[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-029":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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-029","nurse-115-2-medical-surgical-029",115,2,29,"簡先生 6 小時前車禍意外造成全身 40%的熱燒傷，下列敘述何者正確？",{"A":14,"B":15,"C":16,"D":17},"腎絲球過濾（GFR）上升","代謝性鹼中毒","血糖升高","血鉀下降","C",null,[],"本題考點是大面積燒傷後 48 小時內休克期的病理生理變化。依燒傷體液轉移機轉,發炎介質使微血管通透性大增,血漿與蛋白滲入組織間隙形成水腫,循環血量與心輸出量下降;同時大範圍組織傷害啟動壓力反應,兒茶酚胺、皮質醇與升糖素上升,促進肝醣分解與糖質新生並造成周邊胰島素阻抗,故血糖升高,選 C。A 錯,血容積不足使腎血流減少,腎絲球過濾率是下降而非上升,並以尿量減少呈現。B 錯,組織灌流不足導致乳酸堆積,呈代謝性酸中毒。D 錯,細胞受損釋出細胞內鉀且腎排泄變差,早期典型為高血鉀。","延伸病生理:燒傷病程可分為體液轉移期(約前 48 小時)與體液再吸收期(約 48 至 72 小時後)。休克期血液濃縮,血比容與血紅素上升;進入再吸收期後組織間液回流血管,血比容下降、尿量增加,鉀由細胞外回到細胞內或隨尿排出,反而要注意低血鉀。對照口訣:前期高鉀、酸中毒、血糖高、尿少;後期低鉀、尿多。血糖升高屬創傷後代謝的超代謝反應,同時伴隨蛋白質分解與負氮平衡,是燒傷營養需求極高的原因。可連結概念:燒傷面積九分法、Parkland 公式的體液補充概念、吸入性傷害評估。",[24,27,30,32,34],{"term":25,"count":26},"代謝性酸中毒",22,{"term":28,"count":29},"燒傷體液轉移期",1,{"term":31,"count":29},"微血管通透性增加",{"term":33,"count":29},"壓力反應與糖質新生",{"term":35,"count":29},"高血鉀機轉",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-2-medical-surgical-030","異位性皮膚炎病人血液中會出現下列何種免疫球蛋白升高？",30,{"webId":42,"stem":43,"number":44,"year":45,"session":29},"nurse-106-1-medical-surgical-076","有關巴拉刈（Paraquat）中毒之敘述，下列何者錯誤？",76,106,{"webId":47,"stem":48,"number":49,"year":50,"session":29},"nurse-107-1-medical-surgical-010","有關傾倒症候群（Dumping Syndrome）的敘述，下列何者正確？",10,107,{"webId":52,"stem":53,"number":54,"year":55,"session":29},"nurse-108-1-medical-surgical-048","有關溶血性輸血引起的過敏反應，是下列那類免疫球蛋白與補體結合，活化補體系統所致？",48,108,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-2-medical-surgical-012","有關大腸癌的高危險因子，下列何者錯誤？",12,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-2-medical-surgical-046","有關蜂窩性組織炎病人的護理措施，下列何者錯誤？",46,110,"2026-08-06",1787299037186]