[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-maternal-pediatric-044":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":64},"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-044","nurse-115-2-maternal-pediatric-044",115,2,44,"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？",{"A":14,"B":15,"C":16,"D":17},"教導父母 ANC 是評估血球回升的重要指標","教導父母 ANC 低下可能出現自發性出血，需限制活動","教導父母 ANC 的正常值會隨著年齡不同而改變","教導父母和小美採嚴格保護性隔離措施","D",null,[],"本題考點是嗜中性白血球低下的風險分級與其對應的護理措施。ANC 等於白血球總數乘以（節狀核加分節核嗜中性球百分比），一般以低於 1500 為低下、低於 500 為嚴重低下且屬高感染風險。小美 ANC 400 已落在嚴重低下區間，此時最直接對應的護理措施是採嚴格保護性（反向）隔離，降低外源性病原暴露，故選 D。B 錯在把血球種類搞混，自發性出血對應的是血小板低下，嗜中性球低下的核心風險是感染而非出血。A 與 C 敘述的是 ANC 的判讀知識——ANC 回升確實可反映化療後骨髓造血的恢復，兒科嗜中性球的參考範圍也本來就隨年齡分層——但兩者都沒有回應 ANC 400 這個情境該採取何種措施，在比較級上不如 D。","ANC 的計算與意義先分開講清楚：計算式為 WBC ×（segs% ＋ bands%），例如 WBC 2000／mm³、segs 15%、bands 5%，ANC 即為 400／mm³。ANC 有兩層臨床意義，不必互相排除——一是感染風險分級（低於 1500 為低下、低於 1000 中度、低於 500 嚴重），二是化療後骨髓抑制的時間軸判讀，最低點（nadir）多出現在給藥後約 7 至 14 天，之後 ANC 回升即是造血恢復與可否進行下一週期的重要參考，必要時以 G-CSF（如 filgrastim）促進回升。發燒性嗜中性球低下（發燒合併 ANC 低於 500）屬腫瘤急症，處理以立即培養與經驗性抗生素為原則。保護性隔離的內容可整組記：單人房並考量正壓通風、限制有感染症狀的訪客、落實手部衛生、避免生食與未削皮水果、不放鮮花與盆栽、避免量肛溫與使用肛門塞劑，並加強口腔與皮膚黏膜照護。對比記憶：血小板低下的重點是避免碰撞、避免肌肉注射與使用軟毛牙刷；貧血的重點是活動耐受度與休息安排。",[24,27,30,32],{"term":25,"count":26},"保護性隔離",6,{"term":28,"count":29},"絕對嗜中性白血球計數(ANC)",1,{"term":31,"count":29},"嗜中性球低下感染風險分級",{"term":33,"count":29},"化療後骨髓抑制最低點",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-2-maternal-pediatric-045","患有第 1 型糖尿病的病人，突然出現口渴、頻繁排尿及呼吸加快的情況，醫療團隊應首先懷疑的是那一種急性併發症？",45,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-106-2-maternal-pediatric-011","有關護理師進行新生兒抽吸之敘述，下列何者正確？",11,106,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-107-1-maternal-pediatric-025","新生兒經產道出生，首次呼吸產生之機轉過程，下列敘述何者正確？",25,107,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-108-1-maternal-pediatric-063","有關新生兒罹患先天性梅毒的敘述，下列何者錯誤？",63,108,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-2-maternal-pediatric-027","有關新生兒身體評估結果，下列何者異常？",27,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-2-maternal-pediatric-061","有關氣喘病童使用吸入型氣喘藥物，下列敘述何者錯誤？",61,110,"2026-08-06",1787299007346]