[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-062":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-062","nurse-109-2-medical-surgical-062",109,2,62,"有關導致腎病症候群病人全身水腫之病理機轉，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"因鈉離子滯留導致血管內靜力壓上升","因腎上腺功能不足而使醛固酮（aldosterone）分泌減少","腎絲球過濾率下降導致水分滯留","腎絲球通透性增加使蛋白質流失而導致白蛋白減少","D",null,[],"本題考點是腎病症候群（nephrotic syndrome）造成全身水腫的病理機轉。考點在於辨識腎絲球基底膜通透性增加，使大量白蛋白隨尿流失（蛋白尿），血漿白蛋白下降導致血漿膠體滲透壓降低，水分因而由血管滲入組織間隙形成水腫，故選D。A鈉離子滯留使血管內靜力壓上升是續發、次要因素，非主要起因。B敘述醛固酮分泌「減少」方向錯誤，腎病症候群因有效循環容積下降反而使醛固酮續發性增加而保鈉保水。C腎絲球過濾率下降是腎衰竭型水腫的機轉，非腎病症候群的核心。故主要機轉為D低白蛋白血症致膠體滲透壓下降。","腎病症候群四聯：大量蛋白尿（>3.5g\u002F日）、低白蛋白血症、水腫、高血脂。核心是腎絲球通透性增加→漏蛋白→血漿膠體滲透壓（oncotic pressure）下降，依Starling力平衡，血管內留不住水，水分外滲致全身性水腫（常見眼周、下肢、甚至腹水）。有效循環容積下降再啟動RAAS，醛固酮上升續發保鈉保水，加重水腫。護理重點：監測體重與水腫、限鈉、白蛋白與利尿劑使用、感染預防（免疫球蛋白流失）。記憶：「漏蛋白→血裡沒膠體→水跑到組織」。",[24,27,30,32],{"term":25,"count":26},"腎病症候群",7,{"term":28,"count":29},"腎絲球通透性增加",1,{"term":31,"count":29},"低白蛋白血症與膠體滲透壓下降",{"term":33,"count":29},"Starling力平衡",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-109-2-medical-surgical-063","有關腎病症候群病人之診斷性檢查之典型發現，下列何者正確？①血尿 ②菌尿 ③蛋白尿 ④血清白蛋白濃度下降 ⑤血糖上升 ⑥血清膽固醇上升 ⑦血清三酸甘油酯上升 ⑧血清鈣上升",63,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-110-1-medical-surgical-079","有關休克初期身體啟動之正常代償機轉，下列何者錯誤？",79,110,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-111-1-medical-surgical-013","有關膈裂孔疝氣的敘述，下列何者正確？",13,111,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-112-1-medical-surgical-051","協助醫師拔除胸管時，應指導病人採取下列何種呼吸方式？",51,112,{"webId":55,"stem":56,"number":57,"year":58,"session":29},"nurse-113-1-medical-surgical-045","張太太，罹患糖尿病2年，平日使用口服抗血糖藥物控制血糖，今日在家昏倒被送至急診，醫師初步診斷為高滲透壓高血糖狀態（HHS），病人會呈現的徵象，下列何者正確？①呼吸速率26次／分 ②血壓166\u002F84 mmHg ③尿酮呈陽性反應，明顯升高 ④血糖為750 mg\u002FdL。",45,113,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-114-2-medical-surgical-039","有關腎臟結石接受體外震波術後照護措施之敘述，下列何者錯誤？",39,114,"2026-09-04",1788510716865]