[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-maternal-pediatric-045":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":10},"nurse-115-2-產兒科護理學-045","nurse-115-2-maternal-pediatric-045",115,2,45,"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？",{"A":14,"B":15,"C":16,"D":17},"低血糖症","糖尿病酮酸中毒","高滲透壓高血糖狀態","呼吸性酸中毒","B",null,[],"本題考點在於第 1 型糖尿病急性併發症的症狀辨識。胰島素絕對缺乏時脂肪大量分解產生酮體,造成代謝性酸中毒,身體以又深又快的庫斯莫耳氏呼吸代償;同時高血糖引起滲透性利尿而口渴、頻繁排尿,三者合起來正是糖尿病酮酸中毒的典型組合,選 B。A 錯在低血糖以冒冷汗、顫抖、心悸與飢餓感為主,不會多尿。C 錯在高滲透壓高血糖狀態多見於第 2 型糖尿病,血糖極高但酮體與酸中毒不明顯。D 錯在呼吸性酸中毒源於換氣不足,呼吸型態淺慢而非加快。","延伸病生理:第 1 型糖尿病因自體免疫破壞胰島 β 細胞而胰島素絕對不足,葡萄糖無法進入細胞,身體改以脂肪分解供能,產生乙醯乙酸與 β 羥丁酸這類酮酸,血中 pH 下降。診斷三要素為高血糖、血中或尿中酮體陽性、pH 低於 7.3 且碳酸氫根降低,呼氣可帶爛蘋果味。處置順序的觀念是先以生理食鹽水補足容積、再以靜脈胰島素持續輸注降糖並抑制脂肪分解,過程中密切補鉀,因為胰島素會把鉀帶回細胞內造成血鉀急降;血糖與滲透壓的下降速度須控制,以降低腦水腫風險。與高滲透壓高血糖狀態的對比重點是後者仍有部分內生胰島素、足以抑制酮體生成,故血糖與滲透壓更高但酸中毒輕微。可連結概念:三多一少症狀、代謝性酸中毒代償機轉、胰島素種類與作用時間。",[24,25,27,30,32],{"term":15,"count":10},{"term":26,"count":10},"低血糖症狀",{"term":28,"count":29},"庫斯莫耳氏呼吸",1,{"term":31,"count":29},"滲透性利尿",{"term":33,"count":29},"高滲透壓高血糖狀態比較",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-2-maternal-pediatric-046","小金，5 個月大，罹患甲狀腺功能低下症，目前接受 L-thyroxine 治療，有關小金的居家照護，下列敘述何者錯誤？",46,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-106-2-maternal-pediatric-012","有關生產時會陰消毒原則，下列何者錯誤？",12,106,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-107-1-maternal-pediatric-026","出生 3 天的足月新生兒，出生體重為 3,000 公克，採純母乳哺餵，下列何項營養評估的結果為異常﹖",26,107,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-108-1-maternal-pediatric-064","有關新生兒生產過程造成的鎖骨骨折，下列護理措施何者錯誤？",64,108,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-2-maternal-pediatric-028","有關足月新生兒身體成熟度評估，下列特徵何者錯誤？",28,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-2-maternal-pediatric-062","小玲，9 歲，於扁桃腺切除術（tonsillectomy）後，用手指著傷口並抱怨傷口疼痛，下列護理措施何者最適當？",62,110,"2026-08-06",1787299007350]