[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-043":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"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-043","nurse-115-1-medical-surgical-043",115,1,43,"有關嗜鉻細胞瘤切除手術後之護理措施，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"注意有無腎上腺功能不全的徵象，必要時由靜脈輸注皮質醇","監測每小時尿量，維持尿量在20～25 c.c.\u002F小時","觀察術後出血情況與腸蠕動狀態","依醫囑給與靜脈輸液，以維持體液容積","B",null,[],"本題考點是嗜鉻細胞瘤切除術後的血流動力學監測標準。腫瘤移除後過量的兒茶酚胺驟然消失，原本被強力收縮的血管突然鬆弛、有效循環容積相對不足，容易出現低血壓與器官灌流下降，因此尿量是關鍵的灌流指標，成人術後應維持每小時30 mL以上；選項所訂的20～25 c.c.\u002F小時已落在尿量不足的警訊範圍，不能當作維持目標，故B錯誤。A正確，若手術涉及腎上腺組織切除，可能併發腎上腺功能不全，必要時依醫囑靜脈輸注皮質醇。C正確，腹膜後手術須觀察出血與腸蠕動恢復。D正確，補充靜脈輸液以維持體液容積與血壓穩定。","嗜鉻細胞瘤源自腎上腺髓質嗜鉻細胞，會不受控地分泌腎上腺素與正腎上腺素，典型表現是陣發性高血壓伴頭痛、心悸、大量出汗三聯症，並可有高血糖與體重下降；診斷靠尿中兒茶酚胺代謝物如VMA與變腎上腺素。術前照護的邏輯是「先擴張血管再開刀」：使用甲型腎上腺素受體阻斷劑控制血壓並恢復血管內容積，若在甲型阻斷前先給乙型阻斷劑，會因失去乙二受體的血管擴張而使高血壓惡化，這是常考的用藥順序陷阱。術前也須避免觸診腹部、情緒刺激與突然改變姿勢，以免誘發高血壓危機。術後的兩大反轉是低血壓與低血糖，因為兒茶酚胺撤除後升糖作用消失而胰島素相對過多。尿量標準可統一記憶：成人每小時至少30 mL、每日至少約500 mL 才視為腎灌流足夠。",[24,27,29,31,33],{"term":25,"count":26},"嗜鉻細胞瘤",4,{"term":28,"count":10},"兒茶酚胺驟降與低血壓",{"term":30,"count":10},"術後尿量標準每小時30 mL",{"term":32,"count":10},"腎上腺功能不全與皮質醇補充",{"term":34,"count":10},"體液容積維持",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-medical-surgical-044","有關腦下垂體前葉功能低下之敘述，下列何者錯誤？",44,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-1-medical-surgical-040","有關腫瘤病人出現抗利尿激素分泌失調症候群之護理措施，下列何者錯誤？",40,106,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-106-2-medical-surgical-054","有關慢性支氣管炎的病理變化，下列何者錯誤？",54,2,{"webId":51,"stem":52,"number":53,"year":54,"session":10},"nurse-108-1-medical-surgical-012","有關肝硬化病人服用 Lactulose 之敘述，下列何者正確？",12,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-1-medical-surgical-056","蔡先生因急性腎衰竭而住院，正處於少尿期，下列何項護理指導正確？",56,109,{"webId":61,"stem":62,"number":63,"year":64,"session":49},"nurse-110-2-medical-surgical-010","有關腸造瘻口護理指導的敘述，下列何者錯誤？",10,110,"2026-08-06",1787299089042]