[{"data":1,"prerenderedAt":68},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-074":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":38,"lastmod":67},"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-074","nurse-109-2-medical-surgical-074",109,2,74,"有關糖尿病酮酸中毒（DKA）病人之檢驗結果，下列何者正確？①動脈血氧分析 pH 7.2 ②動脈血氧分析 pH 7.5 ③血中碳酸根離子濃度 14 mEq\u002FL ④血中碳酸根離子濃度 25 mEq\u002FL ⑤血清滲透壓>320 mOsm\u002Fkg ⑥血清滲透壓\u003C320 mOsm\u002Fkg",{"A":14,"B":15,"C":16,"D":17},"①③⑥","①④⑥","②③⑤","②④⑤","A","第74題一律給分",[],"本題考點是糖尿病酮酸中毒（DKA）的典型檢驗值。DKA因酮體堆積造成代謝性酸中毒，動脈血pH下降至7.35以下（①pH 7.2符合）、血中碳酸氫根被消耗而降低（③14 mEq\u002FL符合，正常約22～26），且血清滲透壓通常低於320 mOsm\u002Fkg（⑥符合，此點與HHS的大於320相區別），三者組合即選項A。②pH 7.5屬鹼中毒、④碳酸氫根25屬正常、⑤滲透壓大於320是HHS特徵，皆不符DKA，故含這些的B、C、D均錯。故正解為A。","DKA的三聯診斷抓緊：高血糖（多大於250 mg\u002FdL）、酮體陽性、代謝性酸中毒（pH小於7.3、HCO₃⁻小於18、陰離子間隙升高）。機轉是胰島素絕對不足→脂肪分解產生游離脂肪酸→肝臟生成酮酸（β-羥丁酸、乙醯乙酸）→血中氫離子上升消耗碳酸氫根→酸中毒，並代償性深快呼吸（Kussmaul呼吸）排CO₂、呼氣帶爛蘋果味。與HHS關鍵鑑別在滲透壓與酮體：DKA滲透壓相對較低（小於320）但有酸中毒與酮體；HHS滲透壓極高（大於320）卻無明顯酮酸。治療核心是補液、靜脈胰島素、並監測與補充血鉀。",[24,27,30,33,36],{"term":25,"count":26},"代謝性酸中毒",22,{"term":28,"count":29},"糖尿病酮酸中毒",8,{"term":31,"count":32},"陰離子間隙",3,{"term":34,"count":35},"血中碳酸氫根",1,{"term":37,"count":35},"血清滲透壓",[39,43,48,53,58,63],{"webId":40,"stem":41,"number":42,"year":9,"session":10},"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":10},"nurse-110-2-medical-surgical-011","有關肝硬化之飲食建議，下列何者正確？",11,110,{"webId":49,"stem":50,"number":51,"year":52,"session":35},"nurse-111-1-medical-surgical-025","有關聽力喪失病人的護理指導，下列何者錯誤？",25,111,{"webId":54,"stem":55,"number":56,"year":57,"session":35},"nurse-112-1-medical-surgical-063","有關抗利尿激素分泌不當症候群（SIADH）病人之臨床表徵，下列何者錯誤？",63,112,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-113-2-medical-surgical-007","有關胃癌的敘述，下列何者正確？",7,113,{"webId":64,"stem":65,"number":35,"year":66,"session":32},"nurse-114-3-medical-surgical-001","有關癲癇病人的症狀及其治療，下列敘述何者最不適當？",114,"2026-09-04",1788510716989]