[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-1-medical-surgical-058":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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-058","nurse-109-1-medical-surgical-058",109,1,58,"承上題，下列何項處置可以最有效的改善王先生酸鹼不平衡之問題？",{"A":14,"B":15,"C":16,"D":17},"立即給予紙袋罩住口鼻","注射 NaHCO 3","注射 KCL","指導病人緩慢呼吸","B",null,[],"本題考點為代謝性酸中毒的矯正處置。承前題,病人為急性腎衰竭導致的代謝性酸中毒,其原發問題是血中碳酸氫根不足與酸堆積,故直接補充鹼基——注射碳酸氫鈉(NaHCO3)中和過多氫離子、回升HCO3⁻,是最有效改善酸鹼不平衡的方式,選B。A紙袋罩口鼻用於過度換氣造成的呼吸性鹼中毒,方向相反;C注射KCL補鉀,腎衰竭常已高血鉀,不但無助酸鹼且危險;D緩慢呼吸會使二氧化碳滯留,反而加重酸中毒,故最有效者為B。","代謝性酸中毒治本在處理病因(腎衰竭、乳酸、酮酸),補NaHCO3屬症狀性中和,常用於嚴重酸中毒(pH\u003C7.1)或無法自行代償者。補鹼須留意鈉負荷、低血鉀與低血鈣。呼吸代償(過度換氣)是身體自救,不可用紙袋或抑制呼吸去對抗它。",[24,27,30,32],{"term":25,"count":26},"呼吸代償",5,{"term":28,"count":29},"代謝性酸中毒矯正",2,{"term":31,"count":10},"碳酸氫鈉NaHCO3",{"term":33,"count":10},"補充鹼基",[35,39,43,48,53,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-109-1-medical-surgical-059","有關急性腎盂腎炎之敘述，下列何者正確？①常見於下泌尿道上行性感染 ②常見有肋骨脊柱角處疼痛 ③紅血球沉降速率（ESR）下降 ④急性期時應大量攝取液體",59,{"webId":40,"stem":41,"number":42,"year":9,"session":29},"nurse-109-2-medical-surgical-075","糖尿病病人在下列何種情況下不宜增加胰島素的劑量？",75,{"webId":44,"stem":45,"number":46,"year":47,"session":29},"nurse-110-2-medical-surgical-009","下列何項指標可以用在術前診斷大腸癌及術後追蹤癌症是否復發？",9,110,{"webId":49,"stem":50,"number":51,"year":52,"session":29},"nurse-111-2-medical-surgical-047","有關燒傷的病生理變化，下列何者錯誤？",47,111,{"webId":54,"stem":55,"number":56,"year":57,"session":58},"nurse-112-3-medical-surgical-011","有關急性胰臟炎的處置，下列敘述何者最不適當？",11,112,3,{"webId":60,"stem":61,"number":26,"year":62,"session":10},"nurse-114-1-medical-surgical-005","有關左側大腦損傷可能引起的功能缺失症狀，下列敘述何者正確？①計算能力降低           ②空間缺損 ③半側忽略   ④語言障礙",114,"2026-09-04",1788510712847]