[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-016":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":63},"內外科護理學","medical-surgical",{"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-內外科護理學-016","nurse-115-1-medical-surgical-016",115,1,16,"有關心包膜炎照護之敘述，下列何者不適宜？",{"A":14,"B":15,"C":16,"D":17},"鼓勵病人採平躺及深呼吸，以減緩胸痛","發燒時應臥床休息，以減少心肌耗氧量","退燒藥可使用阿斯匹靈（Aspirin）","提供高蛋白、高醣飲食","A",null,[],"本題考點是心包膜炎胸痛的姿勢相關性。依其病生理,發炎的心包膜兩層在心臟搏動與呼吸時互相摩擦而產生疼痛,平躺會使心臟貼近並壓迫發炎的心包與鄰近膈膜,疼痛加劇,深呼吸也因胸腔壓力與心包牽動而更痛,因此鼓勵平躺與深呼吸並不適宜,坐起並身體前傾才能減少摩擦而緩解,故選 A。B 適宜:發燒使代謝率與心跳上升,臥床休息可降低心肌耗氧量。C 適宜:阿斯匹靈等非類固醇抗炎藥兼具退燒與抗發炎作用,是常用處置。D 適宜:發炎與發燒消耗增加,高蛋白高醣飲食可補足熱量需求。","考題辨識口訣:心包膜炎的痛「吸氣痛、平躺痛、前傾好」,並可在心前區聽到摩擦音;心肌梗塞的痛則與姿勢、呼吸無關,且不因休息緩解,兩者鑑別是臨床與國考的高頻點。若心包腔積液快速增加,將出現心包填塞:頸靜脈膨脹、血壓下降、心音遙遠的 Beck 三徵,以及脈搏異常起伏(奇異脈),此時需心包穿刺引流。心電圖早期可見廣泛 ST 段上升但無對應導極的鏡像下降,可與心肌梗塞區別。延伸複習:縮限性心包膜炎造成心室舒張受限、右心衰竭表現與心包剝離術。",[24,27,29,31],{"term":25,"count":26},"心肌耗氧量",4,{"term":28,"count":10},"心包膜炎胸痛特徵",{"term":30,"count":10},"前傾坐姿緩解",{"term":32,"count":10},"心包摩擦音",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-115-1-medical-surgical-017","有關血栓性靜脈炎之評估與照護原則，下列敘述何者錯誤？",17,{"webId":39,"stem":40,"number":41,"year":42,"session":10},"nurse-106-1-medical-surgical-013","有關因 B、C 型肝炎感染後導致肝硬化之類型，下列何者正確？",13,106,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-106-2-medical-surgical-027","毛地黃中毒最常出現的症狀，下列何者正確？",27,2,{"webId":49,"stem":50,"number":51,"year":52,"session":47},"nurse-107-2-medical-surgical-065","有關接受前列腺切除術病人之護理措施與指導，下列何者錯誤？",65,107,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-109-1-medical-surgical-029","有關冠狀動脈疾病病人接受鉈-201 之檢查目的，下列何者正確？",29,109,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-110-1-medical-surgical-063","泌尿道結石成分為尿酸時之處置與照護，下列何者正確？",63,110,"2026-08-06",1787299088697]