[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-114-1-medical-surgical-008":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":65},"內外科護理學","medical-surgical",{"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-114-1-內外科護理學-008","nurse-114-1-medical-surgical-008",114,1,8,"肝性腦病變的病人給與Lactulose的目的，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"酸化糞便以減少氨在腸道吸收","抑制腸內細菌以減少氨的分解","預防發生肝腎症候群","減輕腹水的產生","A",null,[],"本題考點在於 Lactulose 治療肝性腦病變（hepatic encephalopathy）的作用機轉。Lactulose 在腸道被細菌代謝產生酸、酸化腸道與糞便，使氨（NH₃）轉為不易吸收的銨離子（NH₄⁺）並隨糞便排出，減少氨經腸道吸收入血，選 A。（B）錯：抑制腸內細菌以減少產氨是抗生素（如 rifaximin、neomycin）的機轉，非 lactulose。（C）錯：肝腎症候群的預防與 lactulose 的降氨作用機轉無直接關係。（D）錯：減輕腹水靠限鈉、利尿劑與白蛋白，非 lactulose 的目的。核心是酸化腸道、捕捉並排出氨。","肝性腦病變因肝無法代謝氨等含氮毒素、血氨升高影響中樞。Lactulose（合成雙醣）機轉：腸菌發酵產生乳酸醋酸→酸化腸腔→NH₃＋H⁺→NH₄⁺（帶電不被吸收）→滲透性瀉下排出，兼具降氨與導瀉。療效指標為每日 2–3 次軟便及意識改善。合併 rifaximin 抑制產氨菌。護理重點：監測意識、血氨、電解質，避免過度腹瀉致脫水低鉀。",[24,27,30,32,34],{"term":25,"count":26},"肝性腦病變",9,{"term":28,"count":29},"Lactulose",2,{"term":31,"count":29},"血氨代謝",{"term":33,"count":29},"腸道酸化",{"term":35,"count":10},"rifaximin",[37,40,45,50,55,60],{"webId":38,"stem":39,"number":26,"year":9,"session":10},"nurse-114-1-medical-surgical-009","有關胰臟炎急性發作及其治療的敘述，下列何者錯誤？",{"webId":41,"stem":42,"number":43,"year":9,"session":44},"nurse-114-3-medical-surgical-005","有關單純頭部損傷病人，其顱內壓升高非代償期初期階段的徵象，下列敘述何者正確？",5,3,{"webId":46,"stem":47,"number":48,"year":49,"session":10},"nurse-115-1-medical-surgical-049","有關病人誤食強鹼溶液之處置，下列何者錯誤？",49,115,{"webId":51,"stem":52,"number":53,"year":54,"session":29},"nurse-106-2-medical-surgical-067","有關第 2 型糖尿病之敘述，下列何者正確？",67,106,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-108-1-medical-surgical-031","主要症狀為腹水、下肢水腫及肝脾腫大之瓣膜性心臟病病人，其最可能的瓣膜問題為下列何者？",31,108,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-109-1-medical-surgical-065","長期使用類固醇製劑而導致愛迪生氏症（Addison’s disease）之病人所呈現的臨床表徵，下列何者錯誤？",65,109,"2026-09-04",1788510757246]