[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-019":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-019","nurse-115-1-maternal-pediatric-019",115,1,19,"有關新生兒出生時維生素 K 缺乏的原因，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"腸道相關的菌落叢不足","肝臟功能尚未成熟","維生素 K 不易從母體經由胎盤進入胎兒體內","腸道的吸收能力尚未成熟","D",null,[],"本題考點是新生兒維生素 K 缺乏的成因。依維生素 K 的來源與代謝,新生兒缺乏的標準成因有三:腸道尚無菌落定植,無法由正常菌叢合成維生素 K;肝臟功能未成熟,依賴維生素 K 的凝血因子Ⅱ、Ⅶ、Ⅸ、Ⅹ合成不足;維生素 K 屬脂溶性且不易經胎盤由母體傳給胎兒,故出生時體內儲存量低。D 所述腸道吸收能力尚未成熟,並非教科書列舉的主要原因,故為錯誤選項。A、B、C 三項均為前述標準成因,敘述正確。這也是新生兒出生後例行給予維生素 K 以預防新生兒出血性疾病的依據。","把維生素 K 依賴的凝血因子記成「1972」(Ⅹ、Ⅸ、Ⅶ、Ⅱ)最快。機轉上維生素 K 是γ-羧化反應的輔因子,缺乏時這些因子雖被合成卻無法與鈣結合、失去活性,檢驗上表現為凝血酶原時間(PT)延長。維生素 K 缺乏性出血(VKDB)依時間分三型:早發型在出生 24 小時內,多與母親服用抗癲癇藥或抗凝血劑有關;典型在出生 2 至 7 天,表現為腸胃道出血、臍部或注射處滲血;晚發型在 2 週至 6 個月,常見於純母乳哺育且未接受預防性給藥者,顱內出血比例高、後果嚴重。母乳的維生素 K 含量低於配方奶,是晚發型的重要背景因素,但這不構成停止哺乳的理由,而是預防性給藥的理由。台灣新生兒常規於出生後肌肉注射維生素 K1 一劑作為預防。可延伸複習:新生兒生理性凝血功能低下與臍帶護理時的出血觀察。",[24,26,28,30,32],{"term":25,"count":10},"維生素 K 依賴凝血因子",{"term":27,"count":10},"腸道菌叢合成",{"term":29,"count":10},"肝臟功能未成熟",{"term":31,"count":10},"胎盤通透性",{"term":33,"count":10},"維生素 K 缺乏性出血",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-1-maternal-pediatric-020","張女士，懷孕 32 週，突然感到下腹疼痛，陰道流出暗紅色血液，立即就診，下列何者為最有可能的問題？",20,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-106-1-maternal-pediatric-016","王女士，46 歲，因子宮肌瘤接受子宮切除手術，有關術後出院照護指導內容，下列何者適當？",16,106,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-106-2-maternal-pediatric-030","有關新生兒黃疸的敘述，下列何者正確？",30,2,{"webId":50,"stem":51,"number":52,"year":53,"session":48},"nurse-107-2-maternal-pediatric-068","有關嬰兒玫瑰疹（roseola infantum），下列何者錯誤？",68,107,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-maternal-pediatric-032","孕婦早期破水的評估與處置，下列何者錯誤？",32,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-1-maternal-pediatric-066","有關胎兒出生後的心臟血管變化，下列敘述何者錯誤？",66,110,"2026-08-06",1787299089334]