[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-maternal-pediatric-042":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"產兒科護理學","maternal-pediatric",{"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-115-2-產兒科護理學-042","nurse-115-2-maternal-pediatric-042",115,2,42,"小力，4 歲，診斷為重度 β 型海洋性貧血，居家使用注射型排鐵劑（desferal），下列敘述何者不適當？",{"A":14,"B":15,"C":16,"D":17},"若長期輸血會導致皮膚呈現青銅色","可搭配服用維生素 C，以增加排鐵的效果","居家以皮下注射以減少血鐵質沉著現象","若尿液顏色呈現橘紅色為出血現象，應儘快回診","D",null,[],"本題考點在於注射型排鐵劑 desferal 的作用與正常反應辨識。此藥與體內過多的鐵形成螯合物後由尿液排出,尿液因此呈橘紅或玫瑰紅色,屬預期的藥效表現,並非出血現象,故 D 的敘述不適當。A 適當,重度海洋性貧血需長期輸血,鐵沉積於皮膚會使膚色呈青銅色。B 適當,維生素 C 可促使組織中的鐵釋出,提高螯合排出效率。C 適當,居家治療多以皮下注射方式持續給藥,以減緩心臟、肝臟等器官的血鐵質沉著。","延伸藥理:deferoxamine 與三價鐵以一比一形成 ferrioxamine,經腎臟排出而使尿液變色,這個顏色變化在臨床上反而被當作藥效指標;常見副作用為注射部位紅腫硬結,長期或高劑量使用需注意聽力與視力毒性及生長抑制,故需定期聽力與眼科追蹤。口服選項如 deferasirox 提供替代途徑,兩者常在考題中對照。鐵質過載的器官後果是心衰竭與心律不整、肝纖維化、糖尿病與其他內分泌功能低下,也是重度海洋性貧血預後的主要決定因素,因此輸血與排鐵是一組不可分的治療。維生素 C 雖能增加排鐵效率,教科書同時提醒須適量並在使用排鐵劑期間給予,以免游離鐵增加造成心臟毒性。可連結概念:β 型海洋性貧血基因遺傳、輸血依賴與血鐵質沉著、鐵蛋白 ferritin 追蹤。",[24,27,29,31,33],{"term":25,"count":26},"deferoxamine 螯合排鐵",1,{"term":28,"count":26},"尿液橘紅色為藥效表現",{"term":30,"count":26},"血鐵質沉著",{"term":32,"count":26},"維生素 C 增加排鐵效率",{"term":34,"count":26},"β 型海洋性貧血治療",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-maternal-pediatric-043","罹患血友病病童，有關其護理指導，下列敘述何者錯誤？",43,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-2-maternal-pediatric-009","有關海洋性貧血的敘述，下列何者錯誤？",9,106,{"webId":46,"stem":47,"number":48,"year":49,"session":26},"nurse-107-1-maternal-pediatric-023","黃女士 G 1 P 1 ，產後第三天，主訴乳房觸痛、發熱、變硬且有硬塊，下列護理指導何項正確？",23,107,{"webId":51,"stem":52,"number":53,"year":54,"session":26},"nurse-108-1-maternal-pediatric-061","小華，4 歲，住院接受靜脈輸液導管治療，有關導管拔除前後之護理措施，下列何者正確？",61,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-maternal-pediatric-025","有關母乳之敘述，下列何者正確？",25,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-2-maternal-pediatric-059","有關麻疹與德國麻疹的臨床表徵之比較，下列何者正確？",59,110,"2026-08-06",1787299007329]