[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-112-2-medical-surgical-077":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"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-077","nurse-112-2-medical-surgical-077",112,2,77,"有關敗血症第一小時組合照護（hour-1 bundle）之敘述，下列何者正確？①應快給與抗生素使用，但須先做血液培養 ②施打 1 種或多種廣效抗生素療程約 7～10 天 ③病人低血壓或血清乳酸值大於 2 mmol\u002FL，應儘快輸液以 40 mL\u002Fkg 量輸注 ④病人低血壓在輸液後維持平均動脈壓至少大於或等於 60 mmHg",{"A":14,"B":15,"C":16,"D":17},"①②","①③","②④","③④","A",null,[],"本題考點是敗血症第一小時組合照護(hour-1 bundle)的正確項目。①先抽血液培養再儘快給予抗生素——正確,培養須在抗生素前採檢以免影響結果。②給予1種或多種廣效抗生素、療程約7–10天——符合經驗性廣效抗生素與一般療程,正確。③『低血壓或乳酸>2應以40mL\u002Fkg輸液』錯誤,指引建議為30mL\u002Fkg晶體液,且快速輸液的乳酸門檻為≥4mmol\u002FL。④『輸液後維持平均動脈壓(MAP)至少≥60mmHg』錯誤,目標為MAP≥65mmHg。故正確者為①②,選A。","Surviving Sepsis hour-1 bundle五要點:①測乳酸(>2需追蹤,≥4為積極輸液指標);②在抗生素前採血液培養;③給予廣效抗生素;④低血壓或乳酸≥4時,快速輸注晶體液30mL\u002Fkg;⑤若輸液後仍低血壓,加用升壓劑維持MAP≥65mmHg。本題兩個干擾數字要記牢:輸液量是30(非40)mL\u002Fkg、MAP目標是65(非60)mmHg。核心精神是『黃金第一小時』同步進行診斷(乳酸、培養)與治療(抗生素、輸液、升壓),越早達標越能降低死亡率。作答時逐項核對數字即可辨出③④之誤。",[24,26,29,31,33],{"term":25,"count":10},"血液培養先於抗生素",{"term":27,"count":28},"敗血症hour-1 bundle",1,{"term":30,"count":28},"晶體液30mL\u002Fkg",{"term":32,"count":28},"目標MAP≥65mmHg",{"term":34,"count":28},"乳酸≥4輸液指標",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-112-2-medical-surgical-078","當車禍造成嚴重創傷的病人送到急診出現：脈搏 124 次／分、呼吸 32 次／分胸部起伏明顯，血壓 130\u002F100 mmHg、皮膚溼且冰冷、尿量減少、呈現呼吸性鹼中毒情形，下列休克階段的分期，何者正確？",78,{"webId":41,"stem":42,"number":43,"year":44,"session":28},"nurse-113-1-medical-surgical-044","有關雙胍類降血糖藥物metformin（Glucophage®）之敘述，下列何者錯誤？",44,113,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-113-3-medical-surgical-038","有關腹膜透析治療之敘述，下列何者正確？",38,3,{"webId":51,"stem":52,"number":53,"year":54,"session":28},"nurse-115-1-medical-surgical-036","有關肺栓塞造成的通氣與灌流比失衡（ventilation and perfusion mismatch）之敘述，下列何者正確？",36,115,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-106-2-medical-surgical-060","與尿液 pH 值無關之尿路結石成分，下列何者正確？",60,106,{"webId":61,"stem":62,"number":63,"year":64,"session":28},"nurse-108-1-medical-surgical-014","有關橫膈食道裂孔疝氣的臨床表徵，下列何者錯誤？",14,108,"2026-09-04",1788510747954]