[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-106-2-medical-surgical-041":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":37,"lastmod":66},"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-041","nurse-106-2-medical-surgical-041",106,2,41,"有關腫瘤溶解症候群的處置，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"預防性給與類固醇及抗組織胺劑","水分補充","預防性給與降尿酸藥物","密切監控病人尿量及小便酸鹼值","A",null,[],"本題考點在腫瘤溶解症候群(TLS)的病理與處置對應。TLS 是大量腫瘤細胞裂解,細胞內鉀、磷、核酸釋出,尿酸與磷酸鈣沉積於腎小管導致急性腎損傷,故處置核心是「稀釋與排除」。B 大量水分補充增加腎血流與尿量,沖走沉積物,正確;C 預防性 allopurinol 或 rasburicase 降尿酸生成,防止尿酸性腎病變,正確;D 監測尿量與尿液酸鹼(過去主張鹼化尿液促尿酸溶解)屬標準監測項目,正確。A 類固醇與抗組織胺劑是用於預防輸液或化療藥物的過敏反應,與 TLS 的代謝紊亂機轉無關,並非 TLS 的預防處置,故為錯誤選項,選 A。","TLS 四大代謝異常記法「高鉀、高磷、高尿酸、低鈣」——高磷會與鈣結合成磷酸鈣沉積,故繼發低血鈣。高危族群為高腫瘤負荷、對化療高度敏感者(如急性白血病、Burkitt 淋巴瘤)。預防三支柱:積極水化、降尿酸藥(allopurinol 抑制黃嘌呤氧化酶阻止尿酸生成;rasburicase 直接分解既存尿酸)、密切監測電解質與腎功能。類固醇\u002F抗組織胺是 premedication 概念,勿與代謝急症的處置混淆。",[24,27,30,33,35],{"term":25,"count":26},"腫瘤溶解症候群",4,{"term":28,"count":29},"高尿酸血症",3,{"term":31,"count":32},"allopurinol\u002Frasburicase",1,{"term":34,"count":32},"急性腎損傷",{"term":36,"count":32},"水化治療",[38,42,47,51,56,61],{"webId":39,"stem":40,"number":41,"year":9,"session":10},"nurse-106-2-medical-surgical-042","有關一氧化碳中毒的臨床表徵，下列何者正確？",42,{"webId":43,"stem":44,"number":45,"year":46,"session":32},"nurse-107-1-medical-surgical-058","當病人出現大量化膿性濃稠痰液，且將痰液靜置於杯子內，會分成上層泡沫、中層清澈、下層濃稠，下列何者為其最可能之診斷？",58,107,{"webId":48,"stem":49,"number":50,"year":46,"session":10},"nurse-107-2-medical-surgical-072","有關糖尿病人足部照護之敘述，下列何者正確？",72,{"webId":52,"stem":53,"number":54,"year":55,"session":32},"nurse-109-1-medical-surgical-030","有關二尖瓣閉鎖不全或逆流所產生之心雜音，在心動周期出現的時間，下列何者正確？",30,109,{"webId":57,"stem":58,"number":59,"year":60,"session":32},"nurse-110-1-medical-surgical-074","長期接受血液透析的病人，突然意識改變、出現抽筋及肌肉無力情況，入急診求治，抽血檢查結果：尿素氮／肌酸酐 120 mg\u002FdL／10.6 mg\u002FdL、鉀離子 7.8 mg\u002FdL、鈉離子 135 mg\u002FdL，動脈血液氣體分析結果：pH 7.28、PaO 70 mmHg、PaCO 30 mmHg、 HCO _ 20 mEq\u002FL。下列判斷何者正確？ 2 2 3",74,110,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-111-2-medical-surgical-028","有關冠狀動脈繞道手術後，為維持正常心輸出量的處置，下列敘述何者錯誤？",28,111,"2026-09-04",1788510698619]