[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-111-2-maternal-pediatric-016":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":63},"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-111-2-產兒科護理學-016","nurse-111-2-maternal-pediatric-016",111,2,16,"王女士，G 1 P 0 ，子宮頸口開 10 公分，待產時宮縮疼痛，下列措施何者最適當？",{"A":14,"B":15,"C":16,"D":17},"直接送入分娩室，等醫師來方可用力生產","可採膀胱截石臥位，此為最有助於產程進展之姿勢","當進入第二產程每 30 分鐘監測待產婦的血壓、脈搏和呼吸","有強烈便意感時，可採緩慢開聲門用力生產","D",null,[],"本題考點在第二產程用力的正確指導。子宮頸全開10公分且有強烈便意感時，代表胎頭下降壓迫直腸，此時可指導產婦採「開放式聲門（open glottis）緩慢吐氣用力」，避免長時間閉氣（Valsalva）造成胎兒缺氧與產婦血壓波動，故選D。考點在於開放聲門用力優於閉氣用力。選項A「直接送分娩室、等醫師才可用力」不符實務，用力時機依產婦身體狀態與產程而非硬性等醫師；選項B膀胱截石臥位並非「最有助產程進展」的姿勢，仰臥截石位反而壓迫下腔靜脈、不利胎頭下降，直立或側臥更佳；選項C第二產程生命徵象監測頻率描述不當、且非最適當處置。三個錯項各在時機、姿勢或監測上出錯。","第二產程用力方式：實證支持自發性、開放聲門用力（隨便意感自然使力、緩慢吐氣），優於指導式閉氣用力（Valsalva）；後者長時間閉氣使胸內壓上升、靜脈回流下降，導致母體血壓波動與胎盤灌流減少、胎心變異。姿勢方面直立、蹲、側臥利用重力與擴大骨盆出口徑；仰臥截石位壓迫主動脈與下腔靜脈（仰臥低血壓症候群），非最佳。",[24,27,30,33],{"term":25,"count":26},"第二產程",9,{"term":28,"count":29},"生產姿勢",3,{"term":31,"count":32},"開放聲門用力",1,{"term":34,"count":32},"Valsalva閉氣",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-111-2-maternal-pediatric-017","使用催產素催生的待產婦女，當發生下列何種情況仍可持續使用催產素促進產程？",17,{"webId":41,"stem":42,"number":43,"year":44,"session":32},"nurse-112-1-maternal-pediatric-033","當產科急症造成瀰漫性血管內凝血（Disseminated Intravascular Coagulation, DIC）時，下列檢驗數值何者正確？①凝血酶原時間（PT）、部分凝血酶原時間（PTT）延長 ②D-dimer 數值下降 ③血小板數值下降 ④纖維蛋白原（fibrinogen）數值上升",33,112,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-112-2-maternal-pediatric-047","有關兒童生理的發展，下列敘述何者正確？",47,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-113-3-maternal-pediatric-015","王女士，初產婦，陰道生產，採純母乳哺育，產後 6 週重返職場的一週後，因發燒乳房紅腫熱痛求診，診斷為乳腺炎。下列的護理措施何者不適當？",15,113,{"webId":55,"stem":56,"number":57,"year":58,"session":32},"nurse-115-1-maternal-pediatric-019","有關新生兒出生時維生素 K 缺乏的原因，下列何者錯誤？",19,115,{"webId":60,"stem":61,"number":43,"year":62,"session":10},"nurse-106-2-maternal-pediatric-033","有關妊娠糖尿病的敘述，下列何者錯誤？",106,"2026-09-04",1788510739131]