[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-110-1-maternal-pediatric-014":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"產兒科護理學","maternal-pediatric",{"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":10},"nurse-110-1-產兒科護理學-014","nurse-110-1-maternal-pediatric-014",110,1,14,"有關脊髓阻斷（Spinal Block）之敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"常用於減痛分娩，有效緩解第一產程產痛","在 L 4-5 或 L 5 -S 1 下針","麻醉前 30 分鐘須給予較多的靜脈輸液","麻醉後須平躺 3～4 小時，預防頭痛","C",null,[],"本題考點是脊髓阻斷（Spinal Block）麻醉的照護。考點在於脊髓麻醉會阻斷交感神經、使下肢血管擴張而易發生低血壓，故麻醉前約30分鐘須先以靜脈點滴預先補充較多液體（preloading）以維持血壓，故C正確。A錯在脊髓阻斷起效快、範圍固定，常用於剖腹產麻醉，減痛分娩則多採硬脊膜外阻斷。B錯在下針部位應在脊髓圓錐末端以下（約L3-4），以避免傷及脊髓，L5-S1並非典型部位。D錯在術後為預防脊髓穿刺後頭痛應採平躺並補充水分，時間界定也非固定3至4小時。理解「交感神經阻斷導致低血壓」是本題核心。","脊髓麻醉將局部麻醉劑注入蜘蛛膜下腔的腦脊髓液中，阻斷脊神經與交感神經節前纖維，造成血管擴張、靜脈回流下降而低血壓，故術前預灌液體、術中可能需升壓劑（如ephedrine）並採子宮左傾避免仰臥低血壓。穿刺點取L3-4或L4-5，因成人脊髓圓錐終於L1-2，於此下針安全。脊髓穿刺後頭痛（PDPH）源自腦脊髓液自穿刺孔外漏致顱內壓下降，平躺、補充水分與咖啡因可緩解，嚴重者行血液貼片（blood patch）。與硬脊膜外阻斷相比，脊髓阻斷起效快、劑量小、範圍界限明確。",[24,26,28,30],{"term":25,"count":10},"脊髓麻醉交感神經阻斷",{"term":27,"count":10},"術前預灌液體preloading",{"term":29,"count":10},"脊髓穿刺後頭痛PDPH",{"term":31,"count":10},"穿刺部位L3-4",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-110-1-maternal-pediatric-015","以下那些護理評估可以知道待產婦已開始進入第二產程？①破水 ②子宮規則收縮 ③陰道排出粉紅色黏液 ④子宮頸完全擴張 ⑤會陰可見胎頭膨出，個案有不自主用力感",15,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-110-2-maternal-pediatric-031","王女士，懷孕 32 週，突然發生陰道出血而入院，醫囑住院安胎。評估個案未覺腹痛，出血呈鮮紅色、量中。護理師的處置與指導，下列何者錯誤？",31,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-111-1-maternal-pediatric-045","林小弟，1 個月大，剛確診膽道閉鎖，父母正為是否接受手術猶豫不決。根據以家庭為中心的兒科護理特色，下列何者最適當？",45,111,{"webId":48,"stem":49,"number":50,"year":51,"session":41},"nurse-112-2-maternal-pediatric-003","趙女士至門診確認懷孕 8 週，有孕吐現象，詢問有關孕期熱量攝取，下列何者為最適當的回答？",3,112,{"webId":53,"stem":54,"number":55,"year":56,"session":41},"nurse-113-2-maternal-pediatric-027","陳小妹在媽媽的麵店玩耍，不小心撞到端著熱湯的媽媽，左手臂被燙傷，燙傷部分表皮皮膚微紅且出現水泡，當下立即處理何者最適當？",27,113,{"webId":58,"stem":59,"number":60,"year":61,"session":50},"nurse-114-3-maternal-pediatric-021","楊女士，28 歲，G 1 P 0 ，孕前 BMI 正常，本次懷孕為同卵雙胞胎，胎位皆為頭位，下列護理指導何者最適當？",21,114,"2026-09-04",1788510721687]