[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-1-maternal-pediatric-011":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"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-011","nurse-113-1-maternal-pediatric-011",113,1,11,"劉女士，G1P0，子宮頸開4公分，每3分鐘宮縮一次，無胎頭骨盆不對稱（CPD），使用硬脊膜外麻醉，持續2 小時都未見胎頭下降，此時最優先之處置為何？",{"A":14,"B":15,"C":16,"D":17},"評估膀胱的情形","評估胎頭大小","給與ritodrine點滴注射，促進子宮收縮","評估羊水量","A",null,[],"本題考點在於硬脊膜外麻醉下產程遲滯、胎頭不下降時的護理優先評估。此案例已排除胎頭骨盆不對稱（CPD），使用硬脊膜外麻醉 2 小時胎頭未下降，須先找可矯正的阻礙因素。依產程照護原則，最優先為 A「評估膀胱情形」，因硬脊膜外麻醉會減弱膀胱脹感、易致尿液滯留，膨脹的膀胱會佔據骨盆空間、阻礙胎頭下降，導出後常見產程再進展。B「評估胎頭大小」與 CPD 相關，題目已排除故非首要。C「給 ritodrine 促進收縮」錯誤，ritodrine 是子宮鬆弛安胎藥，會抑制而非促進宮縮。D「評估羊水量」與此情境的立即阻礙關聯較弱。故正解為 A。","臨床延伸：硬脊膜外麻醉阻斷薦神經，降低膀胱充盈感與尿意，產婦常在不自覺下膀胱過度充盈；一個膨脹膀胱可上推子宮、佔據骨盆並抑制有效宮縮，是產程停滯常被忽略卻可逆的原因，故『先導尿、再觀察進展』是簡單有效的第一步。ritodrine、terbutaline 屬 β₂ 受體促效的子宮鬆弛劑，用於安胎而非引產，記憶時勿與催產的 oxytocin 混淆。可連結產程遲滯的『3P』評估——Power（產力）、Passenger（胎兒）、Passage（產道）。",[24,27,29,31],{"term":25,"count":26},"硬脊膜外麻醉",2,{"term":28,"count":10},"膀胱脹滿阻礙胎頭下降",{"term":30,"count":10},"產程遲滯評估",{"term":32,"count":10},"ritodrine為子宮鬆弛劑",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-maternal-pediatric-012","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，主訴發燒38℃，右側乳房情況如圖所示，觸診溫熱且有痛感。最可能的診斷是？",12,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-113-3-maternal-pediatric-008","潘女士，G 1 P 0 ，懷孕 41 週，因規則陣痛而入院待產，胎位為左枕前位（LOA），未接受硬脊膜外麻醉。現因宮縮強且密集，陰道內診發現子宮頸已擴張完全，胎兒高度+2。在此情境下，下列敘述何者不適當？",8,3,{"webId":44,"stem":45,"number":26,"year":46,"session":26},"nurse-114-2-maternal-pediatric-002","下列何者為懷孕的確實徵候？",114,{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-115-2-maternal-pediatric-050","小富，17 歲，因左側股骨骨折須以石膏固定，有關小富所需要的護理，下列敘述何者正確？",50,115,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-107-1-maternal-pediatric-044","李小弟， 6 個月大，醫師開立醫囑為 Gentamycin 4.8mg I.V. drip q8h ，每毫升（mL）含 Gentamycin 40mg ，請問護理師每次給藥應該抽多少藥量？",44,107,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-108-1-maternal-pediatric-078","張小弟，2 個月大，經由鼻胃管餵食，下列有關管灌餵食的敘述何者正確？",78,108,"2026-09-04",1788510750742]