[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-114-1-medical-surgical-023":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"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-023","nurse-114-1-medical-surgical-023",114,1,23,"中樞神經系統癌症病人，若選用難以通過血腦障壁之化學治療時，下列何者為最適切之給藥途徑？ ①Port-A   ②Ommaya reservoir   ③Hickman catheter   ④intrathecal injection",{"A":14,"B":15,"C":16,"D":17},"①③","①④","②③","②④","D",null,[],"本題考點在於中樞神經系統腫瘤化療的給藥途徑選擇。依血腦障壁的藥物通透限制，當化療藥難以穿越血腦障壁時，須改採可直達腦脊髓液的途徑。②Ommaya reservoir為植入頭皮下、導管通入腦室的貯池，可直接注入藥物；④intrathecal injection經腰椎鞘內注射入蜘蛛膜下腔，兩者皆繞過血腦障壁使藥物直達中樞，故選D。①Port-A與③Hickman catheter均為中心靜脈系統的全身性給藥裝置，藥物仍受血腦障壁阻擋，無法有效進入中樞，故排除。","血腦障壁由緊密連接的腦微血管內皮構成，多數親水性大分子化療藥難以通過，故中樞白血病或腦膜轉移須採區域性給藥。Ommaya reservoir適合反覆給藥並可抽取腦脊髓液，藥物分布均勻；鞘內注射則須慎選藥物（如MTX、Ara-C），禁用vincristine以免致命神經毒性。記憶點：中樞要用藥就得「進到腦脊髓液裡」，靜脈裝置只到血液。",[24,27,29,31],{"term":25,"count":26},"鞘內注射",2,{"term":28,"count":10},"血腦障壁",{"term":30,"count":10},"Ommaya reservoir",{"term":32,"count":10},"中樞神經系統化療",[34,38,43,48,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-114-1-medical-surgical-024","為一位乳癌骨轉移合併脊髓壓迫的病人進行身體評估時，下列症狀或徵象何者最不常出現？",24,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-114-3-medical-surgical-020","病人剛開始輸血 20 mL 就發生皮膚癢、蕁麻疹、哮喘，最有可能發生下列那一種輸血反應？",20,3,{"webId":44,"stem":45,"number":46,"year":47,"session":26},"nurse-115-2-medical-surgical-014","有關使用耳滴劑的注意事項，下列何者正確？①使用前搖動藥水使其均勻 ②躺向健側使患耳朝上 ③滴耳藥前要先滴生理食鹽水 ④滴藥後以棉棒擦拭耳內多餘藥水",14,115,{"webId":49,"stem":50,"number":26,"year":51,"session":10},"nurse-107-1-medical-surgical-002","林先生因置有腦室外引流系統而造成細菌感染，其腦脊髓液的實驗室檢查結果，下列何者正確？",107,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-108-1-medical-surgical-046","有關燒傷病人接受自體移植後出院之護理指導，下列何者錯誤？",46,108,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-109-1-medical-surgical-080","病人因腰椎椎間盤突出接受手術治療，術後依醫囑需穿硬背架 3 個月，下列敘述何者錯誤？",80,109,"2026-09-04",1788510757372]