[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-021":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"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-021","nurse-115-1-maternal-pediatric-021",115,1,21,"張女士，30 歲，G1P0，妊娠 16 週產檢的血壓量測值為 118\u002F75 mmHg，尿蛋白與尿糖測試均為陰性（-）。妊娠 28 週產檢的血壓值為 140\u002F96 mmHg，間隔四小時再測之血壓值 145\u002F100 mmHg，尿蛋白與尿糖測試均為陰性（-），依據上述相關症狀的敘述，下列何者為張女士最可能之診斷？",{"A":14,"B":15,"C":16,"D":17},"慢性高血壓（chronic hypertension）","妊娠高血壓（gestational hypertension）","子癇前症（preeclampsia）","白袍高血壓（white coat hypertension）","B",null,[],"本題考點是妊娠期高血壓疾病的分類準則。依診斷標準,妊娠 20 週後首次出現血壓達 140\u002F90 mmHg 以上,且間隔至少 4 小時重複測量仍偏高,尿蛋白為陰性、也無器官受損證據者,診斷為妊娠高血壓;本案 28 週測得 140\u002F96 與 145\u002F100 mmHg,恰符合此定義,故 B 正確。A 慢性高血壓須在懷孕前或妊娠 20 週之前即存在,本案 16 週血壓 118\u002F75 mmHg 正常,可排除。C 子癇前症除高血壓外,還須合併蛋白尿或血小板下降、肝腎功能異常等器官受損徵象,本案尿蛋白陰性且無其他症狀。D 白袍高血壓指診間偏高而居家血壓正常,本案兩次診間測量皆升高且無居家數據佐證。","妊娠期高血壓疾病依「時間點」與「有無器官受損」分四類:慢性高血壓(20 週前即有)、妊娠高血壓(20 週後才有、無蛋白尿與器官受損)、子癇前症與子癇症(20 週後、有蛋白尿或器官受損,後者加上抽搐)、慢性高血壓合併子癇前症。本題正是拿 16 週的正常血壓當定錨點,排除慢性高血壓;若沒有這筆早期數據,分類就無法確立,可見產檢連續記錄的意義。臨床上妊娠高血壓具有進展性,相當比例會在後續發展為子癇前症,故照護重點是持續監測血壓、尿蛋白、體重與胎兒生長,並教導辨識嚴重徵象:持續頭痛、視覺模糊或閃光、右上腹或上腹痛、噁心嘔吐、尿量減少與突發性水腫。嚴重型的客觀指標包括血壓達 160\u002F110 mmHg 以上、血小板低於 10 萬、肝酵素升高、肌酸酐上升、肺水腫與腦部或視覺症狀。可延伸複習:HELLP 症候群三要素(溶血、肝酵素升高、血小板低下)與硫酸鎂用於預防抽搐時的中毒徵象。",[24,27,30,32,34],{"term":25,"count":26},"子癇前症",5,{"term":28,"count":29},"蛋白尿",4,{"term":31,"count":10},"妊娠高血壓診斷標準",{"term":33,"count":10},"慢性高血壓",{"term":35,"count":10},"白袍高血壓",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-1-maternal-pediatric-022","下列何者是發生產後血栓靜脈炎的主要原因？",22,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-1-maternal-pediatric-018","使用 Bishop 評估引產成功的可能性，須包括之項目為何？①子宮頸擴張 ②懷孕週數 ③子宮頸變薄 ④胎位 ⑤子宮頸位置",18,106,{"webId":47,"stem":48,"number":49,"year":45,"session":50},"nurse-106-2-maternal-pediatric-032","有關孕婦缺鐵性貧血之敘述，下列何者錯誤？",32,2,{"webId":52,"stem":53,"number":54,"year":55,"session":50},"nurse-107-2-maternal-pediatric-070","兒童的呼吸道系統由於尚未完全發展成熟，而與成人有差異，下列何者正確？",70,107,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-1-maternal-pediatric-034","有關產褥感染，下列何者正確？①其定義是產後任 2 天體溫在 38℃或 38℃以上 ②最常見的細菌為陰道內的細菌，例如 B 群鏈球菌 ③以腸胃道感染最常見 ④每天至少需 2,500～3,000 毫升的水分攝入",34,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-1-maternal-pediatric-068","小凌，16 歲，罹患再生不良性貧血，住院接受抗淋巴球蛋白（ALG）及 cyclosporin 治療，下列護理措施何者較適當？",68,110,"2026-08-06",1787299089360]