[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-023":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"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-023","nurse-115-1-medical-surgical-023",115,1,23,"王老太太因便秘、意識不清，家屬送至急診求治，發現有心律不整的問題，下列何者是王老太太最有可能發生的問題？",{"A":14,"B":15,"C":16,"D":17},"高血磷","高血鈣","高血鉀","高尿酸","B",null,[],"本題考點是多發性骨髓瘤最常見的電解質併發症。依其溶骨機轉,惡性漿細胞活化蝕骨細胞造成骨質破壞,大量鈣離子由骨骼釋入血流而形成高血鈣。血鈣升高會抑制腸道與膀胱的平滑肌張力而造成便秘;抑制中樞神經與神經肌肉興奮性,表現為嗜睡、意識不清與深腱反射減弱;並縮短心肌動作電位而引起心律不整,三項症狀正好與題幹的便秘、意識不清、心律不整完全吻合,選 B。高血磷與高尿酸主要見於腎衰竭或大量細胞崩解,高血鉀的心律不整常伴肌肉無力而非便秘,均不如高血鈣貼合此組合。","高血鈣症狀口訣可記「渴、懶、便、亂」:多渴多尿(鈣干擾抗尿激素作用造成腎性尿液濃縮障礙)、疲倦無力嗜睡、便秘噁心、意識混亂與心律不整,嚴重可進展至昏迷。鈣與神經肌肉興奮性成反比是關鍵觀念,故低血鈣反而抽筋、Chvostek 與 Trousseau 徵象陽性,兩者剛好相反,一起背最不會錯。心電圖上高血鈣使 QT 間期縮短,低血鈣則延長。惡性腫瘤引起高血鈣的兩大機轉是溶骨轉移與腫瘤分泌類副甲狀腺素蛋白。延伸複習:骨髓瘤病人脫水會加重血鈣濃度與腎輕鏈沉積的惡性循環。",[24,27,29,31],{"term":25,"count":26},"惡性腫瘤高血鈣",2,{"term":28,"count":10},"溶骨性骨病灶",{"term":30,"count":10},"鈣與神經肌肉興奮性",{"term":32,"count":10},"電解質失衡症狀",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-115-1-medical-surgical-024","王老太太意識恢復後，針對其目前的問題，下列護理措施何者正確？",24,{"webId":39,"stem":40,"number":41,"year":42,"session":10},"nurse-106-1-medical-surgical-020","左股骨粗隆骨折之病人，手術治療後，左大腿肌肉強度為 2 分，此時提供患側之運動訓練型式，下列何者最適宜？",20,106,{"webId":44,"stem":45,"number":46,"year":42,"session":26},"nurse-106-2-medical-surgical-034","有關乳癌病人荷爾蒙治療之敘述，下列何者錯誤？",34,{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-107-2-medical-surgical-072","有關糖尿病人足部照護之敘述，下列何者正確？",72,107,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-109-1-medical-surgical-036","有關靜脈導管 Port-A 之敘述，下列何者正確？①放置 Port-A 人工血管，須採全身麻醉方式 ②Port-A 導管可由腋靜脈放置到鎖骨下靜脈 ③注射起泡性藥物時，應測試是否有回血 ④注射藥物時，使用一般空針 90 度插入，以免發生外滲",36,109,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-110-1-medical-surgical-070","有關糖尿病病人產生腎臟病變之敘述，下列何者正確？",70,110,"2026-08-06",1787299088778]