[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-112-2-maternal-pediatric-054":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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-112-2-產兒科護理學-054","nurse-112-2-maternal-pediatric-054",112,2,54,"小強，13 歲大，罹患骨肉瘤（Osteosarcoma），經歷化學治療與手術治療後，癌細胞仍轉移到肺部。當小強在生命末期時，護理師可評估到的生理變化，下列敘述何者正確？",{"A":14,"B":15,"C":16,"D":17},"呼吸呈現深快的庫斯莫爾氏呼吸（Kussmaul’s respiration）","周邊循環增加，使得四肢末梢脈搏變強","括約肌控制降低，造成大小便失禁","痛覺變遲鈍，視力最後消失","C",null,[],"本題考點為兒童生命末期的生理變化辨識。依瀕死期生理，隨中樞與自主神經功能衰退，括約肌張力下降導致大小便失禁，故選 C。A 錯在庫斯莫爾氏呼吸（Kussmaul）是代謝性酸中毒的深快代償呼吸，瀕死期常見的是陳施氏呼吸（Cheyne-Stokes）或臨終喉鳴等不規則呼吸型態。B 錯在瀕死時心輸出量下降、周邊循環減少，四肢末梢冰冷、脈搏變弱且不易觸得，而非增強。D 錯在感覺消失的順序一般是視覺先減退、聽覺最後消失，痛覺並非最先遲鈍且視力最後消失的敘述有誤。","瀕死常見徵象：周邊循環衰竭（四肢冰冷、發紺、花斑、脈搏細弱）、呼吸型態改變（陳施氏呼吸、臨終喉鳴）、意識下降、括約肌失能致失禁。感官消退口訣「視覺先走、聽覺最後」，故臨終陪伴仍鼓勵溫和言語與觸摸。Kussmaul 呼吸專屬糖尿病酮酸中毒等代謝性酸中毒，勿與瀕死呼吸混淆，是本題主要陷阱。",[24,27,29,32],{"term":25,"count":26},"陳施氏呼吸",3,{"term":28,"count":10},"感官消退順序",{"term":30,"count":31},"瀕死期生理變化",1,{"term":33,"count":31},"括約肌失能",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-112-2-maternal-pediatric-055","黃小妹為 35 週出生的早產兒，罹患高膽紅素血症（Hyperbilirubinemia），有關傳統照光機執行照光治療的護理措施，下列敘述何者錯誤？",55,{"webId":40,"stem":41,"number":42,"year":43,"session":31},"nurse-113-1-maternal-pediatric-021","接受子宮頸環紮術（cervical cerclage）之孕婦狀況，下列何者最適合？",21,113,{"webId":45,"stem":46,"number":47,"year":43,"session":26},"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,{"webId":49,"stem":50,"number":51,"year":52,"session":31},"nurse-115-1-maternal-pediatric-013","蘇女士 G3P3，懷孕 34 週早期破水緊急剖腹生產，產後第 9 天在家來電主訴：「擠奶 30 分鐘後，身體移動時陰道感覺有東西流出，發現有如 50 元硬幣大小的血塊（如圖示），廁所途中仍持續出血，2 天前開始喝生化湯」，下列解釋何者最不適當？",13,115,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-106-2-maternal-pediatric-037","最常導致婦女泌尿道感染的病原體為何？",37,106,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-107-2-maternal-pediatric-071","持續靜脈灌注前列腺素 E 1 （PGE 1 ）可維持動脈導管開放，增加肺動脈血流。下列何種先天性心臟病，不適合使用 PGE 1 治療？",71,107,"2026-09-04",1788510748448]