[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-111-1-maternal-pediatric-074":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":64},"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-111-1-產兒科護理學-074","nurse-111-1-maternal-pediatric-074",111,1,74,"咚咚，4 個月大，疑似泌尿道感染（urinary tract infection）住院，經排尿性膀胱尿道攝影（Voiding cystourethrogram, VCUG）檢查，確認為第三級，下列敘述何者正確？",{"A":14,"B":15,"C":16,"D":17},"屬輕微的尿液逆流，不需治療會自行痊癒","出院後每 3 個月做 1 次尿液培養至少 1 年","宜限制水分攝取，避免發生低血鉀","安排開刀，避免尿液大量逆流，造成腎臟損傷","B",null,[],"本題考點在於膀胱輸尿管逆流（VUR）分級與處置原則。依國際分級，第三級屬中度逆流，輸尿管與腎盂已擴張但尚未嚴重扭曲，治療原則以預防性抗生素加長期追蹤為主，需定期做尿液培養監測有無反覆感染，故選 B（每 3 個月培養 1 次至少 1 年）。A 錯在把第三級當成第一、二級的輕度逆流，中度以上不會單靠自癒且仍需介入。C 錯在腎病症候群才需控水，VUR 反而應鼓勵足量水分沖洗尿路，低血鉀也非本症重點。D 錯在手術多保留給第四、五級或反覆感染合併腎損傷者，第三級並非首選開刀。","VUR 分級依 VCUG 影像判定：I 級僅逆流至輸尿管、II 級達腎盂但無擴張、III 級輸尿管與腎盂輕中度擴張、IV 級明顯扭曲、V 級嚴重擴張且腎盞變鈍。低級數多能隨膀胱輸尿管接合處成熟而自然緩解，故採內科保守療法（continuous antibiotic prophylaxis）加尿培養追蹤；級數越高、自癒率越低，腎瘢痕（reflux nephropathy）風險越大，才考慮輸尿管再植手術。記憶重點：逆流傷腎的機轉是含菌尿液逆衝腎實質造成瘢痕與高血壓，故監測感染比急著開刀更關鍵。",[24,26,28,30,32],{"term":25,"count":10},"膀胱輸尿管逆流分級",{"term":27,"count":10},"VCUG",{"term":29,"count":10},"預防性抗生素",{"term":31,"count":10},"尿液培養追蹤",{"term":33,"count":10},"腎瘢痕",[35,39,44,49,54,60],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-111-1-maternal-pediatric-075","有關先天性巨結腸症的臨床表徵，下列敘述何者錯誤？",75,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-112-1-maternal-pediatric-011","張女士，G 2 P 1 ，懷孕 40 週，子宮頸口擴張 8 公分，變薄 90%，如果出現宮縮強且胎頭迅速下降想用力，下列護理措施何者較不恰當？",11,112,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-112-2-maternal-pediatric-025","蔡女士，初產婦，新生兒出生體重 3,800 公克。採完全哺餵母乳，護理師進行產後兩週之出院後電話關懷時發現，新生兒出生兩週體重為下降至 3,700 公克。下列何者為最優先的處置？",25,2,{"webId":50,"stem":51,"number":52,"year":53,"session":48},"nurse-113-2-maternal-pediatric-043","小琪，女嬰，新生兒篩檢診斷為先天性腎上腺增生症（congenital adrenal hyperplasia, CAH），護理師提供給小琪父母的護理指導，下列敘述何者最不適當？",43,113,{"webId":55,"stem":56,"number":57,"year":58,"session":59},"nurse-114-3-maternal-pediatric-047","諾羅病毒（norovirus）引起的急性腸胃炎，下列敘述何者正確？",47,114,3,{"webId":61,"stem":62,"number":42,"year":63,"session":48},"nurse-106-2-maternal-pediatric-011","有關護理師進行新生兒抽吸之敘述，下列何者正確？",106,"2026-09-04",1788510736044]