[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-111-1-psychiatric-community-016":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"精神科與社區衛生護理學","psychiatric-community",{"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-111-1-精神科與社區衛生護理學-016","nurse-111-1-psychiatric-community-016",111,1,16,"林先生因為雙相情緒障礙症（Bipolar Disorder）躁症發作住院，主要治療藥物為鋰鹽、carbamazepine （Tegretol ® ）。護理師發現林先生顯得倦怠、無力，緊急抽血鋰鹽濃度為 0.8 mEq\u002FL、Na 為 120 mEq\u002FL。下列何項護理措施最適當？",{"A":14,"B":15,"C":16,"D":17},"鋰鹽濃度偏高，立即停止服用鋰鹽，預防中毒","是 carbamazepine 的嚴重不良反應，立即停止服用","注意評估病人飲水量","再隔 2 個月抽血檢查鋰鹽及 Na 濃度","C",null,[],"本題考點為鋰鹽治療併發低血鈉的護理判斷。數據顯示鋰鹽濃度 0.8 mEq\u002FL 在治療範圍內（約 0.6 至 1.2）、並非過高，但血鈉僅 120 mEq\u002FL 為明顯低血鈉；鈉與鋰在腎小管競爭再吸收，低血鈉會使鋰滯留、升高中毒風險，故應評估病人飲水量以找出低血鈉成因，選 C。A 錯，鋰鹽濃度並不偏高，無須立即停藥。B 錯，倦怠無力與低血鈉較相關，非 carbamazepine 的嚴重不良反應之典型判定。D 錯，出現低血鈉屬需即時處理的狀況，延至兩個月後才追蹤過於延誤。","鋰鹽的排除高度依賴腎臟且與鈉平衡連動：鋰與鈉在近端腎小管競爭再吸收，當鈉流失或攝取不足、或水分過量稀釋（如過度飲水、SIADH）時，腎臟保鈉同時保鋰，血中鋰濃度上升而易中毒。故治療期須維持穩定的鈉與水分攝取，避免脫水、限鈉飲食或大量流汗。鋰中毒早期表徵包括腸胃不適、細顫、倦怠、運動失調，重則意識改變與抽搐。評估飲水量可辨別是水分過量致稀釋性低血鈉抑或攝取失衡。可連結治療濃度監測與 carbamazepine 亦可能引起低血鈉的交互影響。",[24,27,29,31,33],{"term":25,"count":26},"鋰鹽治療濃度",3,{"term":28,"count":10},"鋰與鈉競爭再吸收",{"term":30,"count":10},"低血鈉",{"term":32,"count":10},"鋰中毒風險",{"term":34,"count":10},"飲水量評估",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-111-1-psychiatric-community-017","黃先生，診斷為思覺失調症（Schizophrenia），規則服藥，在社區復健機構接受治療時，被一位女性踩到腳，他認為自己是病人，又沒結婚，那位女性才會故意踩他的腳。下列何項護理措施最適當？",17,{"webId":41,"stem":42,"number":43,"year":9,"session":44},"nurse-111-2-psychiatric-community-033","慢性思覺失調症病人，於急性病房出院後，轉介至社區復健中心接受工作技能訓練。以三級預防概念來看，「社區復健中心」是屬於何種層級的預防性服務範疇？",33,2,{"webId":46,"stem":47,"number":48,"year":49,"session":10},"nurse-112-1-psychiatric-community-047","有關三角致病模式的要素，下列何者正確？①壓力 ②環境 ③病原體 ④宿主",47,112,{"webId":51,"stem":52,"number":53,"year":54,"session":10},"nurse-113-1-psychiatric-community-035","有關高血壓護理指導後的衝擊評價指標，下列何者最適當？①時間的安排 ②計畫的經費 ③控制高血壓的態度 ④高血壓的就醫行為 ⑤高血壓的罹病率",35,113,{"webId":56,"stem":57,"number":58,"year":59,"session":44},"nurse-114-2-psychiatric-community-039","有關噪音的影響，超過多少分貝可能會干擾內分泌及自主神經系統？",39,114,{"webId":61,"stem":62,"number":43,"year":63,"session":10},"nurse-106-1-psychiatric-community-033","依據精神衛生法規定，嚴重病人不遵醫囑致病情不穩或生活功能有退化之虞，經審查會決定接受社區治療之必要，於社區復健機構治療期間之醫療費用，由誰給付？",106,"2026-09-04",1788510736270]