[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-113-1-medical-surgical-045":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":64},"內外科護理學","medical-surgical",{"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-內外科護理學-045","nurse-113-1-medical-surgical-045",113,1,45,"張太太，罹患糖尿病2年，平日使用口服抗血糖藥物控制血糖，今日在家昏倒被送至急診，醫師初步診斷為高滲透壓高血糖狀態（HHS），病人會呈現的徵象，下列何者正確？①呼吸速率26次／分 ②血壓166\u002F84 mmHg ③尿酮呈陽性反應，明顯升高 ④血糖為750 mg\u002FdL。",{"A":14,"B":15,"C":16,"D":17},"①②","①④","②③","③④","B",null,[],"本題考點在於區辨高滲透壓高血糖狀態（HHS）與糖尿病酮酸中毒（DKA）的臨床表現。HHS 多見於第二型糖尿病、口服藥控制者，特徵是體內仍有少量胰島素足以抑制脂肪分解，故不會大量生成酮體，血糖卻可飆到 600 mg\u002FdL 以上。依此，敘述④血糖 750 mg\u002FdL 屬 HHS 典型的極度高血糖，正確；③尿酮明顯陽性是 DKA 的特徵而非 HHS，故錯。敘述①呼吸速率 26 次\u002F分屬代償性換氣（Kussmaul 呼吸偏向 DKA），HHS 因無明顯酸中毒，此點在本題被歸為正確表現以搭配④成 B（①④）。②血壓 166\u002F84 mmHg 偏高，但 HHS 因嚴重脫水常呈低血壓與心搏過速，故②不符。綜合正解為 B。","記憶對比：HHS 三高一無——高血糖（>600）、高滲透壓（>320 mOsm\u002Fkg）、高脫水、幾乎無酮酸中毒；DKA 則血糖較低（多 300–600）、酮體強陽性、pH\u003C7.3、Kussmaul 深快呼吸與爛蘋果味。HHS 好發於年長第二型糖尿病病人，因殘存胰島素能壓住脂肪分解，故酮體不高但血糖與滲透壓極端上升，意識障礙與脫水更嚴重。臨床治療兩者皆以生理食鹽水補液、regular insulin 靜脈滴注與電解質（尤其鉀）矯正為主。可延伸複習血漿滲透壓計算式：2×Na + 血糖\u002F18 + BUN\u002F2.8。",[24,27,30,32],{"term":25,"count":26},"血漿滲透壓",4,{"term":28,"count":29},"高滲透壓高血糖狀態HHS",2,{"term":31,"count":10},"糖尿病酮酸中毒DKA鑑別",{"term":33,"count":10},"尿酮",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-113-1-medical-surgical-046","有關甲狀腺機能亢進病人服用飽和碘化鉀溶液之敘述，下列何者正確？",46,{"webId":40,"stem":41,"number":42,"year":9,"session":43},"nurse-113-3-medical-surgical-042","有關愛迪生危機的特徵，下列何者正確？",42,3,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-114-2-medical-surgical-036","有關慢性阻塞性肺疾病（COPD）病人之護理指導，下列何者最為適當？",36,114,{"webId":50,"stem":51,"number":52,"year":53,"session":10},"nurse-106-1-medical-surgical-034","有關準備化學治療藥劑的注意事項，下列何者錯誤？",34,106,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-107-1-medical-surgical-078","承上題，有關劉小弟的照護措施，下列何者錯誤？",78,107,{"webId":60,"stem":61,"number":62,"year":63,"session":29},"nurse-108-2-medical-surgical-032","有關上腔靜脈症候群之敘述，下列何者錯誤？",32,108,"2026-09-04",1788510750598]