[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-107-1-medical-surgical-033":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-107-1-內外科護理學-033","nurse-107-1-medical-surgical-033",107,1,33,"手術後輸血導致出現溶血性黃疸所造成之檢驗值變化，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"肝功能指數正常","凝血酶原時間延長","尿膽紅素增加","結合型血清膽紅素增加","A",null,[],"本題考點在溶血性（肝前性）黃疸的檢驗值特徵。依溶血機轉，紅血球大量破壞使非結合型（間接）膽紅素上升，但肝細胞本身功能正常，故肝功能指數（AST、ALT）正常，選 A。B 錯在凝血酶原時間延長屬肝細胞性損傷表現，溶血性黃疸不影響肝合成功能。C 錯在非結合型膽紅素不溶於水、無法經腎排出，尿膽紅素不會增加（增加的是尿膽素原）。D 錯在溶血上升的是非結合型膽紅素，結合型（直接）膽紅素增加見於阻塞性或肝細胞性黃疸。","三型黃疸鑑別：肝前性（溶血）＝間接膽紅素↑、尿膽紅素陰性、尿膽素原↑、肝功能正常；肝細胞性＝直接與間接皆↑、PT 延長、肝酵素↑；肝後性（阻塞）＝直接膽紅素↑、尿膽紅素↑、糞色變白。關鍵區辨在「膽紅素是否已被肝臟結合」——結合型才水溶、才進尿。溶血還可見 LDH↑、間接膽紅素↑、網狀紅血球↑、觸珠蛋白（haptoglobin）↓，可與本題檢驗變化互相印證。",[24,27,29,31,33],{"term":25,"count":26},"溶血性黃疸",2,{"term":28,"count":10},"非結合型(間接)膽紅素",{"term":30,"count":10},"尿膽素原與尿膽紅素",{"term":32,"count":10},"肝功能指數",{"term":34,"count":10},"三型黃疸鑑別",[36,40,44,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-107-1-medical-surgical-034","有關化學藥物發生滲漏之處置，下列何者正確？",34,{"webId":41,"stem":42,"number":43,"year":9,"session":26},"nurse-107-2-medical-surgical-050","有關愛滋病防治之敘述，下列何者正確？",50,{"webId":45,"stem":46,"number":47,"year":48,"session":10},"nurse-108-1-medical-surgical-064","有關腎病症候群病人之處置，下列何者錯誤？",64,108,{"webId":50,"stem":51,"number":52,"year":53,"session":26},"nurse-109-2-medical-surgical-022","有關聽力喪失可聽見的音量敘述，下列何者錯誤？",22,109,{"webId":55,"stem":56,"number":57,"year":58,"session":26},"nurse-110-2-medical-surgical-066","引起代謝性酸中毒的原因，下列何者正確？①延腦異常 ②急性腎衰竭 ③肺擴張不全 ④血糖過高",66,110,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-112-1-medical-surgical-020","有關骨質疏鬆症病人對於護理指導之回覆，下列何者表示病人已經清楚指導內容？",20,112,"2026-09-04",1788510702732]