[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-fundamental-nursing-034":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":65},"基本護理學與護理行政","fundamental-nursing","基本護理學(包括護理原理、護理技術)與護理行政",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-115-2-基本護理學與護理行政-034","nurse-115-2-fundamental-nursing-034",115,2,34,"協助病人抽取靜脈血液檢體送檢之敘述，下列何者正確？",{"A":15,"B":16,"C":17,"D":18},"可於病人靜脈輸液管路處抽取檢體，避免病人再扎針","空針針頭斜面向下，使針頭與採血處呈 45 度角插入","頭靜脈及貴要靜脈是最常抽取血液檢體之處","採血後應邊按揉、邊加壓靜脈採血處","C",null,[],"本題考點是靜脈採血的部位選擇與操作細節。上肢肘前區的頭靜脈(cephalic vein)與貴要靜脈(basilic vein)管徑較大、走向直、有周圍組織支撐而不易滑動,是靜脈採血最常選用的部位,故 C 正確。A 錯在自靜脈點滴管路抽血,檢體會被輸注液稀釋並受其中電解質與藥物污染,檢驗值失真。B 錯在採血時針頭斜面應朝上,與皮膚呈約 15–30 度角進針,斜面向下且 45 度角容易穿透血管後壁。D 錯在採血後應直接加壓止血,邊按揉會使穿刺處滲血、造成皮下瘀青與檢體溶血,故選 C。","部位選擇的原理是「粗、直、固定、避開危險結構」:肘前區的中間肘靜脈與頭靜脈最常用,貴要靜脈雖粗但內側鄰近正中神經與肱動脈,順位較後。手腕內側與足背因神經血管密集或循環較差,通常避開。針頭斜面向上的目的是讓最鋒利的尖端先切開皮膚與血管壁,阻力最小、組織創傷最少;角度過大則在刺入血管的同一動作中就穿出後壁,形成皮下血腫。溶血是檢驗誤差的主因之一,會使鉀離子、乳酸脫氫酶與間接膽紅素假性升高,來源包括用力按揉、過細針頭、用力抽拉針筒與採血後劇烈搖晃試管。可延伸連結採血管顏色順序與抗凝劑種類。",[25,28,30,32,34],{"term":26,"count":27},"靜脈採血部位",1,{"term":29,"count":27},"頭靜脈與貴要靜脈",{"term":31,"count":27},"進針角度與針頭斜面",{"term":33,"count":27},"檢體稀釋與污染",{"term":35,"count":27},"溶血影響檢驗值",[37,41,45,50,55,60],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-115-2-fundamental-nursing-035","陳老太太，因 12 小時未自解尿液，單導後發現尿液呈現混濁、乳靡狀，下列何者為可能的原因？",35,{"webId":42,"stem":43,"number":27,"year":44,"session":11},"nurse-106-2-fundamental-nursing-001","引起外生性院內感染的病菌，下列何者最常見？",106,{"webId":46,"stem":47,"number":48,"year":49,"session":27},"nurse-107-1-fundamental-nursing-015","下列那項護理可減少病人傷口感染的機會？",15,107,{"webId":51,"stem":52,"number":53,"year":54,"session":27},"nurse-108-1-fundamental-nursing-053","下列何種抽血檢驗在收集檢體前，病人不需要禁食 6～8 小時？",53,108,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-2-fundamental-nursing-017","針對一位「營養狀況改變：營養少於身體需求」的病人，其護理目標之擬訂，下列何者最適當？",17,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-2-fundamental-nursing-051","有關入院病人護理措施，下列何者適當？ ①需在接病人的當班內完成所有的護理評估等病歷內容 ②自我介紹及觀察病人是最先的護理活動 ③需建立身高、體重及生命徵象的資料 ④護理人員應主動保管病人貴重物品，以免遺失",51,110,"2026-08-06",1787299031809]