[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-maternal-pediatric-043":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-043","nurse-115-2-maternal-pediatric-043",115,2,43,"罹患血友病病童，有關其護理指導，下列敘述何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"宜儘量避免靜脈注射與肌肉注射等侵入性治療","關節血腫時，給予局部熱敷以促進血循","定期接受牙齒檢查，避免牙齦出血","儘量勿進行躲避球、籃球等易衝撞的活動","B",null,[],"本題考點在於血友病關節出血的急性期處置原則。關節腔內出血時應以冷敷使血管收縮,配合加壓、抬高與制動來達到止血;熱敷會造成局部血管擴張,加重出血與腫脹,故 B 錯誤。A 正確,凝血因子缺乏使侵入性治療容易造成穿刺處持續出血與深部血腫,故盡量避免肌肉注射。C 正確,定期口腔與牙齒檢查可預防牙齦發炎出血,降低不易止血的風險。D 正確,躲避球、籃球等碰撞性活動容易引發關節與軟組織出血,教科書歸類為應避開的項目。","延伸病生理:血友病 A 缺乏第八凝血因子、血友病 B 缺乏第九凝血因子,皆為 X 性聯隱性遺傳,以男性發病為主;內在凝血途徑受阻使 aPTT 延長,而血小板數與出血時間正常,這組實驗數據常被拿來與血小板疾病對照出題。關節出血最常見於膝、踝、肘等承重與活動關節,反覆出血形成目標關節,血鐵沉積引發滑膜炎與軟骨破壞,最終導致關節變形與肌肉萎縮,因此急性期處置的關鍵字是休息、冰敷、加壓、抬高這一組。治療核心為凝血因子替代療法,輕度 A 型可考慮 DDAVP 促使儲存的第八因子釋出;止痛避免使用 aspirin 與非類固醇抗發炎藥,因其抑制血小板功能。可連結概念:X 性聯隱性遺傳圖譜、aPTT 與 PT 判讀、von Willebrand 疾病比較。",[24,27,29,31,33],{"term":25,"count":26},"血友病凝血因子缺乏",1,{"term":28,"count":26},"關節出血冷敷加壓制動",{"term":30,"count":26},"避免肌肉注射",{"term":32,"count":26},"目標關節與關節病變",{"term":34,"count":26},"碰撞性活動限制",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-maternal-pediatric-044","小美，3 歲，罹患癌症需接受化學藥物治療，住院抽血檢查結果，絕對嗜中性白血球（absolute neutrophil count, ANC）數目為 400\u002Fmm 3 ，下列護理措施何者正確？",44,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-2-maternal-pediatric-010","5 歲小美詢問媽媽：「為什麼妹妹會住在媽媽的肚子裡面，妹妹可以出來和我見面嗎？」護理師給予母親的建議，下列何者最適當？",10,106,{"webId":46,"stem":47,"number":48,"year":49,"session":26},"nurse-107-1-maternal-pediatric-024","避孕針劑是利用何種高濃度的荷爾蒙干擾精卵運送及子宮內膜發育？",24,107,{"webId":51,"stem":52,"number":53,"year":54,"session":26},"nurse-108-1-maternal-pediatric-062","有關早產兒在保溫箱中的感官刺激，下列護理措施何者正確？",62,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-maternal-pediatric-026","有關產後生殖器官的復舊過程，下列何者正確？",26,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-2-maternal-pediatric-060","幼兒感染腸病毒後的 5 天內，需要密切注意腸病毒的嚴重合併症狀，下列選項何者除外？",60,110,"2026-08-06",1787299007342]