[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-056":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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-109-2-內外科護理學-056","nurse-109-2-medical-surgical-056",109,2,56,"下列動脈血液氣體分析的報告，何者最能顯示慢性阻塞性肺疾病（COPD）病人的情況惡化？",{"A":14,"B":15,"C":16,"D":17},"pH 7.30，PaCO 2 60 mmHg，PaO 2 70 mmHg，HCO 3- 30 mEq\u002FL","pH 7.38，PaCO 2 45 mmHg，PaO 2 88 mmHg，HCO 3- 24 mEq\u002FL","pH 7.40，PaCO 2 40 mmHg，PaO 2 94 mmHg，HCO 3- 22 mEq\u002FL","pH 7.55，PaCO 2 30 mmHg，PaO 2 80 mmHg，HCO 3- 26 mEq\u002FL","A",null,[],"本題考點是動脈血液氣體分析（ABG）判讀慢性阻塞性肺疾病（COPD）惡化。考點在於辨識COPD惡化時二氧化碳蓄積加劇、氧合下降，呈現「呼吸性酸中毒合併低血氧」；A報告pH 7.30（酸血）、PaCO₂ 60mmHg（升高）、PaO₂ 70mmHg（偏低）、HCO₃⁻ 30mEq\u002FL（代償性上升）最能反映急性惡化，故選A。B、C各項數值皆在正常範圍，代表氣體交換穩定。D的pH 7.55、PaCO₂ 30mmHg為呼吸性鹼中毒（過度換氣），與COPD二氧化碳蓄積方向相反。故唯一顯示惡化者為A。","COPD病生理：慢性氣流阻塞使肺泡通氣不足、CO₂滯留，腎臟代償性保留HCO₃⁻維持pH，形成「代償性慢性呼吸性酸中毒」（pH接近正常低值、PaCO₂高、HCO₃⁻高）。急性惡化時CO₂進一步上升、pH跌破7.35且低氧，屬急性合併慢性呼吸性酸中毒。氧療須謹慎，過高氧濃度可能抑制其低氧驅動並惡化CO₂滯留，目標SpO₂約88–92%。判讀口訣：「pH看酸鹼、CO₂反向為呼吸性、HCO₃同向為代謝性」。A的酸＋高CO₂＝呼吸性酸中毒惡化。",[24,27,30,32],{"term":25,"count":26},"呼吸性酸中毒",8,{"term":28,"count":29},"動脈血氣體分析判讀",1,{"term":31,"count":29},"COPD二氧化碳蓄積",{"term":33,"count":29},"腎臟代償HCO3−",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-109-2-medical-surgical-057","一位被診斷為「疑似細菌性肺炎」的病人剛入院，最優先執行下列那一個醫囑？",57,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-110-1-medical-surgical-073","有關糖尿病足之護理指導，下列何者正確？",73,110,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-111-1-medical-surgical-007","有關腦波檢查的護理措施，下列何者錯誤？",7,111,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-112-1-medical-surgical-045","有關皮膚癌的預防或處置，下列敘述何者錯誤？",45,112,{"webId":55,"stem":56,"number":57,"year":58,"session":29},"nurse-113-1-medical-surgical-039","有關透析治療比較之敘述，下列何者正確？",39,113,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-114-2-medical-surgical-033","有關預防吸入性肺炎病人之護理措施，下列何者最不適當？",33,114,"2026-09-04",1788510716809]