[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-007":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"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-115-1-產兒科護理學-007","nurse-115-1-maternal-pediatric-007",115,1,7,"張女士，G1P0，懷孕 40 週入院待產。目前子宮頸擴張 4 公分，變薄 50%，先露部位高度為 0，羊膜完整，無特殊異常狀況，胎心率為 140 bpm。她詢問：「我可以下床走走嗎？」，護理師最適當的回答是：",{"A":14,"B":15,"C":16,"D":17},"「不可以，只能在床上翻身減輕不舒適」","「可以，但要注意安全」","「可以，只能去上廁所」","「不可以，你下床羊膜容易破裂」","B",null,[],"本題考點是待產期間活動與臥床限制的適應症判斷。依產程照護原則,本案羊膜完整、先露部位高度為 0 表示胎頭雙頂徑已達骨盆入口平面(已固定),胎心率 140 bpm 在正常範圍 110–160 bpm 內且無其他異常,臍帶滑脫風險低,此時下床走動可藉重力促進胎頭下降、增加骨盆活動度並分散疼痛注意力,僅需留意跌倒安全,故 B 最適當。A 全面限制在床上翻身缺乏依據,反而可能延長第一產程並增加不適。C 只准如廁同樣是不必要的限制。D 錯在羊膜破裂與下床活動無因果關係,破水主要與宮縮造成的羊膜腔壓力與胎膜張力有關,這樣的說法只會造成不必要的恐懼。","先露部位高度(station)以坐骨棘平面為 0,負值代表胎頭仍在坐骨棘之上、正值代表已下降至其下方;station 0 即固定(engagement),意義在於胎頭已填塞骨盆入口,即使破水,臍帶滑脫的機會也顯著降低。反過來說,需要臥床的情境是「破水且先露部位未固定或胎位不正」,因為此時羊水湧出可能把臍帶帶到胎頭前方形成臍帶滑脫,屬產科急症。自由活動的好處已被納入友善生產照護:走動、搖擺、坐生產球與淋浴都能縮短產程感受、減少止痛藥需求,並提高產婦控制感。安全前提是評估:有無使用麻醉藥或硬膜外麻醉造成下肢無力、有無頭暈或血壓不穩、胎心監測是否正常。可延伸複習:胎心率基準線變異性、早期減速與臍帶壓迫造成的變異減速。",[24,27,29,31,33],{"term":25,"count":26},"先露部位高度",2,{"term":28,"count":10},"胎頭固定",{"term":30,"count":10},"臍帶滑脫",{"term":32,"count":10},"待產活動促進產程",{"term":34,"count":10},"胎心率正常範圍",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-maternal-pediatric-008","吳女士，懷孕 40 週，規則陣痛入院待產，主述：「清晨 1 點開始，陸續出現不規則陣痛，清晨 3 點開始規律宮縮，大約 5～6 分鐘就痛一次。」下午 3 點子宮頸口完全擴張（10 公分）。下午 4 點 10 分自然娩出一健康男嬰。下午 4 點 20 分胎盤娩出。吳女士此次生產第二產程歷經多久時間？",8,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-1-maternal-pediatric-004","下列何者為懷孕之確實徵候？①聽診到胎心音 ②月經未現 ③觸診到胎兒四肢的活動 ④超音波掃描到妊娠囊 ⑤觸摸到胎兒的外形輪廓",4,106,{"webId":46,"stem":47,"number":48,"year":44,"session":26},"nurse-106-2-maternal-pediatric-018","李女士 G 3 P 0 ，已入院待產 12 小時。她說：「我好想用力哦！」，此時護理師最佳的評估是下列何者？",18,{"webId":50,"stem":51,"number":52,"year":53,"session":26},"nurse-107-2-maternal-pediatric-056","小倫，1 個月大，接種 B 型肝炎疫苗。下列何者是適合肌肉注射的部位？",56,107,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-maternal-pediatric-020","有關待產的麻醉藥物減痛之敘述，下列何者正確？",20,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-1-maternal-pediatric-054","有關兒童事故傷害的預防與處置，下列敘述何者正確？",54,110,"2026-08-06",1787299089212]