[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-107-1-maternal-pediatric-013":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":65},"產兒科護理學","maternal-pediatric",{"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-107-1-產兒科護理學-013","nurse-107-1-maternal-pediatric-013",107,1,13,"有關硬腦膜外減痛分娩的使用機轉與時間之敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"麻醉劑需同時注射於硬膜外腔與蜘蛛膜外腔","進行減痛分娩最佳時機是子宮頸口開 1 公分時","減痛分娩主要是阻斷腰部的交感神經","感覺神經和運動神經皆被阻斷","C",null,[],"本題考點在硬膜外（epidural）減痛分娩的作用機轉。依麻醉解剖，硬膜外麻醉將局部麻醉劑注入硬膜外腔，主要阻斷經此通過的脊神經根，減少子宮與產道疼痛傳導，並伴隨阻斷腰部交感神經，故 C 正確。A 錯在硬膜外麻醉只注入硬膜外腔，不會同時注入蜘蛛膜下腔（同時注入是脊硬聯合，且蜘蛛膜『外』腔用詞本身錯誤）。B 錯在最佳時機並非開 1 公分，一般在進入活動期、規則宮縮且產程確立後給予較適當，過早可能延緩產程。D 錯在理想的減痛分娩追求感覺神經阻斷而盡量保留運動神經，使產婦仍能用力，若運動神經全被阻斷反不利第二產程用力。","硬膜外腔位於黃韌帶與硬腦膜之間，內有脊神經根與硬膜外靜脈叢；藥物在此擴散阻斷神經根傳導。差異化阻斷（differential block）原理：細的感覺與交感纖維較粗的運動纖維更易被低濃度局麻藥阻斷，故臨床用低濃度局麻藥＋鴉片類達到『可動性硬膜外』（walking epidural），止痛但保留下肢肌力。交感被阻斷會導致周邊血管擴張、可能低血壓，故給藥前後需補液並監測血壓。記憶：脊麻＝蜘蛛膜下腔、單次、起效快、範圍大；硬膜外＝硬膜外腔、可留置持續給藥、可調控。可連結概念：脊神經根、差異化神經阻斷、交感阻斷性低血壓。",[24,27,30,32,34],{"term":25,"count":26},"硬膜外麻醉",7,{"term":28,"count":29},"交感神經阻斷",3,{"term":31,"count":10},"脊神經根阻斷",{"term":33,"count":10},"差異化神經阻斷",{"term":35,"count":10},"減痛分娩時機",[37,41,46,51,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-107-1-maternal-pediatric-014","下列何者為宮縮時胎心率加速之臨床意義？",14,{"webId":42,"stem":43,"number":44,"year":9,"session":45},"nurse-107-2-maternal-pediatric-030","有關新生兒神經成熟度評估之描述，下列何者是早產兒的特徵？",30,2,{"webId":47,"stem":48,"number":49,"year":50,"session":10},"nurse-108-1-maternal-pediatric-044","有關腸病毒傳染途徑的敘述，下列何者錯誤？",44,108,{"webId":52,"stem":53,"number":45,"year":54,"session":45},"nurse-109-2-maternal-pediatric-002","有關以家庭為中心的產科照護，下列何者錯誤？",109,{"webId":56,"stem":57,"number":58,"year":59,"session":45},"nurse-110-2-maternal-pediatric-046","美國精神疾病診斷準則手冊第五版（DSM-5）將自閉症、亞斯伯格症及未分類廣泛性發展障礙，統稱為自閉症類群障礙症（autism spectrum disorder, ASD），有關其身心表徵，下列何者錯誤？",46,110,{"webId":61,"stem":62,"number":63,"year":64,"session":45},"nurse-111-2-maternal-pediatric-080","張小弟，5 個月大，因不慎跌落床下，診斷為顱內出血，有顱內壓增高（increase intracranial pressure, IICP）現象，有關其護理措施，下列敘述何者較不適當？",80,111,"2026-09-04",1788510703361]