[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-111-2-medical-surgical-040":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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":26},"nurse-111-2-內外科護理學-040","nurse-111-2-medical-surgical-040",111,2,40,"林先生在輸血過程中出現頭痛、咳嗽、呼吸困難、心跳加快及血壓升高等情形，最有可能是出現下列那一種輸血反應？",{"A":14,"B":15,"C":16,"D":17},"急性溶血反應","循環過度負荷","過敏反應","輸血相關之急性肺損傷","B",null,[],"本題考點為輸血反應的鑑別,關鍵在症狀組合。頭痛、咳嗽、呼吸困難、心跳加快、血壓升高,反映的是短時間內輸入過多血量使循環容積負荷過重、肺部鬱血(如同肺水腫),屬循環過度負荷(TACO),選 B。A 急性溶血反應以發燒、寒顫、腰背痛、血紅素尿與休克(血壓下降)為主;C 過敏反應以蕁麻疹、搔癢、支氣管痙攣為主;D 輸血相關急性肺損傷(TRALI)雖有呼吸困難,但典型為低血壓而非血壓升高,與本題血壓上升不符。","輸血相關呼吸窘迫的兩大鑑別是 TACO 與 TRALI,常考其血壓差異:TACO(循環過載)因容量過多,血壓「上升」、頸靜脈怒張、對利尿劑有反應;TRALI(急性肺損傷)為免疫機轉的非心因性肺水腫,血壓「下降」、利尿劑無效。本題血壓升高是判 TACO 的關鍵線索。預防 TACO 須放慢輸血速度、心衰或老幼病人尤須警覺,必要時輸血前給利尿劑。急性溶血反應則屬 ABO 不合的最危險反應,一旦發生應立即停止輸血並保留血袋送驗。",[24,27,29,32],{"term":25,"count":26},"輸血反應",3,{"term":28,"count":10},"循環過度負荷 TACO",{"term":30,"count":31},"TACO 與 TRALI 鑑別",1,{"term":33,"count":31},"容積負荷過重",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-111-2-medical-surgical-041","長期攝取低纖維或精緻飲食，可能與下列何種癌症的發生最有關？",41,{"webId":40,"stem":41,"number":42,"year":43,"session":31},"nurse-112-1-medical-surgical-057","病人有心衰竭病史，因車禍造成左側肋骨骨折與氣血胸，目前出現急性呼吸衰竭的情形，下列護理措施何者最不適宜？",57,112,{"webId":45,"stem":46,"number":47,"year":43,"session":10},"nurse-112-2-medical-surgical-071","有關胰島素注射之敘述，下列何者正確？",71,{"webId":49,"stem":50,"number":51,"year":52,"session":26},"nurse-113-3-medical-surgical-039","有關體外震波碎石術之敘述，下列何者錯誤？",39,113,{"webId":54,"stem":55,"number":56,"year":57,"session":31},"nurse-115-1-medical-surgical-043","有關嗜鉻細胞瘤切除手術後之護理措施，下列何者錯誤？",43,115,{"webId":59,"stem":60,"number":42,"year":61,"session":10},"nurse-106-2-medical-surgical-057","肺炎病人接受抗生素治療，下列何者表示抗生素已發揮作用？",106,"2026-09-04",1788510738573]