[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-106-2-medical-surgical-043":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"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-043","nurse-106-2-medical-surgical-043",106,2,43,"有關嚴重燒傷病人急性期的疼痛處置，下列何者最適當？",{"A":14,"B":15,"C":16,"D":17},"morphine 4 mg IV every 5 minutes","morphine 10 mg IM q4H","meperidine 50 mg PO q4H","fentanyl citrate（Duragesic）75 mcg patch q3D","A",null,[],"本題考點為嚴重燒傷急性期的疼痛給藥途徑選擇。急性期因大量體液滲漏與周邊循環不良,肌肉與皮下組織灌流差,IM 或 PO 給藥吸收不穩、藥效延遲且可能在循環恢復後突然大量吸收造成過量,故止痛應採靜脈注射(IV)並小劑量、短間隔滴定。A morphine 4 mg IV 可快速起效並依疼痛反覆評估調整,符合急性期原則,選 A。B morphine IM 因灌流不良吸收不可靠;C meperidine PO 口服吸收更不可靠且其代謝物 normeperidine 有神經毒性不宜久用;D fentanyl 貼片是長效穩態給藥,適合慢性穩定疼痛而非急性劇痛的快速控制。故選 A。","燒傷急性期血流動力不穩,IM\u002FSC\u002FPO 一律不可靠——這是燒傷疼痛管理的鐵律:『acute burn pain 走 IV titration』。貼片(transdermal)需數小時到穩態,起效慢且無法即時調整,只適用穩定的慢性疼痛。meperidine 已多國除役,因 normeperidine 蓄積致癲癇,考題常設為錯誤誘答。口訣:急性劇痛→IV 嗎啡小量頻給,滴定到止痛且呼吸穩定。",[24,27,29,31,33],{"term":25,"count":26},"燒傷急性期",1,{"term":28,"count":26},"靜脈注射給藥",{"term":30,"count":26},"嗎啡滴定",{"term":32,"count":26},"組織灌流不良",{"term":34,"count":26},"fentanyl 貼片藥動學",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-106-2-medical-surgical-044","有關疥瘡病人照護方式之敘述，下列何者錯誤？",44,{"webId":41,"stem":42,"number":43,"year":44,"session":26},"nurse-107-1-medical-surgical-060","有關低血鈣臨床表徵之敘述，下列何者正確？",60,107,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-107-2-medical-surgical-074","有關長期服用 prednisolone 的護理指導，下列何者錯誤？",74,{"webId":50,"stem":51,"number":52,"year":53,"session":26},"nurse-109-1-medical-surgical-032","有關惡性腫瘤特徵的敘述，下列何者正確？①細胞通常分化不良 ②腫瘤通常有被膜包覆 ③生長速度通常很迅速 ④易轉移易復發",32,109,{"webId":55,"stem":56,"number":57,"year":58,"session":26},"nurse-110-1-medical-surgical-076","有關第一期心腦肺甦醒術（cardiopulmonary cerebral resuscitation; CPCR）的執行步驟，下列何者最優先？",76,110,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-111-2-medical-surgical-030","有關心包填塞（cardiac tamponade）症狀的敘述，下列何者錯誤？",30,111,"2026-09-04",1788510698635]