[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-1-maternal-pediatric-013":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"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":10},"nurse-113-1-產兒科護理學-013","nurse-113-1-maternal-pediatric-013",113,1,13,"蔡女士，初產婦，因產程遲滯而行剖腹生產，新生兒出生體重3,800公克。產婦計畫要完全哺餵母乳，擔心自己奶水不足，因為從生產至今已兩天，都沒有脹奶的感覺，而且新生兒幾乎是含著乳房入睡，放下來就哭。有關蔡女士對奶量的擔心，下列措施何者不適當？",{"A":14,"B":15,"C":16,"D":17},"評估新生兒兩天的排尿及排便情況","告訴產婦產程過長及剖腹生產都會延後脹奶出現的時間，這是正常的","肯定產婦完全母乳哺育的決定，了解這兩天新生兒吃奶及含乳的情況","了解產婦執行手擠乳的情況，討論增加手擠奶頻率的可行性","B",null,[],"本題考點在於剖腹產初產婦擔心奶水不足時的正確衛教，屬反向題，須找出不適當者。不適當敘述為 B「告訴產婦產程過長及剖腹生產都會延後脹奶時間，這是正常的」。此說法把奶水建立問題歸因於不可改變的生產方式、且暗示只能等待，未提供積極促進泌乳的協助，等於變相打擊持續哺乳的信心，故不適當為答案。A 適當，評估新生兒兩天排尿排便可客觀判斷奶水攝取是否足夠。C 適當，肯定全母乳決定並了解含乳與吸吮狀況，有助找出問題。D 適當，了解並鼓勵增加手擠奶頻率可刺激泌乳、建立奶量。判別關鍵在是否『積極促進泌乳並支持信心』，故選 B。","泌乳生理延伸：產後泌乳依賴頻繁有效的吸吮或擠乳刺激乳頭，促進泌乳素（prolactin）與催產素（oxytocin）分泌，形成供需回饋——愈常移出乳汁、奶量愈多。剖腹產或產程過長雖可能略延後脹奶（乳汁生成第二期，lactogenesis II，約產後 2～3 天），但正確處置是增加吸吮\u002F擠乳頻率、確保正確含乳，而非消極等待。新生兒『含著入睡、放下就哭』常反映含乳姿勢無效或吸吮不足，須評估含乳。評估排尿排便次數是判斷母乳攝取是否足夠的實用指標。",[24,26,28,30],{"term":25,"count":10},"母乳哺育",{"term":27,"count":10},"泌乳素與供需回饋",{"term":29,"count":10},"剖腹產後泌乳",{"term":31,"count":10},"有效含乳與擠乳",[33,37,42,48,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-113-1-maternal-pediatric-014","何女士，G1P1，採陰道分娩，無任何產後合併症，產後4小時，觸診子宮底時發現位於臍上一指且偏右，下列何者為首要的護理措施？",14,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-113-3-maternal-pediatric-010","徐女士 30 歲，G 2 P 1 ，懷孕 35 週。因在家感覺子宮規則收縮疼痛，故入院。檢查發現每隔 10 分鐘宮縮一次，持續 30 秒，強度 40 mmHg，內診子宮頸口開 4 公分，70%變薄，胎位為臀位，主訴有很多水從陰道流出。護理師最優先的照護措施為下列何者？",10,3,{"webId":43,"stem":44,"number":45,"year":46,"session":47},"nurse-114-2-maternal-pediatric-004","懷孕 10 週婦女，以超音波評估胎兒大小，下列測量部位何者最適當？",4,114,2,{"webId":49,"stem":50,"number":47,"year":51,"session":10},"nurse-106-1-maternal-pediatric-002","有關現今產科照護發展趨勢的敘述，下列何者正確？",106,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-107-1-maternal-pediatric-046","林小弟，出生時，哭聲宏亮大聲，心跳速率：170 次\u002F分，軀幹顏色粉紅手腳微發紫，四肢屈曲彈性好，吸取鼻腔黏液時，臉部扭曲，其 Apgar score 的評估數值何者正確？",46,107,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-108-1-maternal-pediatric-080","張小妹，4 個月大，被診斷水腦（Hydrocephalus），接受腦室腹膜分流（V-P shunt）手術，有關手術後護理措施，下列何者錯誤？",80,108,"2026-09-04",1788510750751]