[{"data":1,"prerenderedAt":59},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-001":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":31,"lastmod":58},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":10,"stem":11,"options":12,"answer":17,"answerNote":18,"images":19,"explanation":20,"explanationDeep":21,"topics":22,"freq":24},"nurse-115-1-內外科護理學-001","nurse-115-1-medical-surgical-001",115,1,"陳先生T3～T5脊髓損傷，目前血壓250\u002F140 mmHg，心跳50～55次／分，有大量出汗情形，主訴頭部嚴重疼痛、看東西模糊，超過6小時以上未解尿，陳先生可能發生何種現象？",{"A":13,"B":14,"C":15,"D":16},"神經性休克","自主神經過度反射","脊髓自動症","脊髓休克","B",null,[],"本題考點在辨識脊髓損傷併發症的血壓型態。依自主神經過度反射的機轉,T6 以上脊髓損傷者遇膀胱過度膨脹等有害刺激時,損傷位置以下交感神經大量放電造成血管劇烈收縮、血壓驟升;主動脈弓與頸動脈竇壓力接受器偵測到高血壓後經迷走神經反射,產生代償性心搏徐緩,同時出現損傷位置以上大量出汗、劇烈頭痛與視力模糊,與超過六小時未解尿的膀胱膨脹情境相符,故選 B。神經性休克與脊髓休克的表現皆為低血壓、心搏徐緩與反射喪失,與 250\u002F140 mmHg 高血壓方向相反;脊髓自動症指損傷位置以下出現不受意識支配的反射動作,不會造成高血壓與頭痛。","此反射的關鍵是脊髓損傷後,腦幹下行的抑制訊號無法通過損傷處,交感反射弧成為失控的局部迴路,所以病灶愈高愈易發生,T6 是常被列為分水嶺的高度。最常見的觸發刺激是膀胱膨脹,其次是糞便阻塞、壓迫傷口與緊繃衣物,因此考題常以「未解尿數小時」當線索。記憶對比表:自主神經過度反射=高血壓+慢心跳+損傷以上潮紅出汗、損傷以下蒼白冰冷;脊髓休克與神經性休克=低血壓+慢心跳+皮膚溫暖乾燥。可連結延伸複習:脊髓損傷分級 ASIA、壓力接受器反射(baroreceptor reflex)、交感神經節前纖維由 T1–L2 發出的解剖分布。",[23,25,28,29],{"term":16,"count":24},5,{"term":26,"count":27},"T6 以上脊髓損傷",2,{"term":14,"count":10},{"term":30,"count":10},"壓力接受器反射",[32,35,39,44,49,54],{"webId":33,"stem":34,"number":27,"year":9,"session":10},"nurse-115-1-medical-surgical-002","有關重症肌無力之敘述，下列何者正確？①屬於自體免疫疾病，體內產生攻擊Ach接受器的抗體           ② 第一型僅侵犯眼肌，造成複視和眼瞼下垂          ③四肢肌肉的無力發生在遠端和下肢且為不對稱   ④當侵犯肋間肌，通氣容積會減少，嚴重呼吸困難致死",{"webId":36,"stem":37,"number":38,"year":9,"session":27},"nurse-115-2-medical-surgical-048","有關中毒症狀與處置之敘述，下列何者正確？",48,{"webId":40,"stem":41,"number":42,"year":43,"session":27},"nurse-106-2-medical-surgical-012","有關食道癌的敘述，下列何者錯誤？",12,106,{"webId":45,"stem":46,"number":47,"year":48,"session":27},"nurse-107-2-medical-surgical-050","有關愛滋病防治之敘述，下列何者正確？",50,107,{"webId":50,"stem":51,"number":52,"year":53,"session":10},"nurse-109-1-medical-surgical-014","有關腦脊髓液的檢查，下列何者異常？",14,109,{"webId":55,"stem":56,"number":38,"year":57,"session":10},"nurse-110-1-medical-surgical-048","有關愛滋病檢驗的敘述，下列何者正確？",110,"2026-08-06",1787299088532]