[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-037":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":64},"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":10},"nurse-115-1-內外科護理學-037","nurse-115-1-medical-surgical-037",115,1,37,"提供腎絲球過濾率為17 mL\u002Fmin\u002F1.73 m 2的病人之護理指導，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"應攝取高鉀食物，以預防因低血鉀導致肌無力","鼓勵多攝取蛋白質，以維持體力提升免疫力","若皮膚乾燥導致搔癢可用calamine lotion減緩","鼓勵病人每日補充水份3,000 mL，以維持腎臟灌流","C",null,[],"本題考點在慢性腎臟病後期的護理指導方向。腎絲球過濾率 17 mL\u002Fmin\u002F1.73 m² 落在第四期(15 至 29),此時含氮廢物、磷與鉀開始蓄積、尿液濃縮與排水能力下降。尿毒性搔癢在此期常見,calamine lotion 是含氧化鋅與碳酸鋅的局部止癢收斂製劑,可緩解癢感,故 C 正確;它本身不具保濕效果,皮膚乾燥的部分需另以潤膚保濕製劑處理。A 錯誤,此期的風險是高血鉀而非低血鉀,指導方向為限鉀。B 錯誤,含氮廢物累積使蛋白質需適量限制並選高生物價蛋白,不宜鼓勵多攝取。D 錯誤,水分須依尿量與體重調整,固定每日三千毫升會造成水腫與心衰竭風險。","分期記法:第一期正常或偏高、第二期輕度下降、第三期中度、第四期 15 至 29、第五期低於 15 需準備替代療法。第四期的飲食四限一足:限鉀、限磷、限鈉與水分、限總蛋白量,但保留足夠熱量避免身體分解自身蛋白質而使含氮廢物更高;蛋白質選蛋、奶、魚、肉等高生物價來源。高血鉀的心電圖變化順序值得背:T 波高尖 → PR 間期延長與 P 波變平消失 → QRS 波增寬 → 正弦波與心室顫動。尿毒性搔癢的機轉是多因的——尿毒素蓄積、續發性副甲狀腺功能過高、鈣磷產物沉積於皮膚,加上皮脂與汗腺功能下降造成乾燥,因此止癢與保濕是兩件不同的事。可延伸複習:磷結合劑隨餐使用的理由、貧血與紅血球生成素不足、代謝性酸中毒的表徵。",[24,26,28,30,32],{"term":25,"count":10},"慢性腎臟病第四期",{"term":27,"count":10},"尿毒性搔癢",{"term":29,"count":10},"calamine lotion 止癢收斂",{"term":31,"count":10},"高血鉀心電圖變化",{"term":33,"count":10},"限蛋白與高生物價蛋白",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-1-medical-surgical-038","有關感染性膀胱炎導因之敘述，下列何者最不適當？",38,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-106-1-medical-surgical-034","有關準備化學治療藥劑的注意事項，下列何者錯誤？",34,106,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-106-2-medical-surgical-048","有關過敏性疾病的實驗室檢查，下列何者錯誤？",48,2,{"webId":50,"stem":51,"number":52,"year":53,"session":10},"nurse-108-1-medical-surgical-006","病人突然左側肢體無力，由家屬送入急診，目前肌肉力量右側肢體 5 分、左手 3 分、左腳 1 分，請問最有可能是那一條腦血管的阻塞？",6,108,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-medical-surgical-050","當肺炎病人出現呼吸道清除功能失效與分泌物增加，且無法進行有效性咳嗽。下列護理措施何者最能促進其清除痰液？",50,109,{"webId":60,"stem":61,"number":62,"year":63,"session":48},"nurse-110-2-medical-surgical-004","顱內動脈瘤（aneurysms）破裂導致蜘蛛膜下腔出血，進行神經學檢查時會出現的徵象，下列何者錯誤？",4,110,"2026-08-06",1787299088960]