[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-113-2-maternal-pediatric-021":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"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-113-2-產兒科護理學-021","nurse-113-2-maternal-pediatric-021",113,2,21,"初產婦 34 歲，妊娠 38 週胎兒發育符合妊娠週數，因破水入院後 24 小時仍無宮縮，予以評估子宮頸成熟度，發現其子宮頸擴張＜1 公分，子宮頸變薄 30%，無法觸診到胎兒的先露部位，子宮頸位置在後方且堅硬。依據上述情境，若採 Bishop 計分法評估，以決定後續相關處置，下列敘述何者較適當？",{"A":14,"B":15,"C":16,"D":17},"得分為 6 分，適用催生針劑靜脈滴注催產","子宮頸已成熟，適用前列腺素針劑靜脈滴注催產","得分為 0 分，適用前列腺素陰道塞劑促子宮頸成熟","子宮頸不成熟，可繼續觀察 48 小時，若無產兆且確定無感染則可返家待產","C",null,[],"本題考點在於 Bishop 評分法的計分與後續處置判讀。Bishop 分數由子宮頸擴張、變薄、位置、質地與先露部位胎頭高度五項評估。本情境：擴張＜1 公分（0 分）、變薄 30%（0 分）、先露部位無法觸診代表胎頭甚高（0 分）、子宮頸位置在後方（0 分）、質地堅硬（0 分），總分為 0 分，屬子宮頸極不成熟。子宮頸不成熟時應先促進子宮頸成熟，以前列腺素陰道塞劑軟化子宮頸，故選 C。A 錯，得分並非 6 分（6 分才算成熟），且未成熟不宜直接催產。B 錯，子宮頸並未成熟，且前列腺素主要作用是促成熟而非直接靜脈滴注催產（催產用的是催產素 oxytocin）。D 錯，已破水 24 小時無宮縮，繼續等待 48 小時會顯著增加絨毛膜羊膜炎與感染風險，不宜返家待產。本題須正確累計 Bishop 各項分數並連結促成熟處置。","Bishop 五項各 0–3 分（位置與質地為 0–2），總分 ≥6（部分教材 ≥8）視為子宮頸成熟、引產成功率高，可直接用催產素引產；＜6 為不成熟，須先用前列腺素（如 dinoprostone 陰道塞劑）或機械性（Foley 導管）促子宮頸成熟。本題五項全 0，是典型「極不成熟」。臨床概念：破水後感染時鐘已啟動，破水超過 18–24 小時未生產屬 PROM 併發感染高風險，不能無限期等待，須促成熟後引產。催產素與前列腺素分工要分清：前列腺素「軟化子宮頸」，催產素「發動並增強宮縮」。",[24,27,30,32],{"term":25,"count":26},"子宮頸成熟度",5,{"term":28,"count":29},"破水後感染風險",3,{"term":31,"count":10},"前列腺素促子宮頸成熟",{"term":33,"count":34},"Bishop評分法",1,[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-113-2-maternal-pediatric-022","下列那些為重度子癇前症的危險徵候和症狀？①嚴重頭痛 ②視力模糊 ③4 小時尿量為 400 mL ④血清肌酐酸持續下降",22,{"webId":41,"stem":42,"number":43,"year":44,"session":34},"nurse-114-1-maternal-pediatric-018","沐浴前將新生兒置於有磅秤紙的體重計進行體重量測，沐浴後以乾毛巾迅速擦乾其身體，此乃運用下列那些預防體熱喪失的機制？",18,114,{"webId":46,"stem":47,"number":48,"year":44,"session":29},"nurse-114-3-maternal-pediatric-012","陳女士，待產 3 小時，於陰道內診發現其胎兒先露部位到達坐骨棘連線上 1 公分。下列紀錄何者正確？",12,{"webId":50,"stem":51,"number":52,"year":53,"session":34},"nurse-106-1-maternal-pediatric-060","有關嬰兒及兒童接受氧氣治療之相關敘述，下列何者正確？",60,106,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-107-2-maternal-pediatric-024","有關產後性行為（sexual intercourse）的護理指導，下列敘述何者最適當？",24,107,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-108-2-maternal-pediatric-058","小明，9 歲，因患白血病被告知需住院至少一個月接受治療，此階段兒童最關心的事為何？",58,108,"2026-09-04",1788510755502]