[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-112-2-medical-surgical-010":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-112-2-內外科護理學-010","nurse-112-2-medical-surgical-010",112,2,10,"李先生因胃癌接受次全胃切除手術（Billroth II），術後開始進食稀飯，約 20 分鐘出現腹脹、噁心嘔吐、心悸、頭暈等現象，下列何者為其最可能造成的原因？",{"A":14,"B":15,"C":16,"D":17},"食糜快速進入腸道，引起細胞內、外液電解質不平衡","高張性碳水化合物食糜進入腸道，促使 Insulin 大量分泌","細胞外液迅速移入腸道，快速液體移位減少了循環血量","高張性脂肪性食糜進入腸道，促使 Amylase 大量分泌","C",null,[],"本題考點是胃切除術後的傾食症候群（dumping syndrome）中「早期傾食」的病生理機轉。依傾食症候群機轉，Billroth II 術後失去幽門括約肌的調節，高張性食糜（尤其醣類）在進食後 15–30 分鐘快速傾入小腸，腸腔滲透壓驟升將大量細胞外液吸入腸道，導致有效循環血量下降，出現腹脹、噁心、心悸、頭暈、冒汗等血管運動症狀，故選 C。A 敘述錯誤，主要機轉是滲透性體液移位而非電解質不平衡；B 描述的胰島素大量分泌造成低血糖屬「晚期傾食」（進食後 1.5–3 小時），與本題 20 分鐘的時序不符；D 高張性脂肪與 amylase 分泌與此機轉無關，敘述錯誤。","傾食症候群分早、晚兩期，區辨關鍵在時間與機轉。早期傾食（進食後 15–30 分鐘）：高張食糜快速入腸→腸腔滲透壓高→細胞外液滲入腸道→循環血量減少→腹脹、心悸、頭暈、盜汗、腹瀉。晚期傾食（進食後 1.5–3 小時）：大量醣類快速吸收→血糖飆升→胰島素過度分泌→反應性低血糖→顫抖、冒汗、無力。護理指導核心：少量多餐、乾濕分離（進餐時少喝湯水）、避免高糖高張飲食、增加蛋白質與脂肪比例、餐後採平躺或半坐臥以減緩胃排空。本題以「20 分鐘」明確指向早期傾食的體液移位機轉。",[24,26,29,31],{"term":25,"count":10},"傾食症候群",{"term":27,"count":28},"早期傾食",1,{"term":30,"count":28},"高張食糜滲透移位",{"term":32,"count":28},"Billroth II",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-112-2-medical-surgical-011","有關消化性潰瘍的治療藥物，下列何者錯誤？",11,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-112-3-medical-surgical-027","病人剛接受骨髓移植 2 週，主訴右上腹痛，評估有黃疸、腹水，下列何者是病人最有可能發生的問題？",27,3,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-113-2-medical-surgical-021","有關惡性貧血的敘述，下列何者錯誤？①與自體免疫有關 ②曾接受胃切除手術者較易罹患 ③可以進行骨髓切片檢查確定診斷 ④須終生補充維生素 B 12",21,113,{"webId":49,"stem":50,"number":51,"year":52,"session":42},"nurse-114-3-medical-surgical-019","針對正在接受化學治療病人的護理指導，下列敘述何者最不適當？",19,114,{"webId":54,"stem":55,"number":56,"year":57,"session":28},"nurse-106-1-medical-surgical-073","關於糖化血色素（HbA1c）之敘述，下列何者正確？",73,106,{"webId":59,"stem":60,"number":41,"year":61,"session":10},"nurse-107-2-medical-surgical-027","針對心房纖維顫動病人使用 warfarin（coumadin）之目的，下列何者正確？",107,"2026-09-04",1788510747352]