[{"data":1,"prerenderedAt":62},["ShallowReactive",2],{"q-nurse-108-2-medical-surgical-014":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":61},"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":25},"nurse-108-2-內外科護理學-014","nurse-108-2-medical-surgical-014",108,2,14,"病人骨盆骨折後第 2 天，突然發生意識改變、呼吸與心跳加速、瘀斑及發燒等徵象，下列何者為病人最可能發生的問題？",{"A":14,"B":15,"C":16,"D":17},"腔隙症候群","脂肪栓塞症候群","骨頭感染致敗血症","動脈損傷致內出血","B",null,[],"本題考點是骨盆或長骨骨折後的脂肪栓塞症候群。依骨折後 24～72 小時內，骨髓腔內脂肪球進入血循環，栓塞於肺與腦部微血管，典型出現意識改變、呼吸窘迫、心搏加速及點狀出血性瘀斑，完全對應題幹，故選 B。選項 A 腔隙（腔室）症候群為肢體筋膜腔內壓升高致局部劇痛、感覺與循環障礙，不會造成全身意識與瘀斑；選項 C 感染致敗血症通常需更長時間發展且以感染徵象為主；選項 D 動脈損傷內出血表現為局部腫脹與失血徵象，不會出現特徵性瘀斑與呼吸窘迫三聯徵。考點在於辨識脂肪栓塞的經典三徵。","脂肪栓塞症候群（fat embolism syndrome）好發於長骨與骨盆骨折後 24–72 小時，經典三聯徵：低血氧性呼吸窘迫（脂肪栓塞肺）、神經症狀（意識改變、躁動）、皮膚點狀出血性瘀斑（petechiae，好發於前胸、腋下、結膜）。機轉為脂肪球機械性阻塞加上游離脂肪酸引發發炎反應。記憶口訣：骨折後兩三天，『喘、亂、紅點點』就想脂肪栓塞。與腔室症候群鑑別——後者是『局部』的 6P（疼痛、蒼白、無脈、感覺異常、麻痺、腫脹壓力升高），前者是『全身』表現。可連結長骨骨折早期固定可降低發生率。",[24,26,29,31],{"term":15,"count":25},4,{"term":27,"count":28},"經典三聯徵",1,{"term":30,"count":28},"點狀出血瘀斑",{"term":32,"count":28},"腔室症候群鑑別",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-108-2-medical-surgical-015","有關左側脛骨骨折病人使用柺杖之護理指導，下列何者錯誤？",15,{"webId":39,"stem":40,"number":41,"year":42,"session":28},"nurse-109-1-medical-surgical-031","下列血脂肪之檢驗值何者不正常？",31,109,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-109-2-medical-surgical-045","有關使用 Braden scale 評估壓傷危險因子和處置之敘述，下列何者正確？",45,{"webId":48,"stem":49,"number":50,"year":51,"session":28},"nurse-111-1-medical-surgical-003","有關腰椎椎間盤突出的敘述，下列何者錯誤？",3,111,{"webId":53,"stem":54,"number":55,"year":56,"session":28},"nurse-112-1-medical-surgical-047","有關細胞毒殺過敏反應之敘述，下列何者錯誤？",47,112,{"webId":58,"stem":59,"number":41,"year":60,"session":28},"nurse-113-1-medical-surgical-031","有關全身性紅斑性狼瘡（SLE）臨床表徵之敘述，下列何者錯誤？",113,"2026-09-04",1788510706297]