[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-2-maternal-pediatric-043":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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":26},"nurse-113-2-產兒科護理學-043","nurse-113-2-maternal-pediatric-043",113,2,43,"小琪，女嬰，新生兒篩檢診斷為先天性腎上腺增生症（congenital adrenal hyperplasia, CAH），護理師提供給小琪父母的護理指導，下列敘述何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"教導父母觀察小琪有無脫水情形","若小琪合併醛固酮不足，應減少飲食的鹽分","確實監測小琪的身高和體重的變化","需要按時讓小琪服用皮質醇（cortisone）","B",null,[],"本題考點在於先天性腎上腺增生症（CAH）的護理指導，屬反向題，須找出「最不適當」的敘述。最不適當為 B：CAH（多為 21-羥化酶缺乏）常合併「醛固酮不足（失鹽型）」，導致鈉流失、脫水與高血鉀，故飲食應「補充鹽分」而非「減少鹽分」，選項方向相反，為正解。A 適當，失鹽型 CAH 易脫水，教導父母觀察脫水徵象（食慾差、嘔吐、體重下降、活力減退）很重要。C 適當，過量或不足的皮質類固醇治療都會影響生長，須確實監測身高體重以評估用藥適當性。D 適當，CAH 因皮質醇合成不足，需按時補充皮質醇（如 hydrocortisone\u002Fcortisone）以抑制過度的 ACTH 刺激並維持代謝。本題須掌握失鹽型 CAH 需「補鹽補水補類固醇」的照護核心。","先天性腎上腺增生症最常見為 21-羥化酶缺乏，導致皮質醇（與失鹽型的醛固酮）合成受阻、雄性素前驅物堆積。失鹽型（salt-wasting）因醛固酮不足，腎臟保鈉排鉀失能，新生兒期即可能出現嘔吐、脫水、低血鈉、高血鉀與腎上腺危象，需補充鹽分、水分並給予礦物皮質素（fludrocortisone）與糖皮質素（hydrocortisone）。女嬰因雄性素過高常有外生殖器男性化（模糊外觀），新生兒篩檢可早期發現。長期須監測生長、骨齡與藥物劑量。記憶法：失鹽型 CAH「缺醛固酮就流失鈉」，所以要「加鹽」不是減鹽；同時終身補類固醇、生病或壓力時要增量（stress dose）。",[24,27,29,31],{"term":25,"count":26},"先天性腎上腺增生症",1,{"term":28,"count":26},"21-羥化酶缺乏失鹽型",{"term":30,"count":26},"醛固酮不足補鹽分",{"term":32,"count":26},"皮質醇補充治療",[34,38,43,48,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-2-maternal-pediatric-044","有關白血病病童接受化學治療期間，依醫囑注射 Rasburicase 及 Allopurinol 的目的，下列敘述何者正確？",44,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-114-1-maternal-pediatric-040","小強，5歲，長期服用毛地黃（digoxin）之護理指導，下列敘述何者最適當？",40,114,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-114-3-maternal-pediatric-034","有關早產兒呼吸暫停的照護處置，下列敘述何者錯誤？",34,3,{"webId":49,"stem":50,"number":10,"year":51,"session":10},"nurse-106-2-maternal-pediatric-002","產科護理師針對護理照顧內容進行討論，並發展及驗證合適的護理措施，藉以提升專業之照護品質，是屬於下列何種角色功能？",106,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-107-2-maternal-pediatric-046","鐮狀細胞貧血（sickle cell anemia）病童不會出現下列何項臨床表徵？",46,107,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-108-2-maternal-pediatric-080","有關腰椎穿刺之敘述，下列何者錯誤？",80,108,"2026-09-04",1788510755686]