[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-048":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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-048","nurse-115-1-medical-surgical-048",115,1,48,"有關有機磷中毒臨床處置之敘述，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"給予Apomorphine是因此藥為有機磷中毒的拮抗劑","進行胃灌洗、應維持呼吸道通暢必要時給與插管","其可從皮膚吸收，照護者須戴口罩、手套及穿隔離衣","對於沾有嘔吐物的衣物應除去並協助沐浴","A",null,[],"本題考點是有機磷中毒的解毒機轉與污染防護。有機磷會抑制乙醯膽鹼酯酶，使乙醯膽鹼在突觸處堆積而出現蕈毒鹼型與菸鹼型症狀，其解毒用藥是阻斷蕈毒鹼受體的Atropine，以及能使乙醯膽鹼酯酶重新活化的Pralidoxime。Apomorphine屬中樞性催吐劑，並不是有機磷的拮抗劑，故A為錯誤敘述。B正確，胃灌洗過程有嘔吐與嗆入風險，維持呼吸道通暢、必要時插管是基本原則。C正確，有機磷可經皮膚吸收，照護者須戴口罩、手套並穿隔離衣以防二次暴露。D正確，去除沾染嘔吐物的衣物並協助沐浴可移除仍在吸收的毒物。","有機磷中毒的症狀可用兩組受體來記：蕈毒鹼型用 SLUDGE 口訣（流涎、流淚、排尿、腹瀉、腸胃蠕動增加、嘔吐），再加上瞳孔縮小、支氣管分泌增加與心搏過緩；菸鹼型則是肌肉抽動、無力、抽筋，嚴重時呼吸肌麻痺，中樞則可有意識改變與抽搐。致死主因是呼吸道分泌物過多加上呼吸肌麻痺，因此照護核心是維持呼吸道通暢與氧氣供應，Atropine 的給藥終點也不是看瞳孔，而是看呼吸道分泌物是否乾燥、肺部聽診是否改善。兩種解毒劑分工要分清：Atropine 只擋住蕈毒鹼受體、緩解症狀，卻不救回酵素；Pralidoxime 才是把被磷酸化的乙醯膽鹼酯酶重新活化，且必須在酵素「老化」前及早給予，才能改善肌肉無力。除污也是治療的一部分，衣物與皮膚殘留會讓吸收持續進行，照護者無防護時可能一併中毒。",[24,27,30,32,34],{"term":25,"count":26},"有機磷中毒",6,{"term":28,"count":29},"乙醯膽鹼酯酶抑制",4,{"term":31,"count":10},"Atropine 拮抗蕈毒鹼受體",{"term":33,"count":10},"Pralidoxime 酵素再活化",{"term":35,"count":10},"皮膚吸收與除污防護",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-1-medical-surgical-049","有關病人誤食強鹼溶液之處置，下列何者錯誤？",49,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-1-medical-surgical-045","有關燒傷病人利尿期出現代謝性酸中毒之原因，下列何者錯誤？",45,106,{"webId":47,"stem":48,"number":49,"year":45,"session":50},"nurse-106-2-medical-surgical-059","下列何種藥物可以直接灌注於膀胱內以治療膀胱癌？",59,2,{"webId":52,"stem":53,"number":54,"year":55,"session":10},"nurse-108-1-medical-surgical-017","有關骨髓炎的治療方式，下列何者最為少見？",17,108,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-1-medical-surgical-061","有關尿液檢查的敘述，下列何者錯誤？",61,109,{"webId":62,"stem":63,"number":64,"year":65,"session":50},"nurse-110-2-medical-surgical-015","接受全靜脈營養輸注的病人，突然停止輸注後容易產生的併發症狀，下列何者正確？",15,110,"2026-08-06",1787299089117]