[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-047":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"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-047","nurse-115-1-medical-surgical-047",115,1,47,"有關過敏性休克之敘述，下列何者正確？①接觸的過敏原可能來自藥物、食物、昆蟲叮咬等              ②發生嚴重支氣管擴張及呼吸困難           ③脈搏次數增快、血壓可能正常或降低   ④通常可立即注射 epinephrine改善情況",{"A":14,"B":15,"C":16,"D":17},"①②③","①②④","①③④","②③④","C",null,[],"本題考點是過敏性休克的病生理機轉與處置要點。此症屬第一型立即型過敏反應，肥大細胞與嗜鹼性球大量釋出組織胺等介質，①藥物、食物與昆蟲叮咬都是常見過敏原；介質造成全身血管擴張與通透性增加，血液滯留於周邊並向組織間隙外漏，③心搏因代償而加快，血壓早期可能仍維持正常、隨後才下降；④epinephrine能收縮血管、鬆弛支氣管並抑制介質釋出，是第一線用藥，故①③④正確，選C。②的敘述方向相反，介質引起的是支氣管平滑肌收縮痙攣與黏膜水腫，因而出現喘鳴與呼吸困難。","過敏性休克屬分布性休克，與出血造成的低容積性休克不同：血液總量沒有減少，而是血管床突然擴張使有效循環容積相對不足，加上通透性增加導致血漿外漏，因此處置同時需要血管收縮劑與大量靜脈輸液。epinephrine 的作用可用受體拆解記憶：甲一受體收縮血管、拉高血壓並減輕黏膜水腫；乙一受體增強心肌收縮；乙二受體鬆弛支氣管平滑肌並抑制肥大細胞繼續釋出介質，一支藥同時解決血壓與呼吸兩條致命路徑，這正是它無可取代的原因，抗組織胺與類固醇只能作為輔助與預防延遲反應。臨床辨識重點是症狀出現極快，常在暴露後數分鐘內從皮膚癢、膨疹、口唇與眼周腫脹，進展到喉頭水腫、聲音改變與呼吸窘迫。可延伸複習四型過敏反應分類與皮膚試驗前的過敏史詢問。",[24,27,29,32,34],{"term":25,"count":26},"過敏性休克",3,{"term":28,"count":26},"支氣管痙攣",{"term":30,"count":31},"分布性休克",2,{"term":33,"count":10},"第一型過敏反應與組織胺",{"term":35,"count":10},"epinephrine 受體作用",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-1-medical-surgical-048","有關有機磷中毒臨床處置之敘述，下列何者錯誤？",48,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-1-medical-surgical-044","有關自體皮膚移植病人的護理措施，下列何者錯誤？",44,106,{"webId":47,"stem":48,"number":49,"year":45,"session":31},"nurse-106-2-medical-surgical-058","下列何者為檢測腎絲球過濾率的最佳指標？",58,{"webId":51,"stem":52,"number":53,"year":54,"session":10},"nurse-108-1-medical-surgical-016","有關痔瘡出血手術後之護理措施，下列何者不適當？",16,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-1-medical-surgical-060","血液透析病人之液體攝取量的估計原則，下列何者最適當？",60,109,{"webId":61,"stem":62,"number":63,"year":64,"session":31},"nurse-110-2-medical-surgical-014","有關胃潰瘍的敘述，下列何者正確？①右上腹疼痛 ②常見噁心嘔吐 ③進食後 2～3 小時、半夜、空腹時發生疼痛 ④胃酸分泌正常",14,110,"2026-08-06",1787299089093]