[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-107-1-medical-surgical-038":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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":10},"nurse-107-1-內外科護理學-038","nurse-107-1-medical-surgical-038",107,1,38,"減少腫瘤溶解症候群發生之處置，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"治療前後減少輸液，以降低心臟負擔","給與 Allopurinol，以降低尿酸","Kayexalate 可降低血鉀","Sodium Bicarbonate 可鹼化尿液","A",null,[],"本題考點在腫瘤溶解症候群（TLS）的預防處置，屬選出錯誤敘述題。依 TLS 病生理，大量癌細胞崩解釋出尿酸、鉀、磷，故預防重點在積極水化、增加尿量以促進尿酸與電解質排出，而非減少水分；A 主張治療前後減少補液以降低心臟負擔，方向錯誤，為本題答案。B 正確，Allopurinol 抑制黃嘌呤氧化酶可降低尿酸生成。C 正確，Kayexalate（陽離子交換樹脂）可經腸道排鉀、降低血鉀。D 正確，碳酸氫鈉可鹼化尿液、增加尿酸溶解度以利排除。","TLS 四大代謝異常：高尿酸、高血鉀、高血磷、低血鈣（磷結合鈣所致），可致急性腎損傷與致命性心律不整。預防主軸是「沖」與「降」——大量點滴水化維持尿量、必要時 rasburicase（尿酸氧化酶）快速分解尿酸。鹼化尿液雖助尿酸溶解，但過度鹼化反使磷酸鈣沉積，近年準則已趨保守。好發於高腫瘤負荷、對化療高度敏感者（如白血病、伯基特淋巴瘤）化療啟動後 12～72 小時，屬腫瘤急症。",[24,26,28,30,32],{"term":25,"count":10},"腫瘤溶解症候群 TLS",{"term":27,"count":10},"積極水化與尿量維持",{"term":29,"count":10},"Allopurinol 降尿酸",{"term":31,"count":10},"Kayexalate 降血鉀",{"term":33,"count":10},"碳酸氫鈉鹼化尿液",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-107-1-medical-surgical-039","下列何種細胞的分裂速度最慢？",39,{"webId":40,"stem":41,"number":42,"year":9,"session":43},"nurse-107-2-medical-surgical-055","有關氣管內插管病人之護理措施，下列何者錯誤？",55,2,{"webId":45,"stem":46,"number":47,"year":48,"session":10},"nurse-108-1-medical-surgical-069","下列何者可評估糖尿病病人過去 3 個月的血糖控制情形？",69,108,{"webId":50,"stem":51,"number":52,"year":53,"session":43},"nurse-109-2-medical-surgical-027","心包填塞（cardiac tamponade）之臨床表徵，下列何者正確？①低沉的心音 ②中心靜脈壓上升 ③奇異脈 ④脈搏壓變寬",27,109,{"webId":55,"stem":56,"number":57,"year":58,"session":43},"nurse-110-2-medical-surgical-071","有關蝶骨切除腦下垂體腫瘤的手術後護理處置，下列何者正確？",71,110,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-112-1-medical-surgical-025","有關心包填塞（cardiac tamponade）的徵象，下列何者錯誤？",25,112,"2026-09-04",1788510702799]