[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-1-maternal-pediatric-076":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"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":10},"nurse-109-1-產兒科護理學-076","nurse-109-1-maternal-pediatric-076",109,1,76,"小珍，8 歲，第 1 型糖尿病病童。幾天來出現噁心、嘔吐、易口渴症狀，現因呼吸、心跳快且深而到急診。Blood sugar 780 mg\u002FdL、K + ：5.0 mEq\u002FL、Na + ：138 mEq\u002FL、Urine sugar 3+、ketone+。由上述症狀評估小珍可能出現的問題為：",{"A":14,"B":15,"C":16,"D":17},"高滲透壓高血糖狀態","低滲透壓高血糖狀態","糖尿病酮酸症","低血糖性休克反應","C",null,[],"本題考點在於第一型糖尿病急性併發症的鑑別。依糖尿病酮酸症（DKA）診斷準則，需具備高血糖、酮體陽性與代謝性酸中毒三要素；本情境血糖 780 mg\u002FdL、尿糖 3+、酮體陽性，且出現深快的 Kussmaul 呼吸（身體排出二氧化碳代償代謝性酸中毒），完全符合 DKA，故選 C。A 的高滲透壓高血糖狀態（HHS）多見於第二型糖尿病、血糖常更高但無明顯酮體與酸中毒，與本情境酮體陽性不符。B 的「低滲透壓高血糖狀態」並非臨床標準診斷、不成立。D 的低血糖性休克與本情境高血糖（780）方向相反。故正確為糖尿病酮酸症。","鑑別口訣：DKA＝「高血糖＋酮體＋酸中毒＋Kussmaul 深呼吸＋爛蘋果味（丙酮）」，多見第一型；HHS＝「極高血糖（常＞600）＋高滲透壓＋無明顯酮體\u002F酸中毒」，多見第二型年長者。Kussmaul 呼吸是身體用過度換氣排出 CO₂ 來代償代謝性酸中毒的表現。胰島素絕對不足使脂肪分解產生酮酸，是 DKA 的核心機轉。",[24,26,28,30],{"term":25,"count":10},"糖尿病酮酸症 DKA",{"term":27,"count":10},"高血糖+酮體+代謝性酸中毒",{"term":29,"count":10},"Kussmaul 呼吸",{"term":31,"count":10},"與 HHS 鑑別",[33,37,42,47,52,58],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-109-1-maternal-pediatric-077","王小妹，7 歲，被診斷泌尿道感染（Urinary Tract Infection），出院時醫囑開立 7 天份的口服抗生素 amoxicilline，下列護理指導何者適當？",77,{"webId":38,"stem":39,"number":40,"year":41,"session":10},"nurse-110-1-maternal-pediatric-013","李女士待產時宮縮疼痛非常焦慮不安，下列護理措施何者錯誤？",13,110,{"webId":43,"stem":44,"number":45,"year":41,"session":46},"nurse-110-2-maternal-pediatric-027","有關新生兒髖關節脫臼的身體或姿勢表徵，下列何者錯誤？",27,2,{"webId":48,"stem":49,"number":50,"year":51,"session":46},"nurse-111-2-maternal-pediatric-065","有關早產兒開放性動脈導管的醫療處置，下列敘述何者錯誤？",65,111,{"webId":53,"stem":54,"number":55,"year":56,"session":57},"nurse-112-3-maternal-pediatric-029","小偉因腦膜炎住院，依醫囑給與小偉藥物治療，醫師醫囑為：Dexamethasone（10 mg\u002F2 mL\u002Fvial）7 mg Q8H 靜脈滴注，護理師每次給藥應抽多少 mL 的藥物劑量？",29,112,3,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-114-1-maternal-pediatric-023","王女士，30歲，G 1P 1，有妊娠期糖尿病，有關產後的避孕護理指導，下列何者較為合適？",23,114,"2026-09-04",1788510713863]