的因素,給予氧化鎂(MgO)作為軟便劑可防便秘與用力解便(Valsalva)引起顱內壓上升,故B正確。A錯在血栓溶解劑僅用於缺血性中風,對出血性中風屬禁忌,會加重出血。C錯在Aspirin具抗血小板作用會惡化出血,不可用於出血性中風。D錯在應抬高床頭約30度以促進腦部靜脈回流、降低顱內壓,平躺反而不利靜脈回流、易使顱內壓升高。故正確措施為B。","缺血性與出血性中風處置南轅北轍:缺血性可在時間窗內用血栓溶解劑(rt-PA)或抗血小板藥;出血性則絕對禁用溶栓與抗凝抗血小板,重點在控制血壓、降顱內壓與防再出血。降顱內壓通則:床頭抬高約30度、頭頸維持正中不扭曲、避免Valsalva(故用軟便劑防便秘)、控制發燒與躁動。抓住「出血性=止血降壓、抬床頭、防用力」的主軸,即可排除溶栓與抗血小板等加重出血的干擾選項。",[24,27,29,32],{"term":25,"count":26},"出血性腦中風",3,{"term":28,"count":10},"抬高床頭降顱內壓",{"term":30,"count":31},"軟便劑(MgO)防Valsalva",1,{"term":33,"count":31},"血栓溶解劑禁忌",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-106-2-medical-surgical-005","有關巴金森氏症病人服用 levodopa 藥物之護理指導，下列何者正確？①補充維生素 B 6 以促進藥物吸收 ②補充高蛋白飲食以增加藥物效果 ③可能會出現舞蹈症或不自主運動 ④長期使用會出現 on-off 反應",5,{"webId":40,"stem":41,"number":42,"year":43,"session":31},"nurse-107-1-medical-surgical-021","有關視網膜剝離時立即處理之敘述，下列何者錯誤？",21,107,{"webId":45,"stem":46,"number":47,"year":43,"session":10},"nurse-107-2-medical-surgical-035","有關深部血栓靜脈炎病人之護理措施，下列何者不適當？",35,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-108-2-medical-surgical-073","有關下視丘之敘述，下列何者正確？",73,108,{"webId":54,"stem":55,"number":56,"year":57,"session":31},"nurse-110-1-medical-surgical-037","有關慢性淋巴性白血病的敘述，下列何者錯誤？",37,110,{"webId":59,"stem":60,"number":61,"year":62,"session":31},"nurse-111-1-medical-surgical-071","有關糖尿病病人足部護理，下列何者正確？①直線修剪趾甲緣 ②每日以溫水浸泡清洗足部 30 分鐘 ③穿著色深、柔軟的尼龍襪，且每日更換 ④足部傷口沖洗後，消毒敷料覆蓋，紙膠固定，應儘速就醫",71,111,"2026-09-04",1788510698236]