[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-2-maternal-pediatric-046":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-046","nurse-113-2-maternal-pediatric-046",113,2,46,"王小美，5 歲，罹患巨結腸症（megacolon），進行腸道無神經節部位切除，有關術後之護理措施與指導，下列敘述何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"定時評估其疼痛型態，必要時依醫囑給與止痛劑","教導並協助定時翻身，以預防肺炎或肺部擴張不全","術後觀察肛門狹窄及糞便失禁合併症","提供高纖飲食以促進早期排便","D",null,[],"本題考點在於巨結腸症(Hirschsprung's disease)術後的飲食原則。巨結腸症因遠端腸段缺乏神經節細胞、無法蠕動而近端擴張,手術切除無神經節部位後,腸道吻合處需要時間癒合。本題為反向題,錯誤敘述為 D:此時提供高纖飲食反而增加糞便體積與腸道刺激,可能拉扯尚未穩固的吻合口,術後初期應採低渣飲食待腸道恢復,故 D 為錯誤選項、即答案。A 正確,術後疼痛評估與依醫囑給止痛屬常規照護;B 正確,定時翻身可預防術後臥床導致的肺擴張不全與墜積性肺炎;C 正確,肛門狹窄與糞便失禁正是此類肛門直腸吻合手術常見的長期合併症,須持續觀察。","巨結腸症的病理核心是腸道肌間神經叢(Meissner 與 Auerbach plexus)神經節細胞缺失,導致該段腸道持續痙攣收縮、無法放鬆,糞便堆積於近端形成巨結腸。手術以 pull-through 拉出健康腸段與肛門吻合。術後飲食演進:禁食→清流質→低渣,待吻合穩固後才逐步加纖維。記憶點:凡新做腸道吻合,早期一律低渣護吻合口,高纖是後期預防便秘才用。",[24,27,29,31],{"term":25,"count":26},"巨結腸症",1,{"term":28,"count":26},"腸道吻合術後低渣飲食",{"term":30,"count":26},"神經節細胞缺失",{"term":32,"count":26},"肛門狹窄合併症",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-2-maternal-pediatric-047","有關疫苗接種對象的敘述，下列何者最適當？",47,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-114-1-maternal-pediatric-043","有關初診斷白血病的臨床表徵，下列敘述何者最適當？",43,114,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-114-3-maternal-pediatric-037","在流感好發的季節，一位母親帶著嬰兒來健兒門診詢問護理師，可以接種第一劑流感疫苗的時間，下列何者正確？",37,3,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-106-2-maternal-pediatric-005","孕期婦女需增加碘的攝取，主要促進胎兒何部分的發育？",5,106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-2-maternal-pediatric-049","婷婷，9 個月大，體重 9 公斤，母親主訴最近一天解水便數次，現體重為 8 公斤，此屬於下列何種情況？",49,107,{"webId":59,"stem":60,"number":47,"year":61,"session":26},"nurse-109-1-maternal-pediatric-003","孕婦對懷孕產生負向感覺，並隨著妊娠進展會擔心胎兒是否斷手斷腳或是有缺陷，此為那一孕期最常見的心理反應？",109,"2026-09-04",1788510755719]