[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-1-maternal-pediatric-027":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":63},"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-027","nurse-109-1-maternal-pediatric-027",109,1,27,"糖尿病孕婦所產下體重過重的嬰兒（出生體重在 4,000 公克以上）容易在出生後發生低血糖的狀況，主要原因可能是：",{"A":14,"B":15,"C":16,"D":17},"新生兒出生後無法釋放足夠的胰島素，葡萄糖調節失控所致","新生兒出生後仍保留從母親獲得的大量葡萄糖，胰島素迅速分泌增加所致","母親供應的葡萄糖出生後中斷，新生兒體內存在過多的胰島素快速消耗葡萄糖所致","新生兒剛出生，還沒有開始進食大量奶水，體內葡萄糖容量不足所致","C",null,[],"本題考點在於糖尿病母親嬰兒(IDM)出生後低血糖的病生理機轉。依胎兒代謝生理,母親高血糖使葡萄糖經胎盤大量傳送給胎兒,刺激胎兒胰臟長期分泌過多胰島素形成高胰島素血症;出生後臍帶剪斷、母體葡萄糖供應驟然中斷,而新生兒體內仍殘留過量胰島素快速消耗血糖,遂發生低血糖,故選C。A方向相反,IDM並非胰島素釋放不足,而是過多。B錯在把重點放在「殘留葡萄糖」,實際葡萄糖來源已中斷,問題出在胰島素過量。D以進食不足解釋,並非巨嬰低血糖的主因。因此正確機轉為C。","此為Pedersen高血糖-高胰島素假說:母體高血糖→胎兒高血糖→胎兒胰島β細胞增生、高胰島素→促合成致巨嬰,且胰島素為胎兒重要生長因子。出生後供糖中斷但高胰島素狀態尚未回落,故常於出生後1至2小時內出現低血糖。記憶要點:「巨嬰=高胰島素的後果,低血糖=高胰島素的餘威」。可連結巨嬰症、新生兒呼吸窘迫(胰島素延遲肺表面張力素成熟)、低血鈣等IDM併發症延伸複習。",[24,27,29,31],{"term":25,"count":26},"胎兒高胰島素血症",3,{"term":28,"count":10},"糖尿病母親嬰兒 IDM",{"term":30,"count":10},"Pedersen 假說",{"term":32,"count":10},"母體葡萄糖供應中斷",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-109-1-maternal-pediatric-028","下列何者為新生兒黃疸照光治療的原理？",28,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-109-2-maternal-pediatric-044","有關預防嬰幼兒鉛中毒，下列可減少鉛的吸收之敘述，何者錯誤？",44,2,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-110-1-maternal-pediatric-058","協助學齡前期的手足面對病童瀕死的護理措施，下列敘述何者正確？",58,110,{"webId":49,"stem":50,"number":51,"year":52,"session":42},"nurse-111-2-maternal-pediatric-016","王女士，G 1 P 0 ，子宮頸口開 10 公分，待產時宮縮疼痛，下列措施何者最適當？",16,111,{"webId":54,"stem":55,"number":56,"year":57,"session":42},"nurse-112-2-maternal-pediatric-060","有關嬰幼兒「呼吸系統特徵」之敘述，下列何者最不適當？",60,112,{"webId":59,"stem":60,"number":61,"year":62,"session":26},"nurse-113-3-maternal-pediatric-024","護理師從胎兒監測器得知，胎兒心跳 100 次／分，持續 80 秒，其型態與宮縮沒有一定關係，此胎心率型態為：",24,113,"2026-09-04",1788510713310]