[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-1-maternal-pediatric-022":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":63},"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-022","nurse-113-1-maternal-pediatric-022",113,1,22,"有關妊娠糖尿病之敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"妊娠初期胎盤分泌人類胎盤泌乳激素（hPL）增加，產生胰島素拮抗","容易導致流產及羊水過多","與糖尿病遺傳史無關","口服降血糖藥為主要治療方式","B",null,[],"本題考點在於妊娠糖尿病（GDM）的病生理與臨床特性。依產科學，妊娠糖尿病使母體血糖偏高、胎兒長期處於高血糖與高胰島素環境，易造成巨嬰、多尿而導致羊水過多，也增加流產與胎兒異常風險，故 B「容易導致流產及羊水過多」正確。A 敘述時機錯誤，胎盤泌乳素（hPL）等抗胰島素荷爾蒙是在妊娠中後期（第二、三孕期）大量增加而產生胰島素阻抗，並非妊娠初期，故 A 錯。C「與糖尿病遺傳史無關」錯誤，家族糖尿病史是妊娠糖尿病的重要危險因子。D「口服降血糖藥為主要治療」錯誤，妊娠糖尿病首選飲食控制與運動，血糖仍無法達標時以胰島素注射為主要藥物治療。故正解為 B。","病生理延伸：妊娠中後期胎盤分泌人類胎盤泌乳素（hPL）、雌激素、黃體素、皮質醇等具抗胰島素作用的荷爾蒙，造成胰島素阻抗上升，母體須代償分泌更多胰島素，若代償不足即發生妊娠糖尿病。胎兒因母血高糖經胎盤運送而長期高血糖，刺激自身胰島素分泌（胰島素是胎兒生長因子）造成巨嬰、器官肥大，出生後又易發生新生兒低血糖。治療階梯——飲食與運動優先，達標不佳才用胰島素；口服降血糖藥在孕期使用較受限。可連結產後追蹤，GDM 婦女未來罹患第二型糖尿病風險上升。",[24,26,28,30],{"term":25,"count":10},"妊娠糖尿病GDM",{"term":27,"count":10},"胎盤泌乳素hPL與胰島素阻抗",{"term":29,"count":10},"羊水過多與巨嬰",{"term":31,"count":10},"胰島素治療優先於口服藥",[33,37,42,48,53,58],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-113-1-maternal-pediatric-023","李女士以oxytocin 進行引產，胎心音出現變異性減速，下列處置何者最適當？",23,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-113-3-maternal-pediatric-019","下列何項護理措施較無法改善新生兒溢奶的狀況？",19,3,{"webId":43,"stem":44,"number":45,"year":46,"session":47},"nurse-114-2-maternal-pediatric-013","有關親子同室（rooming-in）的敘述，下列何者錯誤？",13,114,2,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-106-1-maternal-pediatric-011","一位產婦入院待產，子宮頸口開 6 公分，因產痛難耐而要求醫護人員提供針灸止痛的措施時，下列有關護理師的反應何者較為合適？",11,106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-1-maternal-pediatric-055","醫護人員藉由評估嬰幼兒的精細動作，肌肉張力及平衡感等活動，可判斷下列何者之功能？",55,107,{"webId":59,"stem":60,"number":61,"year":62,"session":47},"nurse-108-2-maternal-pediatric-009","懷孕 11 週的黃女士向護理師抱怨有頻尿的現象，可是並無解尿困難的情形，下列何者是較適當的護理指導？",9,108,"2026-09-04",1788510750836]