[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-107-1-maternal-pediatric-033":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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":25},"nurse-107-1-產兒科護理學-033","nurse-107-1-maternal-pediatric-033",107,1,33,"何女士，妊娠 29 週，突然感到腹部劇烈疼痛，檢查結果為 TPR：36.6℃，90 次\u002F分，16 次\u002F分， BP：140\u002F90 mmHg，胎心音難測得，子宮硬且有壓痛，宮縮 60～80 mmHg，無陰道出血或羊水流出。根據何女士的臨床狀況，其可能有下列何項問題？",{"A":14,"B":15,"C":16,"D":17},"急性腹膜炎","前置胎盤","胎盤早期剝離","脅迫性流產","C",null,[],"本題考點在妊娠晚期急性腹痛合併出血徵象的鑑別。依臨床特徵，個案妊娠 29 週突發腹部劇痛、子宮硬且壓痛（板狀腹）、宮縮壓力高、胎心難測、血壓偏高（140\u002F90 mmHg）而『無明顯陰道出血』，最符合胎盤早期剝離（abruptio placentae）的隱性出血型，故選 C。A 急性腹膜炎缺乏發燒與腹膜炎病史脈絡，且不能解釋子宮硬壓痛與胎心變化。B 前置胎盤典型為『無痛性』鮮紅陰道出血、子宮柔軟，與本例劇痛硬腹相反。D 脅迫性流產發生於早期妊娠且以子宮頸擴張為特徵，與 29 週板狀硬腹劇痛不符。合併高血壓更支持胎盤早剝的危險因子。","胎盤早期剝離 vs 前置胎盤鑑別（高頻考點）：早剝＝『痛、子宮硬如板、可為隱性出血（血積於胎盤後）、胎心窘迫、常合併高血壓\u002F子癇前症或外傷』；前置胎盤＝『無痛、鮮紅出血、子宮柔軟、胎位常異常』。本例劇痛＋板狀硬腹＋高血壓＋胎心難測＋外部無出血，是隱性型胎盤早剝的典型。嚴重併發症為胎兒窘迫\u002F死亡與母體 DIC（大量凝血因子消耗）。記憶：早剝＝痛硬隱血高血壓；前置＝無痛鮮血軟子宮。可連結概念：胎盤早期剝離、前置胎盤鑑別、隱性出血、子癇前症危險因子、DIC。",[24,26,29,32,34],{"term":16,"count":25},7,{"term":27,"count":28},"子癇前症",5,{"term":30,"count":31},"前置胎盤鑑別",3,{"term":33,"count":10},"板狀硬腹",{"term":35,"count":10},"隱性出血",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-107-1-maternal-pediatric-034","承上題，針對何女士的狀況，下列措施何者較適當？",34,{"webId":42,"stem":43,"number":44,"year":9,"session":45},"nurse-107-2-maternal-pediatric-050","小珊，10 個月大，因中耳炎合併熱性痙攣住院治療，下列護理措施何者正確？",50,2,{"webId":47,"stem":48,"number":49,"year":50,"session":10},"nurse-108-1-maternal-pediatric-064","有關新生兒生產過程造成的鎖骨骨折，下列護理措施何者錯誤？",64,108,{"webId":52,"stem":53,"number":54,"year":55,"session":45},"nurse-109-2-maternal-pediatric-022","陳先生初次當爸爸，從未參與新生兒照護，表示：「不要抱妹妹給我，她軟軟的，我不敢抱。」下列敘述何者最適當？",22,109,{"webId":57,"stem":58,"number":59,"year":60,"session":45},"nurse-110-2-maternal-pediatric-066","30 週早產之男嬰，出生體重 1,500 公克，診斷開放性動脈導管（patent ductus arteriosus），以 Indomethacin 靜脈注射治療，下列敘述何者正確？",66,110,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-112-1-maternal-pediatric-020","有關母乳中各種營養素對於新生兒成長作用之敘述，下列何者錯誤？",20,112,"2026-09-04",1788510703577]