[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-107-2-psychiatric-community-018":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":64},"精神科與社區衛生護理學","psychiatric-community",{"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-107-2-精神科與社區衛生護理學-018","nurse-107-2-psychiatric-community-018",107,2,18,"林先生，正處於躁症急性期，最近因忙碌進食量減少，目前服用鋰鹽（lithium carbonate），出現腹瀉、手抖、噁心嘔吐等現象，下列何者為最優先的處置？",{"A":14,"B":15,"C":16,"D":17},"協助進食流質飲食","記錄每日體重的變化","與醫療團隊討論測量病患血中鋰鹽濃度","觀察飲食進食狀況","C",null,[],"本題考點是鋰鹽（lithium carbonate）中毒徵象的辨識與優先處置。個案進食量減少、又出現腹瀉、手抖、噁心嘔吐，這些正是鋰鹽血中濃度升高（中毒）的早期表現；因鋰為窄治療指數藥物，且脫水與鈉流失會使血中濃度進一步上升，故最優先應與醫療團隊討論、測量血中鋰鹽濃度以確認並調整，選 C。A 進食流質與 D 觀察進食僅處理攝食，B 記錄體重屬長期監測，皆未針對「可能中毒」此立即的安全風險先確認濃度，故不選。","鋰鹽治療濃度約 0.6–1.2 mEq\u002FL，超過 1.5 mEq\u002FL 出現中毒徵象、2.0 以上屬危險。中毒進程：早期腸胃道（噁心嘔吐腹瀉）與神經肌肉（手抖、無力），續而共濟失調、意識改變、抽搐。關鍵機轉：鋰與鈉在腎小管競爭再吸收，任何造成鈉／體液流失的情況——脫水、低鈉飲食、腹瀉、利尿劑、進食少——都會使鋰滯留、濃度飆升，形成惡性循環。故本題進食少加腸胃症狀是高度警訊。護理重點：確認濃度、維持水分與鈉平衡、監測徵象。記憶：鋰隨鈉走，缺鈉留鋰。",[24,26,29,31],{"term":25,"count":10},"鋰鹽中毒",{"term":27,"count":28},"窄治療指數",1,{"term":30,"count":28},"鈉與鋰競爭再吸收",{"term":32,"count":28},"血中鋰鹽濃度監測",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-107-2-psychiatric-community-019","王同學，20 歲，上課時突然站起毆打鄰座同學，表示同學說他壞話，但同學否認，於是班導師將其轉介到心輔室，一星期後又出現攻擊室友的情形，造成室友受傷而報警處理，因王同學當時情緒非常激動，警察將之制伏後送至急診處理，經家屬同意轉至精神科病房接受治療，王同學頻頻詢問這是何處，環伺四周，神情嚴肅，警戒心高，對問話回應簡短，下列護理措施那項最適當？",19,{"webId":39,"stem":40,"number":41,"year":42,"session":10},"nurse-108-2-psychiatric-community-035","在社區精神衛生護理中，精神科護理之家的設立較屬於那種層級之預防工作？",35,108,{"webId":44,"stem":45,"number":46,"year":47,"session":28},"nurse-109-1-psychiatric-community-049","幸福里成立守望相助隊加強社區安全防護工作，是符合華倫（Warren）所提出五大社區功能中的那一項？",49,109,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-110-2-psychiatric-community-007","護理師在與病人建立關係的過程中常需要自我坦露（self disclosure），有關自我坦露的敘述，下列何者較適當？",7,110,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-111-2-psychiatric-community-051","以走街式調查法進行社區健康評估，較不適合用來收集下列那一個系統的資料？",51,111,{"webId":59,"stem":60,"number":61,"year":62,"session":63},"nurse-112-3-psychiatric-community-005","33 歲病人，躁症發作，午餐時間未用餐，護理師去叫病人吃飯，病人說：「房市我最懂，臺北、新北和竹北我都有置產買房，你叫我吃飯，我就送你一間房。」護理師說：「謝謝，你先告訴我，你要坐在那裡吃午餐？」此時護理師所運用的溝通技巧，下列何項最適宜？",5,112,3,"2026-09-04",1788510726651]