[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-111-2-medical-surgical-026":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"內外科護理學","medical-surgical",{"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-111-2-內外科護理學-026","nurse-111-2-medical-surgical-026",111,2,26,"86 歲男性，長期高血壓，近日經醫師診斷為主動脈瓣狹窄，醫師建議更換心臟瓣膜，有關瓣膜選擇與抗凝劑使用的敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"宜選用機械性人工瓣膜，並需終身服用 Warfarin","宜選用生物性人工瓣膜，不需終身服用 Warfarin","宜選用機械性人工瓣膜，不需終身服用 Warfarin","宜選用生物性人工瓣膜，並需終身服用 Warfarin","B",null,[],"本題考點為人工心臟瓣膜選擇與抗凝劑的搭配原則,關鍵在於病人 86 歲高齡。機械性瓣膜耐久性佳但表面易形成血栓,須終身服用 Warfarin 抗凝;生物性瓣膜(如豬瓣、牛心包)血栓性低,通常僅需短期抗凝或不需終身抗凝,但耐用年限較短。高齡病人餘命較短、瓣膜耐久性問題較不重要,且可避免終身抗凝的出血風險與監測負擔,故宜選生物性瓣膜且不需終身服用 Warfarin,選 B。A、C 選機械瓣不適合高齡且 C 漏了必須抗凝;D 選生物瓣卻說要終身抗凝,與其低血栓特性矛盾,均錯誤。","瓣膜選擇本質是「耐久性 vs 抗凝風險」的權衡。機械瓣以碳纖維製成,可用數十年但異物表面活化凝血,INR 須維持約 2.0～3.0;生物瓣約 10～15 年退化鈣化,但內皮化後血栓風險低。選擇邏輯以年齡為軸:年輕病人選機械瓣以免反覆換瓣,但須承擔終身抗凝;高齡病人選生物瓣,以生物瓣退化年限多半超過餘命、又免除跌倒出血與飲食藥物交互作用的風險。此題 86 歲高齡是決策核心線索。",[24,26,28,31],{"term":25,"count":10},"機械性人工瓣膜",{"term":27,"count":10},"生物性人工瓣膜",{"term":29,"count":30},"Warfarin 抗凝",1,{"term":32,"count":30},"瓣膜選擇年齡考量",[34,38,43,47,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-111-2-medical-surgical-027","關於雷諾氏病的敘述，下列何者錯誤？",27,{"webId":39,"stem":40,"number":41,"year":42,"session":30},"nurse-112-1-medical-surgical-043","護理之家發生火災，許多住民吸入性灼傷，下列緊急處置，何者正確？",43,112,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-112-2-medical-surgical-057","有關單側自發性氣胸病人之身體檢查評估結果，下列何者錯誤？",57,{"webId":48,"stem":49,"number":50,"year":51,"session":52},"nurse-113-3-medical-surgical-025","有關腔隙症候群（compartment syndrome）的臨床表徵，下列何者正確？①患肢有緊縮感 ②患肢脈搏減弱 ③止痛藥物能緩解疼痛 ④患肢比健肢冰冷",25,113,3,{"webId":54,"stem":55,"number":56,"year":57,"session":30},"nurse-115-1-medical-surgical-029","吳太太因腫瘤接受化學治療，口腔出現疱疹性齒齦口腔炎（herpetic gingivostomatitis），下列敘述何者正確？",29,115,{"webId":59,"stem":60,"number":41,"year":61,"session":10},"nurse-106-2-medical-surgical-043","有關嚴重燒傷病人急性期的疼痛處置，下列何者最適當？",106,"2026-09-04",1788510738466]