[{"data":1,"prerenderedAt":62},["ShallowReactive",2],{"q-nurse-112-2-medical-surgical-019":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":61},"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-019","nurse-112-2-medical-surgical-019",112,2,19,"承上題，下列何者為病人最適當的處置？",{"A":14,"B":15,"C":16,"D":17},"將右小腿抬高於心臟","給予右小腿末端冷敷","以彈性繃帶加壓包紮右大腿","去除右小腿石膏","D",null,[],"本題考點承接前題筋膜室症候群的處置原則。依筋膜室症候群的病生理，密閉石膏使筋膜室內壓升高、壓迫神經血管導致缺血，最優先且根本的處置是「解除壓迫來源」——去除或剖開石膏以立即降低筋膜室壓力、恢復灌流，故選 D。A 將患肢抬高於心臟看似合理，但在已疑似筋膜室症候群時抬高過高反而降低動脈灌流壓、加重缺血，不宜；B 冷敷會使血管收縮、進一步減少血流，加劇缺血，不宜；C 以彈性繃帶加壓包紮會再增加外在壓力、惡化筋膜室壓力，方向完全相反，不宜，故正解為去除石膏。","筋膜室症候群的處置邏輯核心是「移除一切外在與升高的壓力」。第一步是解除外部束縛：鬆開或雙瓣剖開石膏、移除敷料繃帶；患肢維持與心臟同高（平放）而非抬高，因為抬高會降低灌流壓、冰敷會血管收縮，都會加重缺血。若解除壓迫後症狀未緩解、測得筋膜室壓力過高（一般 ＞30 mmHg 或與舒張壓差值過小），則需緊急筋膜切開術（fasciotomy）減壓。臨床鐵律是「時間就是肢體」——缺血超過約 6 小時將造成肌肉神經不可逆壞死（Volkmann 攣縮）。此題與 018 的評估—處置連貫，完整呈現一個急症的辨識到處理流程。",[24,26,29,31],{"term":25,"count":10},"筋膜室症候群",{"term":27,"count":28},"石膏移除減壓",1,{"term":30,"count":28},"患肢平放",{"term":32,"count":28},"缺血處置",[34,38,43,48,53,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-112-2-medical-surgical-020","有關接受關節腔鏡檢查病人的陳述，下列何者顯示需要進一步的護理指導？",20,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-112-3-medical-surgical-036","有關執行氣切造口術病人抽痰的敘述，下列何者不適當？",36,3,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-113-2-medical-surgical-030","有關類風溼性關節炎醫療處置之敘述，下列何者錯誤？",30,113,{"webId":49,"stem":50,"number":51,"year":52,"session":42},"nurse-114-3-medical-surgical-028","有關皮膚和傷口照護原則，下列敘述何者最不適當？",28,114,{"webId":54,"stem":55,"number":10,"year":56,"session":10},"nurse-106-2-medical-surgical-002","林先生手術移除額葉腦腫瘤後返回神經外科加護單位觀察，病人突然全身性抽搐，下列措施何者不適當？",106,{"webId":58,"stem":59,"number":41,"year":60,"session":10},"nurse-107-2-medical-surgical-036","心臟週期的那一階段會出現第一心音？",107,"2026-09-04",1788510747422]