[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-2-maternal-pediatric-044":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"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-044","nurse-113-2-maternal-pediatric-044",113,2,44,"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？",{"A":14,"B":15,"C":16,"D":17},"預防卡氏肺囊蟲肺炎","預防腫瘤溶解症候群造成高尿酸血症","預防中樞神經系統白血病的復發","治療念珠菌感染引起的鵝口瘡","B",null,[],"本題考點在於 Rasburicase 與 Allopurinol 在白血病化療期間的用藥目的。白血病化療時大量腫瘤細胞崩解會釋出核酸代謝為尿酸，引發腫瘤溶解症候群（TLS），出現高尿酸血症、高血鉀、高血磷與低血鈣，可致急性腎損傷，故給予 Rasburicase（尿酸氧化酶，分解尿酸為水溶性尿囊素）與 Allopurinol（黃嘌呤氧化酶抑制劑，減少尿酸生成）以預防高尿酸血症與腎損傷，選 B。A 錯，預防卡氏肺囊蟲肺炎用的是 co-trimoxazole（TMP-SMX），非本題藥物。C 錯，預防中樞神經白血病復發用鞘內化療（如 methotrexate）與顱部放射，非這兩種降尿酸藥。D 錯，念珠菌鵝口瘡治療用抗黴菌藥（如 nystatin、fluconazole）。本題須掌握兩藥皆屬「降尿酸、防腫瘤溶解症候群」的支持性用藥。","腫瘤溶解症候群（TLS）好發於高腫瘤負荷、對化療高度敏感的惡性病（如急性白血病、伯基特淋巴瘤）治療初期，細胞快速崩解釋放鉀、磷、核酸。核酸經黃嘌呤氧化酶代謝為尿酸，尿酸結晶沉積腎小管致急性腎衰竭。預防與處置：積極水化、Allopurinol（抑制黃嘌呤氧化酶、減少新尿酸生成，用於預防）、Rasburicase（重組尿酸氧化酶，把既存尿酸分解為易排出的尿囊素，作用快、用於高風險或已升高者，但 G6PD 缺乏者禁用因會溶血），並監測與矯正電解質。記憶法：Allopurinol「不讓尿酸生」、Rasburicase「把尿酸拆掉」，兩者都是防 TLS 的腎臟保衛戰。",[24,27,30,33],{"term":25,"count":26},"腫瘤溶解症候群",4,{"term":28,"count":29},"高尿酸血症",3,{"term":31,"count":32},"Allopurinol黃嘌呤氧化酶抑制",1,{"term":34,"count":32},"Rasburicase尿酸氧化酶",[36,40,45,49,53,58],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-113-2-maternal-pediatric-045","有關病童放置鼻胃管之護理照護，下列敘述何者較適當？",45,{"webId":41,"stem":42,"number":43,"year":44,"session":32},"nurse-114-1-maternal-pediatric-041","有關海洋性貧血兒童使用排鐵劑（deferoxamine）治療，下列敘述何者錯誤？",41,114,{"webId":46,"stem":47,"number":48,"year":44,"session":29},"nurse-114-3-maternal-pediatric-035","小敏，出生後診斷胎便吸入症候群（meconium aspiration syndrome），有關護理照護措施，下列敘述何者不適當？",35,{"webId":50,"stem":51,"number":29,"year":52,"session":10},"nurse-106-2-maternal-pediatric-003","姜女士懷孕 12 週，最後一次月經（LMP）為民國 104 年 2 月 25 日，懷孕前月經週期均約 30 天左右，其預產期約在何時？",106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-2-maternal-pediatric-047","小玉，罹患先天性甲狀腺功能低下（congenital hypothyroidism），長期服用甲狀腺藥物，下列何者不是甲狀腺毒性反應之症狀？",47,107,{"webId":59,"stem":60,"number":32,"year":61,"session":32},"nurse-109-1-maternal-pediatric-001","有關「母嬰親善醫院」認證評鑑的標準，下列何者正確？",109,"2026-09-04",1788510755704]