[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-013":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":65},"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-013","nurse-115-1-maternal-pediatric-013",115,1,13,"蘇女士 G3P3，懷孕 34 週早期破水緊急剖腹生產，產後第 9 天在家來電主訴：「擠奶 30 分鐘後，身體移動時陰道感覺有東西流出，發現有如 50 元硬幣大小的血塊（如圖示），廁所途中仍持續出血，2 天前開始喝生化湯」，下列解釋何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"可能有子宮破裂情形，建議儘速到醫院進一步處理","可能因生化湯與催產素刺激，滯留在子宮的血塊在身體活動時排出","先以手掌掌根按摩子宮底，同時儘快請護理師評估子宮收縮及惡露","增加親自餵奶頻率及密切觀察惡露變化，若持續有大量血塊則儘速就醫","A",null,[],"本題考點是產後晚期出血與子宮破裂的鑑別。依子宮破裂的發生機轉,它主要出現在待產與分娩過程中,子宮承受強力收縮或原有手術疤痕受壓時,典型表現是突發撕裂樣劇痛、宮縮停止、產婦休克與胎心異常,不會在產後第 9 天於家中忽然發生,故 A 的解釋最不適當。B 合理,擠奶刺激催產素釋放而增強子宮收縮,滯留於子宮腔的血塊在身體移動時排出。C 合理,以手掌掌根按摩子宮底並由護理師評估子宮收縮與惡露性質,屬合乎邏輯的評估順序。D 合理,增加哺乳頻率可促進子宮收縮,並以惡露變化與血塊量作為後續觀察指標。題目所附圖形無法檢視,惟上述判斷來自時序與機轉,不受圖片影響。","晚期產後出血指產後 24 小時至 6 週間的出血,常見原因是胎盤碎片滯留、子宮復舊不良與子宮內膜炎,關鍵評估是子宮底高度與硬度、惡露的量色氣味,以及有無發燒與子宮壓痛。惡露的正常演變可作為對照尺:紅色惡露約 3 天、褐色惡露約至第 10 天、白色惡露可延續至 3 週左右;若惡露由淡轉回鮮紅、出現大於雞蛋大小的血塊或有惡臭,即屬異常。子宮破裂真正的高風險族群是前次剖腹產嘗試自然生產(TOLAC)、子宮手術史、催生藥物使用過量或多胎次子宮過度伸張者,且事件發生在產程中,這是本題把它設為最不適當解釋的理由。傳統生化湯多含活血類藥材,對產後出血量的影響證據有限,不宜作為機轉斷言。可延伸複習:產後出血 4T 原因(子宮收縮無力、產道創傷、組織殘留、凝血異常)。",[24,27,29,32,34],{"term":25,"count":26},"晚期產後出血",3,{"term":28,"count":26},"惡露變化",{"term":30,"count":31},"催產素與子宮收縮",2,{"term":33,"count":10},"子宮破裂危險因子",{"term":35,"count":10},"子宮復舊不良",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-1-maternal-pediatric-014","吳女士，G2P1AA1，因胎位不正施行剖腹產，採硬膜外麻醉（epidural anesthesis），剛從恢復室返回病房，其先生表示：「我太太何時可以開始吃東西？」下列護理指導何者最適當？",14,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-1-maternal-pediatric-010","陳女士，懷孕 26 週，下列何項血液變化為正常？",10,106,{"webId":47,"stem":48,"number":49,"year":45,"session":31},"nurse-106-2-maternal-pediatric-024","林女士採陰道生產，會陰四度裂傷。在產後第 2 天可以教導她執行何項產後運動？",24,{"webId":51,"stem":52,"number":53,"year":54,"session":31},"nurse-107-2-maternal-pediatric-062","兒童在瀕死過程中，出現呼吸逐漸由深變淺時，下列護理措施何者正確？",62,107,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-1-maternal-pediatric-026","Apgar score 計分表的評估項目不包含下列那一項？",26,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-1-maternal-pediatric-060","感染麻疹（measles）在卡他期（catarrhal stage）的病童之 3C 症狀，下列敘述何者不適當？",60,110,"2026-08-06",1787299089278]