[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-1-maternal-pediatric-020":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":25},"nurse-113-1-產兒科護理學-020","nurse-113-1-maternal-pediatric-020",113,1,20,"王女士，G1P0，妊娠38週，因早期破水入院待產，待產時宮縮頻率及強度均不好，破水30小時後新生兒才娩出。產後第2天出現下列症狀：體溫38.5～39.5℃、惡露呈紅色有惡臭味、子宮底高度臍平、子宮軟、有頭痛及失眠、下腹部壓痛但無反彈性壓痛。上述王女士的身體狀況，其臨床症狀敘述下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"會陰傷口感染","子宮內膜炎","腹膜炎","泌尿道感染","B",null,[],"本題考點在於依產後感染的臨床表徵鑑別診斷。此案例有早期破水、破水長達 30 小時、產程遷延等高危因子，產後第 2 天出現發燒 38.5～39.5℃、惡露紅且惡臭、子宮軟且底高臍平、下腹壓痛但無反彈痛，這組合最符合 B「子宮內膜炎」。依感染定位，發燒＋惡臭惡露＋子宮壓痛＋子宮復舊不良是子宮內膜炎的典型表現，破水過久與產程長是其重要危險因子。A「會陰傷口感染」局限於會陰局部紅腫熱痛，與全身及子宮徵象不符。C「腹膜炎」會有明顯反彈痛與腹肌僵硬，但本案無反彈痛。D「泌尿道感染」以頻尿、尿急、排尿灼痛或腰痛為主，與惡臭惡露、子宮壓痛不符。故正解為 B。","病生理延伸：產後子宮內膜炎多由陰道與腸道菌上行感染子宮內膜，危險因子包括破水過久、產程遷延、多次內診、剖腹產與胎盤殘留。典型『三聯徵』——產後發燒（常在產後 2～3 天）、子宮壓痛、惡臭惡露，並常見子宮復舊不良（子宮軟、底偏高）。與腹膜炎鑑別關鍵在有無反彈痛與腹膜刺激徵象；與泌尿道感染鑑別在症狀定位。治療以廣效抗生素為主。可連結產褥熱（puerperal fever）定義——產後 24 小時後至 10 天內，兩次體溫≥38℃。",[24,26,28,30],{"term":15,"count":25},2,{"term":27,"count":10},"產後感染鑑別",{"term":29,"count":10},"破水過久與產程遷延危險因子",{"term":31,"count":10},"惡臭惡露與子宮壓痛",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-113-1-maternal-pediatric-021","接受子宮頸環紮術（cervical cerclage）之孕婦狀況，下列何者最適合？",21,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-113-3-maternal-pediatric-017","護理人員使用新貝拉（New Ballard Score）量表，進行四位出生第 3 小時的新生兒成熟度評估，下列那位新生兒可能為早產兒？",17,3,{"webId":43,"stem":44,"number":45,"year":46,"session":25},"nurse-114-2-maternal-pediatric-011","郭女士，懷孕 39 週。主訴：「自今天凌晨 1 點開始陸續出現陣痛，有時半小時，有時 20 分鐘痛一次，不太規則。大概從半夜 3 點開始，宮縮變得規則且明顯，大約 5 分鐘一次」。早上 6 點因子宮頸口開 3 公分且 3～4 分鐘宮縮一次而入院待產。下午 3 點子宮頸口完全擴張（10 公分）。下午 4 點 10 分陰道娩出一健康女嬰。下午 4 點 20 分胎盤娩出。請問郭女士此次生產第一產程時間應記錄為何？",11,114,{"webId":48,"stem":49,"number":50,"year":51,"session":10},"nurse-106-1-maternal-pediatric-009","王女士，33 歲，目前懷孕 9 週，有貧血的現象。下列何種食物可幫助鐵質的吸收？",9,106,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-107-1-maternal-pediatric-053","王小弟，10 歲，長期服用抗癲癇藥物，應定期檢查的項目，下列何者除外？",53,107,{"webId":58,"stem":59,"number":60,"year":61,"session":25},"nurse-108-2-maternal-pediatric-007","吳女士，育有一子，目前懷孕 10 週，她曾自然流產一次，也曾因懷孕 24 週胎死腹中而引產。其生產紀錄史，下列何者正確？",7,108,"2026-09-04",1788510750806]