[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-109-1-medical-surgical-007":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":64},"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-109-1-內外科護理學-007","nurse-109-1-medical-surgical-007",109,1,7,"有關脊髓損傷造成弛緩型神經性膀胱的排尿訓練，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"定時敲擊恥骨上方，以刺激排尿反射","使用副交感神經刺激劑，以利膀胱迫尿肌收縮","練習會陰肌肉收縮運動","尿管留置或尿布使用，以解決滲尿問題","B",null,[],"本題考點在於弛緩型(下運動神經元型)神經性膀胱的排尿訓練原則。弛緩型膀胱因反射弧受損、迫尿肌無力而尿液滯留,故使用副交感神經刺激劑(如 bethanechol)促進迫尿肌收縮以利排空,答案為 B。定時敲擊恥骨上方誘發反射(A)適用於痙攣型(上運動神經元型)膀胱;會陰肌肉收縮運動(C)用於訓練括約肌、改善應力性失禁,無助弛緩型排空;長期留置尿管或使用尿布(D)僅被動處理滲尿,無法達到訓練膀胱排空的目的。考點在於區辨弛緩型與痙攣型神經性膀胱的訓練策略差異。","神經性膀胱依損傷位置分兩型:痙攣型(上運動神經元、薦髓以上損傷)反射弧完整,膀胱過度反射,訓練用叩擊誘發反射性排尿;弛緩型(下運動神經元、薦髓或以下損傷)反射弧被破壞,迫尿肌鬆軟無力、尿液滯留,需靠副交感神經刺激劑(bethanechol)增強迫尿肌收縮,或以 Credé 手法、間歇性導尿協助排空。記法:上位傷=痙攣=敲擊誘發;下位傷=弛緩=用藥或壓迫協助排空。",[24,27,29,31],{"term":25,"count":26},"神經性膀胱",5,{"term":28,"count":10},"弛緩型膀胱",{"term":30,"count":10},"副交感神經刺激劑 bethanechol",{"term":32,"count":10},"上下運動神經元損傷",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-109-1-medical-surgical-008","有關闌尾炎護理措施的敘述，下列何者正確？",8,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-109-2-medical-surgical-024","有關美尼爾氏症之敘述，下列何者正確？①可能原因是外耳淋巴液過多 ②症狀為雙側傳導性聽力減退 ③使用血管擴張劑減輕耳鳴症狀 ④藥物治療無效時，可採迷路切除術",24,2,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-110-1-medical-surgical-038","有關化學藥物發生滲漏的敘述，下列何者正確？",38,110,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-111-1-medical-surgical-076","下列何者不是休克時會發生之代償機轉？",76,111,{"webId":54,"stem":55,"number":56,"year":57,"session":42},"nurse-112-2-medical-surgical-040","王先生因疲倦、蒼白、呼吸困難至醫院求治，檢查發現白血球數值為 30 萬／μL，骨髓檢查發現費城染色體，最有可能罹患下列何種疾病？",40,112,{"webId":59,"stem":60,"number":61,"year":62,"session":63},"nurse-113-3-medical-surgical-004","有關癲癇病人的敘述，下列何者錯誤？",4,113,3,"2026-09-04",1788510712370]