[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-025":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":63},"內外科護理學","medical-surgical",{"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-內外科護理學-025","nurse-115-2-medical-surgical-025",115,2,25,"有關化學治療藥物滲漏之處理方式，下列何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"停止注射，但暫勿將針頭拔除","避免局部加壓動作","抬高外滲部位","紫杉醇藥物滲漏，給予冰敷","D",null,[],"本題考點是化學治療藥物外滲的處理原則與冷熱敷選擇。停止注射但暫不拔除針頭,是為了先回抽殘留藥液並由原針路給予解毒劑,A 適當;局部加壓會把藥液推散到更大範圍的組織,故 B 避免加壓適當;抬高患肢藉重力促進靜脈與淋巴回流、減輕腫脹,C 適當。D 最不適當的依據是國考教科書的藥物來源分類:紫杉醇與長春花鹼同屬植物鹼類,此類外滲以溫敷促進吸收擴散,冰敷與該分類原則相反。須留意近年腫瘤護理指引對紫杉類外滲多改採冰敷,與教科書的植物來源分類法有落差,兩套說法並存,本題的官方答案以教科書分類為判準。","外滲(extravasation)處置有三個共通步驟:立即停止注射並保留原針頭回抽殘餘藥液、標示範圍並避免加壓、抬高患肢減輕水腫。解毒劑則依藥物分類:蒽環類(anthracycline,如 doxorubicin)用 dexrazoxane 或局部 DMSO;長春花鹼類(vinca alkaloid)用 hyaluronidase 幫助藥物擴散稀釋;mechlorethamine 用 sodium thiosulfate 中和。冷熱敷這一段要把兩套標準分清楚:國考教科書依藥物來源分類,植物鹼類(長春花鹼、紫杉醇)外滲給溫敷以促進吸收擴散,蒽環類與烷化劑給冰敷以限制藥物擴散、減少組織壞死;而近年的腫瘤護理相關指引對紫杉類(taxane)外滲多主張冰敷,與植物來源分類法確實不一致,這是知識更新造成的落差,不是記錯。這一題依教科書分類法判 D 最不適當。口訣:「植物溫、蒽環冰」——蒽環類即 anthracycline,勿與抗生素紅黴素(erythromycin)混淆。延伸概念:發疱劑(vesicant)與刺激劑(irritant)的分類差異,以及中心靜脈導管、人工血管可降低外滲風險的理由。",[24,27,29,31],{"term":25,"count":26},"化學治療藥物外滲處置流程",1,{"term":28,"count":26},"發疱劑與刺激劑分類",{"term":30,"count":26},"植物鹼類與蒽環類冷熱敷原則",{"term":32,"count":26},"外滲解毒劑對應",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-115-2-medical-surgical-026","有關乳癌之相關敘述，下列何者最不適當？",26,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-106-1-medical-surgical-072","有關甲狀腺機能亢進之護理指導，下列何者錯誤？",72,106,{"webId":44,"stem":45,"number":46,"year":47,"session":26},"nurse-107-1-medical-surgical-006","有關中風病人功能性尿失禁問題的敘述，下列何者正確？①建立讓病人有表達如廁需要的溝通方法 ②儘量包著尿布以避免因為失禁引起病人的困窘 ③應存放留置尿管以預防尿液滯留 ④白天每 2～3 小時協助病人如廁一次",6,107,{"webId":49,"stem":50,"number":51,"year":52,"session":26},"nurse-108-1-medical-surgical-044","有關蜂窩性組織炎的敘述，下列何者正確？",44,108,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-109-2-medical-surgical-008","陳先生早上騎機車出門上班時，於十字路口與計程車擦撞倒地，同時頭部撞到地面，當時意識清楚但有多處擦傷及撕裂傷，由救護車送至急診室，當醫師正在縫合傷口時，陳先生突然喪失意識，其最大可能為下列何種頭部創傷？",8,109,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-110-2-medical-surgical-042","有關癌症病人感染問題的敘述，下列何者錯誤？",42,110,"2026-08-06",1787299037155]