[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-1-medical-surgical-025":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":63},"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-025","nurse-109-1-medical-surgical-025",109,1,25,"一位 26 歲新婚女性，有計畫懷孕，近日因心臟不適，經醫師診斷二尖瓣狹窄，並建議更換心臟瓣膜，有關瓣膜選擇與抗凝劑使用之敘述，下列何者最適當？",{"A":14,"B":15,"C":16,"D":17},"宜選用機械性人工瓣膜，並需服用 warfarin","宜選用生物性人工瓣膜，不可服用 warfarin","宜選用機械性人工瓣膜，不可服用 warfarin","宜選用生物性人工瓣膜，並需服用 warfarin","B",null,[],"本題考點在於育齡計畫懷孕婦女的人工瓣膜選擇與抗凝劑安全。Warfarin為口服抗凝劑具致畸胎性，懷孕期禁用；機械性瓣膜需終身服warfarin抗凝以防血栓，對計畫懷孕者不利。故此病人宜選生物性人工瓣膜，因其不需長期抗凝，可避免warfarin風險，選B。選項A機械瓣需warfarin，與懷孕衝突；選項C機械瓣卻不服warfarin會致瓣膜血栓，危險；選項D生物瓣通常不需長期warfarin，卻加上warfarin，不合適。故最適當為生物瓣且不用warfarin。","瓣膜選擇權衡：機械瓣耐用（可用數十年）但需終身抗凝，出血與致畸風險高；生物瓣不需長期抗凝，適合育齡婦女或不宜抗凝者，但耐用性較差（約10～15年）易退化需再置換。Warfarin致畸胎表現包括鼻部發育不良與骨骼點狀鈣化。此題核心是「懷孕禁warfarin」導向生物瓣，屬臨床決策整合題。",[24,27,29,31],{"term":25,"count":26},"生物性人工瓣膜",2,{"term":28,"count":10},"Warfarin致畸胎性",{"term":30,"count":10},"機械瓣需終身抗凝",{"term":32,"count":10},"育齡婦女瓣膜選擇",[34,38,42,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-109-1-medical-surgical-026","心臟衰竭病人使用 Dopamine 6 ug\u002Fkg\u002Fmin，給予該劑量 Dopamine 之最主要目的為何？",26,{"webId":39,"stem":40,"number":41,"year":9,"session":26},"nurse-109-2-medical-surgical-042","真性紅血球增多症的臨床表徵，下列何者錯誤？",42,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-110-1-medical-surgical-056","有關抗凝劑 Warfarin 使用的注意事項，下列何者錯誤？",56,110,{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-111-2-medical-surgical-014","有關消化性潰瘍的敘述，下列何者正確？",14,111,{"webId":53,"stem":54,"number":55,"year":56,"session":26},"nurse-112-2-medical-surgical-058","下列何者最不可能出現在肺氣腫病人的肺功能檢查結果？",58,112,{"webId":58,"stem":59,"number":60,"year":61,"session":62},"nurse-113-3-medical-surgical-022","一位正在接受胸壁放射治療的復發性乳癌病人表示：「吞嚥時感到疼痛，胸口有灼熱及緊繃感」。下列何者是病人因放射線治療導致最可能的結果？",22,113,3,"2026-09-04",1788510712536]