[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-2-maternal-pediatric-040":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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-113-2-產兒科護理學-040","nurse-113-2-maternal-pediatric-040",113,2,40,"小光，3 個月大，診斷為法洛氏四重畸形，在矯正手術前，依醫囑給與 prostaglandin E 1 （PGE 1 ）的理由，下列敘述何者正確？",{"A":14,"B":15,"C":16,"D":17},"使動脈導管維持開放，增加主動脈的血量","使動脈導管維持開放，增加肺動脈的血量","使動脈導管儘早關閉，減少肺動脈的壓力","使動脈導管儘早關閉，減少主動脈的壓力","B",null,[],"本題考點在於前列腺素 E1（PGE1）在法洛氏四重畸形術前的作用機轉。法洛氏四重畸形（TOF）含肺動脈狹窄，肺血流不足導致發紺，術前給予 PGE1 的目的是「維持動脈導管開放（keep PDA open）」，讓血液能經開放的動脈導管由主動脈流向肺動脈，增加肺血流與肺部氧合，故選 B（維持動脈導管開放、增加肺動脈血量）。A 錯，目的不是增加主動脈血量，TOF 缺的是肺血流而非體循環血量。C、D 錯，PGE1 的作用是「維持開放」而非「儘早關閉」動脈導管；關閉導管會使依賴導管供應肺血流的發紺型心臟病病嬰惡化。本題須掌握 PGE1 保持動脈導管開放的藥理作用，以及 TOF 需增加肺血流的病生理邏輯。","動脈導管（ductus arteriosus）在胎兒期連接肺動脈與主動脈，出生後因氧分壓上升與前列腺素下降而閉合。前列腺素 E1（alprostadil）能使導管平滑肌鬆弛、維持開放，用於「導管依賴型」先天性心臟病：發紺型（如肺動脈閉鎖、嚴重 TOF、大血管轉位）靠導管把血送去肺部氧合，左心阻塞型（如主動脈弓縮窄、左心發育不全）靠導管維持體循環，術前皆需 PGE1 維持導管開放以爭取手術時機。相對地，早產兒開放性動脈導管（PDA）治療則用 indomethacin／ibuprofen（前列腺素合成抑制劑）促其關閉。記憶法：PGE1「保留水管」（keep the duct open），indomethacin「關水管」。",[24,26,29,31],{"term":25,"count":10},"導管依賴型先天性心臟病",{"term":27,"count":28},"前列腺素E1藥理作用",1,{"term":30,"count":28},"動脈導管維持開放",{"term":32,"count":28},"法洛氏四重畸形肺血流不足",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-2-maternal-pediatric-041","下列何者為急性淋巴性白血病最有效之鑑別診斷？",41,{"webId":39,"stem":40,"number":41,"year":42,"session":28},"nurse-114-1-maternal-pediatric-037","小英，6個月，出現輕微發燒、食慾不振、喉嚨痛、耳後及後頸部淋巴結腫大等症狀。他先在臉部出現粉紅色斑丘疹，再漫延至頸部、手臂、軀幹，而後逐漸往下肢發展，但疹子出現3天即消除。小英最可能感染下列何種疾病？",37,114,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-114-3-maternal-pediatric-031","有關 10 歲兒童的繪畫發展特色，下列敘述何者正確？",31,3,{"webId":49,"stem":50,"number":51,"year":52,"session":28},"nurse-106-1-maternal-pediatric-079","張小弟，罹患腦性麻痺，有咀嚼及吞嚥困難問題，有關幫助其吞嚥的護理措施，下列敘述何者正確？",79,106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-2-maternal-pediatric-043","張太太懷孕 30 週，因早期破水產下重 2,400 公克女嬰，其體重與妊娠週數的關係屬於：",43,107,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-108-2-maternal-pediatric-077","王小弟，3 歲，罹患腎病症候群（nephrotic syndrome），目前服用 prednisolone 治療。護理師在安排與王小弟同住的病童時，下列何者適宜？",77,108,"2026-09-04",1788510755666]