[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-016":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":37,"lastmod":66},"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-016","nurse-115-1-maternal-pediatric-016",115,1,16,"黃女士，G1P1，產後第一天，向護理師詢問：「我現在沒有奶水，可以餵奶嗎？」下列護理師的回應何者最適宜？",{"A":14,"B":15,"C":16,"D":17},"你的擔心是多餘的，奶水很快就會開始分泌","現在你的乳房會分泌初乳，正是寶寶所需要的","即便沒有奶水，還是要讓寶寶吸吮，不然會哺乳失敗","你可以等三天後奶水來了，再開始哺餵","B",null,[],"本題考點是產後初期的泌乳生理與治療性溝通技巧。依泌乳生理,產後前 2 至 3 天乳房分泌的是初乳,量雖少但富含免疫球蛋白 A、白血球與蛋白質,且正符合新生兒胃容量極小的生理狀態,以此回應既提供正確資訊也化解疑慮,故 B 最適宜。A 直接否定產婦感受、說擔心是多餘的,屬阻斷式溝通,無法建立信任關係。C 雖然吸吮刺激確實有助泌乳,但以「不然會哺乳失敗」施壓,會加重母親的罪惡感與焦慮,反而抑制噴乳反射。D 錯在延到三天後才哺餵會減少吸吮刺激,泌乳素分泌不足將延遲並減少乳汁生成。","泌乳的兩條反射軸必須分清:嬰兒吸吮乳頭的感覺神經衝動上傳,一路使腦下垂體前葉分泌泌乳素(prolactin)促成乳汁「製造」,另一路使後葉分泌催產素(oxytocin)使乳腺腺泡周圍的肌上皮細胞收縮,造成乳汁「噴出」。催產素反射易受情緒影響,焦慮、疼痛與缺乏隱私會抑制噴乳,這正是威脅式溝通反效果的生理基礎;催產素同時收縮子宮,所以哺乳時的下腹悶痛屬正常現象。初乳的量之所以「剛好」,是因為新生兒出生第一天胃容量常被引用為僅約 5 至 7 毫升,強調量少不等於不足。乳房脹奶感通常在產後第 2 至 4 天出現,是乳汁大量生成加上血流與淋巴增加的結果,處理方向是持續有效地移出乳汁。可延伸複習:正確含乳的判斷指標(含住大部分乳暈、下唇外翻、吸吮有節律吞嚥聲)與哺乳成效評估(尿布量、體重變化)。",[24,27,30,33,35],{"term":25,"count":26},"治療性溝通",18,{"term":28,"count":29},"初乳",3,{"term":31,"count":32},"新生兒胃容量",2,{"term":34,"count":10},"泌乳素反射",{"term":36,"count":10},"催產素噴乳反射",[38,42,47,51,56,61],{"webId":39,"stem":40,"number":41,"year":9,"session":10},"nurse-115-1-maternal-pediatric-017","有關新生兒頭顱血腫（cephalohematoma）的敘述，下列何者錯誤？",17,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-106-1-maternal-pediatric-013","承上題，護理師提供蘇女士背部按摩以減輕疼痛，此護理措施是根據那一種疼痛理論？",13,106,{"webId":48,"stem":49,"number":50,"year":46,"session":32},"nurse-106-2-maternal-pediatric-027","林小妹，出生 2 個月，體重 5 公斤，每 4 小時餵食配方奶一次，請問每次應餵食多少 c.c.？",27,{"webId":52,"stem":53,"number":54,"year":55,"session":32},"nurse-107-2-maternal-pediatric-065","高危險新生兒常易出現呼吸窘迫症候群（RDS），下列敘述何者錯誤？",65,107,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-1-maternal-pediatric-029","剛出生的女嬰出現假性月經與母親那一個荷爾蒙中斷有關？",29,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-1-maternal-pediatric-063","王小弟，2 歲，因肺部的下葉上節有痰液蓄積，護理師為其執行姿位引流，下列姿勢何者最適當？",63,110,"2026-08-06",1787299089311]