[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-110-2-maternal-pediatric-017":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":37,"lastmod":65},"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":26},"nurse-110-2-產兒科護理學-017","nurse-110-2-maternal-pediatric-017",110,2,17,"蔡女士第一胎，子宮收縮每 2 分鐘一次，每次持續 60 秒，收縮強度為中度，子宮頸口開 8 公分，突然自然破水，羊水呈棕綠色，無晚期減速或變異性減速的情形。此時最優先的護理措施為何？",{"A":14,"B":15,"C":16,"D":17},"內診評估子宮頸口變化","監測子宮收縮","測量體溫、脈搏、呼吸","測量胎心率","D",null,[],"本題考點為破水後羊水呈胎便染色時的優先評估。依胎兒窘迫的判讀,羊水呈棕綠色提示胎便染色,首要須確認胎兒是否有缺氧,故最優先措施為測量胎心率,選D。(A)內診評估子宮頸雖需執行,但非確認胎兒安危的首要。(B)監測子宮收縮無法直接反映胎兒氧合狀態。(C)測量母體體溫、脈搏、呼吸屬感染或生命徵象監測,非此刻最優先。考點在於出現胎便染色時,胎心率(尤其晚期減速或變異減速)是判斷胎兒窘迫最直接、最優先的評估指標。","羊水胎便染色(meconium-stained fluid)可能反映胎兒缺氧或成熟,重點在立即評估胎心以偵測窘迫(晚期減速、變異性減速、心搏過緩)。破水後也須排除臍帶脫垂(先聽胎心)。棕綠色多為陳舊胎便。記憶:「破水+胎便,先聽胎心」。娩出時警覺胎便吸入症候群,備妥新生兒復甦。可連結:胎心監測分類、臍帶脫垂、胎便吸入症候群、破水後護理。",[24,27,30,32,34],{"term":25,"count":26},"胎兒窘迫",6,{"term":28,"count":29},"胎心率監測",3,{"term":31,"count":29},"晚期減速",{"term":33,"count":10},"破水後護理",{"term":35,"count":36},"羊水胎便染色",1,[38,42,47,51,55,60],{"webId":39,"stem":40,"number":41,"year":9,"session":10},"nurse-110-2-maternal-pediatric-018","有關產婦產後第 1 天的生理變化，下列敘述何者錯誤？",18,{"webId":43,"stem":44,"number":45,"year":46,"session":36},"nurse-111-1-maternal-pediatric-034","有關子宮內膜癌之敘述，下列何者錯誤？",34,111,{"webId":48,"stem":49,"number":50,"year":46,"session":10},"nurse-111-2-maternal-pediatric-048","有關執行兒童生命徵象的測量，下列敘述何者錯誤？",48,{"webId":52,"stem":53,"number":26,"year":54,"session":29},"nurse-112-3-maternal-pediatric-006","素食者在懷孕期較易缺乏下列何項維生素？",112,{"webId":56,"stem":57,"number":58,"year":59,"session":36},"nurse-114-1-maternal-pediatric-010","林女士，G 1P 0，懷孕41週，因自然破水及規則陣痛到院檢查，陰道內診子宮頸已擴張2公分，宮縮時疼痛分數為2分（0-10分量表）故協助辦理住院待產。林女士此時最可能出現下列何種行為反應？",10,114,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-115-2-maternal-pediatric-004","趙女士，29 歲，曾流產一次，有一個 4 歲大的兒子（懷孕 40 週出生），一個剛滿 1 歲的女兒（懷孕 36 週出生），現因再次懷孕而到產科門診檢查，病歷記錄趙女士的孕產史為：",4,115,"2026-09-04",1788510729757]