[{"data":1,"prerenderedAt":62},["ShallowReactive",2],{"q-nurse-113-1-maternal-pediatric-014":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":61},"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-014","nurse-113-1-maternal-pediatric-014",113,1,14,"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？",{"A":14,"B":15,"C":16,"D":17},"子宮按摩","下床活動","多喝開水","如廁解尿","D",null,[],"本題考點在於產後子宮底位置異常偏移的成因判讀與首要處置。此案例產後 4 小時子宮底位於臍上一指且偏右，典型代表膀胱脹滿將子宮上推並向右偏移。依產後照護原則，首要護理措施為 D「如廁解尿」，排空膀胱後子宮底通常會下降回位並維持良好收縮，減少子宮收縮不良導致的產後出血。A「子宮按摩」在子宮偏移的成因未解除前效果有限，應先排空膀胱。B「下床活動」與 C「多喝開水」皆非針對膀胱脹滿造成子宮上移的直接處置。判別關鍵在辨識『子宮底高且偏右＝膀胱脹滿』，故正解為 D。","臨床延伸：產後正常子宮底約在肚臍平或臍下一指、位於中線且質地堅硬。若子宮底升高並偏向一側（多偏右），最常見原因是膀胱過度充盈，脹大的膀胱把子宮往上、往對側推移，並妨礙子宮有效收縮而增加出血風險。故評估到此徵象，第一步是協助排尿（必要時導尿），再重新評估子宮底高度與收縮情形。產後利尿與大量點滴會讓膀胱快速充盈，加上會陰疼痛或麻醉影響排尿感，故需主動提醒定時排尿。",[24,27,29,31],{"term":25,"count":26},"產後子宮底評估",2,{"term":28,"count":10},"膀胱脹滿使子宮上移偏右",{"term":30,"count":10},"排空膀胱優先",{"term":32,"count":10},"子宮收縮與產後出血",[34,38,43,48,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-maternal-pediatric-015","有關產後婦女之情緒照顧，下列護理指導何者不適當？",15,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-113-3-maternal-pediatric-011","有關治療子宮內膜異位症的藥物，下列何者錯誤？",11,3,{"webId":44,"stem":45,"number":46,"year":47,"session":26},"nurse-114-2-maternal-pediatric-005","有關胎兒生長過程的敘述，下列何者正確？",5,114,{"webId":49,"stem":50,"number":42,"year":51,"session":10},"nurse-106-1-maternal-pediatric-003","許女士，懷孕 30 週，這兩週血壓上升，尿液檢查也有異常反應，醫師給予胎兒生理活動評估（BPP），有關此評估之敘述下列何者正確？",106,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-107-1-maternal-pediatric-047","陳小妹，妊娠週數 39 週又 5 天，自然產及使用真空吸引娩出，頭部受到擠壓而嚴重變形，出生體重 3,890 公克，在執行身體評估時觸摸其頭部，發現整個頭皮邊緣有水腫且越過骨縫中線，生命徵象穩定，瞳孔大小及對光反射正常，有關陳小妹頭部的創傷問題，下列何者正確？",47,107,{"webId":58,"stem":59,"number":10,"year":60,"session":26},"nurse-108-2-maternal-pediatric-001","依據世界衛生組織及聯合國兒童基金會推行的政策，要成為母嬰親善醫院需符合下列那一項規定？",108,"2026-09-04",1788510750762]