[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-010":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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":10},"nurse-115-1-產兒科護理學-010","nurse-115-1-maternal-pediatric-010",115,1,10,"有關生產姿勢，下列敘述何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"多數待產婦表示直立前傾姿勢最不痛","蹲姿可增寬骨盆出口橫徑","高血壓待產婦可採半坐臥姿勢生產","前傾跪姿適合待產婦之胎兒枕後位者","C",null,[],"本題考點在生產姿勢選擇的生理依據。依仰臥位低血壓症候群的機轉,妊娠子宮會壓迫下腔靜脈使回心血量與心輸出量下降,子宮胎盤灌流隨之減少;半坐臥仍偏向仰臥的軸線,對血壓已異常的待產婦不是首選,採側臥(尤其左側臥)最能解除壓迫並穩定灌流,故 C 最不適當。A 適當,直立前傾姿勢借重力促進胎頭下降並減輕背部受壓,多數待產婦主觀感覺較不痛。B 適當,蹲姿使髖關節外展,撐開骨盆出口的坐骨粗隆間徑與出口前後徑,有利胎頭通過。D 適當,前傾跪姿讓胎背因重力轉向母體前方,協助枕後位的胎兒完成旋轉。","骨盆徑線要分層記,不要把中骨盆與出口混為一談:入口以前後徑(對角徑推估真結合徑)為關鍵;中骨盆的坐骨棘間徑是固定的骨性距離,也是骨盆最狹窄處,姿勢改變不了它;骨盆出口則有活動度,蹲姿與半坐臥的髖屈外展可讓尾骨後移、增加出口前後徑,並使坐骨粗隆間徑(出口橫徑)相對加大。姿勢的三個效益面向:重力(直立姿促進下降)、骨盆徑線(蹲姿與跪姿擴大出口)、血流(側臥維持子宮胎盤灌流)。枕後位的處理邏輯是讓胎兒較重的背部順重力轉向母體腹側,故採前傾跪姿或手膝位並配合對側側臥。可延伸複習:第二產程用力方式對母體血流的影響、產程進展的評估指標、仰臥位低血壓症候群的表徵如頭暈、噁心與胎心率變化。",[24,26,28,30,32],{"term":25,"count":10},"仰臥位低血壓症候群",{"term":27,"count":10},"骨盆出口坐骨粗隆間徑",{"term":29,"count":10},"坐骨棘間徑",{"term":31,"count":10},"枕後位胎位旋轉",{"term":33,"count":10},"直立姿勢與重力",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-1-maternal-pediatric-011","原本對環境充滿好奇且多言的待產婦突然對護理師說：「你看我腿一直抖…怎麼會這樣…然後我開始感覺現血量變多，宮縮變密且更痛，我是不是快生了啊？」護理師可由其言語與行為判斷產程可能進入下列何階段？",11,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-106-1-maternal-pediatric-007","陳女士，妊娠 32 週，接受腹部超音波掃描發現胎兒身長體重與 1 個月前相同，估算約為 28 週，胎盤功能正常，所有檢查數值均在正常範圍，但陳女士體重並未增加。對此結果陳女士因焦慮而哭泣，下列何項敘述正確？",7,106,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-106-2-maternal-pediatric-021","協助產婦產後第一次下床活動，須優先進行何項護理評估？",21,2,{"webId":50,"stem":51,"number":52,"year":53,"session":48},"nurse-107-2-maternal-pediatric-059","運用感官對事物所得的心像來了解世界，但卻仍不能以質量保留以及長度保留來認知事物，此兒童之認知發展處於：",59,107,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-maternal-pediatric-023","有關產後泌尿系統的變化，下列敘述何者錯誤？",23,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-1-maternal-pediatric-057","小花，8 歲，罹患神經母細胞瘤末期，問護理師他是否快要死掉了，下列敘述何者較適當？",57,110,"2026-08-06",1787299089236]