[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-113-1-maternal-pediatric-009":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":64},"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-113-1-產兒科護理學-009","nurse-113-1-maternal-pediatric-009",113,1,9,"有關分娩期預防產後出血的措施，下列何者不適當？",{"A":14,"B":15,"C":16,"D":17},"待產婦在進入第二產程前，開始持續靜脈注射methylergometrine（Methergin）","胎盤娩出後，檢查胎盤以確認胎盤完整娩出","在新生兒及產婦狀況穩定下，協助親子立即肌膚接觸","產後於恢復室觀察，每15分鐘監測產婦的血壓及出血量","A",null,[],"本題考點在於預防產後出血措施的正確性，屬反向題，須找出不適當者。不適當敘述為 A「進入第二產程前即持續靜脈注射 methylergometrine（Methergin）」。依產科用藥原則，子宮收縮劑（如 methylergometrine、oxytocin）應於胎兒與胎盤娩出後才給予，以促進子宮收縮止血；若在胎兒娩出前給予強力子宮收縮劑，會造成子宮強直收縮、胎兒缺氧甚至子宮破裂，故 A 不適當為答案。B 正確，胎盤娩出後檢查其完整性可避免胎盤殘留造成的出血。C 正確，母嬰穩定下立即肌膚接觸可促進內源性催產素分泌、助子宮收縮並促進哺乳。D 正確，產後於恢復室每 15 分鐘監測血壓與出血量屬標準觀察。故選 A。","藥理延伸：methylergometrine（麥角新鹼）作用於平滑肌造成持續強直性收縮，禁用於胎兒未娩出前，且因會升高血壓，妊娠高血壓\u002F子癇前症病人禁用。相對地，oxytocin 產生節律性收縮，是第三產程積極處置（active management）常用藥。預防產後出血的四大主因記憶為『4T』——Tone（子宮收縮乏力，最常見）、Trauma（產道裂傷）、Tissue（胎盤組織殘留）、Thrombin（凝血異常）。故積極處置強調娩出後給宮縮劑、控制性臍帶牽引與子宮按摩。",[24,27,29,31],{"term":25,"count":26},"產後出血預防",5,{"term":28,"count":10},"methylergometrine用藥時機",{"term":30,"count":10},"子宮收縮劑禁忌",{"term":32,"count":10},"第三產程積極處置",[34,38,43,48,54,59],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-maternal-pediatric-010","胎兒為頭產式，胎頭呈部分屈曲，其最可能以下列那條徑線通過產道？",10,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-113-3-maternal-pediatric-006","第三孕期婦女抱怨下肢腫脹，傍晚時鞋子就穿不下，下列護理指導何者不適當？",6,3,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-114-1-maternal-pediatric-050","小美，15個月大，從樓梯跌落導致頭部受傷，急診護理師依據兒童適用之葛氏昏迷量表（Glasgow coma scale, GCS）評估其意識程度，結果顯示叫他時會睜眼，雖會哭泣但可安撫，輕觸其手臂會收縮反應，請問小美的昏迷指數為幾分？",50,114,{"webId":49,"stem":50,"number":51,"year":52,"session":53},"nurse-115-2-maternal-pediatric-048","有關小兒急性腸胃炎（acute gastroenteritis）臨床表徵之敘述，下列何者錯誤？",48,115,2,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-107-1-maternal-pediatric-042","有關燒燙傷之敘述，下列何者錯誤？",42,107,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-108-1-maternal-pediatric-076","副甲狀腺功能低下（Hypoparathyroidism）的兒童會出現的臨床表徵，下列何者正確？",76,108,"2026-09-04",1788510750719]