[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-108-2-medical-surgical-063":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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-108-2-內外科護理學-063","nurse-108-2-medical-surgical-063",108,2,63,"改善其酸鹼不平衡問題最有效的措施，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"給予紙袋罩住口鼻","注射 NaHCO 3","補充 NH 4 Cl","使用人工呼吸器","B",null,[],"本題考點為急性腎衰竭所致代謝性酸中毒的矯正措施。此病人為代謝性酸中毒(HCO₃⁻ 偏低)，最直接有效的處置是補充鹼基，靜脈注射碳酸氫鈉(NaHCO₃)可提升血中 HCO₃⁻ 中和過多酸，故選 B。選項 A 給予紙袋罩住口鼻是用於過度換氣導致的呼吸性鹼中毒，讓病人重吸回 CO₂，與本題代謝性酸中毒方向相反。選項 C 補充 NH₄Cl(氯化銨)本身為酸化劑，用於治療代謝性鹼中毒，會使酸中毒惡化。選項 D 使用人工呼吸器主要處理通氣衰竭或呼吸性問題，無法直接矯正代謝性酸的根本缺鹼。故補充碳酸氫鈉最有效。","對症配對記憶：代謝性酸中毒→補 NaHCO₃;代謝性鹼中毒→補 NH₄Cl 或處理病因;呼吸性鹼中毒(過度換氣)→紙袋回吸 CO₂;呼吸性酸中毒→改善通氣。急性腎衰竭因排酸與生成 HCO₃⁻ 障礙而酸堆積。補鹼須監測血鉀，因酸中毒矯正後鉀會由細胞外移回細胞內，可能出現低血鉀。",[24,27,29,32,34],{"term":25,"count":26},"急性腎衰竭",8,{"term":28,"count":10},"代謝性酸中毒矯正",{"term":30,"count":31},"碳酸氫鈉 NaHCO3",1,{"term":33,"count":31},"NH4Cl 酸化劑",{"term":35,"count":31},"酸鹼配對",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-108-2-medical-surgical-064","蔡先生目前正處於少尿期，其生化檢驗可能產生的變化，不包括下列何者？",64,{"webId":42,"stem":43,"number":44,"year":45,"session":31},"nurse-109-1-medical-surgical-080","病人因腰椎椎間盤突出接受手術治療，術後依醫囑需穿硬背架 3 個月，下列敘述何者錯誤？",80,109,{"webId":47,"stem":48,"number":49,"year":50,"session":31},"nurse-110-1-medical-surgical-014","下列何者不是結腸癌的典型臨床表徵？",14,110,{"webId":52,"stem":53,"number":54,"year":55,"session":31},"nurse-111-1-medical-surgical-052","有關使用呼氣末期陽壓（PEEP）治療急性呼吸窘迫症候群的主要目的，下列何者正確？",52,111,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-112-2-medical-surgical-016","有關食道癌的病因，下列何者正確？",16,112,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-113-2-medical-surgical-030","有關類風溼性關節炎醫療處置之敘述，下列何者錯誤？",30,113,"2026-09-04",1788510706728]