[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-109-1-maternal-pediatric-014":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"產兒科護理學","maternal-pediatric",{"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-109-1-產兒科護理學-014","nurse-109-1-maternal-pediatric-014",109,1,14,"李女士每 1 分鐘子宮收縮一次，每次持續 50 秒，子宮頸口全開，變薄程度 100%，胎兒先露部位高度為＋2，有強烈想用力的感覺。當子宮收縮時，下列的護理指導何者最恰當？",{"A":14,"B":15,"C":16,"D":17},"告知不要喊叫","採持續長時間閉氣用力法","打開聲門用力法","腹式呼吸","C",null,[],"本題考點在於第二產程有效用力法的選擇。情境為子宮頸全開、變薄 100%、先露 +2 且有強烈便意，已可用力；此時宜採打開聲門用力法，即用力時保持聲門開放、避免長時間閉氣，維持氧合並減少對母胎血循的不利影響，故選 C。A 全開後產婦有強烈用力感時不宜壓抑，「告知不要喊叫」非此刻護理重點，故錯。B 持續長時間閉氣用力（Valsalva）會升高胸內壓、減少靜脈回流與胎盤灌流，易致胎心音減速，故錯。D 腹式呼吸屬第一產程或用力間歇的呼吸，非全開娩出技巧，故錯。核心在辨識全開後採開放性聲門用力較安全有效。","第二產程用力法比較：開放性聲門（open-glottis）用力隨宮縮短促用力、保持吐氣發聲，維持氧合、較少胎心音減速與會陰創傷；相對地長時間閉氣（Valsalva）雖推力大，但升高胸內壓、降低心輸出與胎盤血流。現行趨勢傾向自發性、開放性用力。記憶：「開聲門吐氣用力，好過憋氣硬撐」。",[24,27,30,31,33],{"term":25,"count":26},"第二產程",9,{"term":28,"count":29},"胎盤灌流",7,{"term":16,"count":10},{"term":32,"count":10},"Valsalva 閉氣用力",{"term":34,"count":10},"自發性用力",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-109-1-maternal-pediatric-015","有關待產時胎心音之監測，下列敘述何者錯誤？",15,{"webId":41,"stem":42,"number":43,"year":9,"session":44},"nurse-109-2-maternal-pediatric-031","根據臺灣優生保健法施行細則規定，除醫療行為外，人工流產應於幾週內施行？",31,2,{"webId":46,"stem":47,"number":48,"year":49,"session":10},"nurse-110-1-maternal-pediatric-045","小瑄，1 歲 1 個月，因不明原因發燒而入住兒童病房，測量小瑄的生命徵象時，下列護理措施何者較不適當？",45,110,{"webId":51,"stem":52,"number":53,"year":54,"session":44},"nurse-111-2-maternal-pediatric-003","有關周產期死亡率的定義，下列何者正確？",3,111,{"webId":56,"stem":57,"number":58,"year":59,"session":44},"nurse-112-2-maternal-pediatric-047","有關兒童生理的發展，下列敘述何者正確？",47,112,{"webId":61,"stem":62,"number":63,"year":64,"session":53},"nurse-113-3-maternal-pediatric-011","有關治療子宮內膜異位症的藥物，下列何者錯誤？",11,113,"2026-09-04",1788510713180]