[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-033":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"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":10},"nurse-115-2-內外科護理學-033","nurse-115-2-medical-surgical-033",115,2,33,"黃先生因肺癌接受右全肺切除術（pneumonectomy），下列術後護理措施，何者最適當？①需確認術後胸腔水下引流系統是完整且功能正常 ②協助執行右側肩膀及手臂運動，以防關節黏滯導致冰凍肩 ③告知術後 3～6 個月，右側胸部傷口處肌肉較無力是正常的 ④教導術後盡量採左側躺，以利於剩餘肺臟的擴張",{"A":14,"B":15,"C":16,"D":17},"①②","③④","②③","①④","C",null,[],"本題考點是全肺切除術後照護與一般肺葉切除的差異。依術後解剖與生理改變,②正確,患側肩臂主動與被動運動可預防關節黏滯攣縮與冰凍肩;③正確,開胸切口影響胸壁肌肉與肋間神經,術後三至六個月患側肌力較弱與麻木感屬預期恢復過程,故選 C。①不適當,全肺切除後患側肋膜腔預期由積液與纖維組織逐步填充以穩定縱膈腔位置,臨床上常不放置水下引流或將引流管夾住間歇開放,並非以維持持續引流通暢為目標。④不適當,長時間完全側躺於健側會壓迫僅存的肺並限制其擴張,擺位以半坐臥或朝患側為原則。","延伸原理:肺葉切除與全肺切除的引流邏輯剛好相反。肺葉切除留有肺組織需擴張填滿殘餘空間,所以要靠水下引流排氣排液、觀察氣泡與水面波動;全肺切除後整側沒有肺可擴張,若持續強力引流會使縱膈腔被拉向患側,壓迫大血管而影響靜脈回流與心輸出量。擺位口訣:全肺切除記得不壓好肺,半坐臥最安全。術後觀察重點是氣管位置是否偏移、有無皮下氣腫與突發呼吸困難,這些提示縱膈腔移位。可連結概念:縱膈腔擺盪、胸腔水下引流三瓶原理、術後肺擴張運動與誘發性肺量計。",[24,26,29,31,33],{"term":25,"count":10},"縱膈腔移位",{"term":27,"count":28},"全肺切除術後照護",1,{"term":30,"count":28},"胸腔水下引流原則",{"term":32,"count":28},"冰凍肩預防",{"term":34,"count":28},"術後擺位",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-medical-surgical-034","張力性氣胸是指空氣滯留在以下那個部位無出口，造成吸氣時空氣進入，吐氣時卻無法排出，而產生單向瓣膜效應（one-way valve effect）？",34,{"webId":41,"stem":42,"number":43,"year":44,"session":28},"nurse-106-1-medical-surgical-080","有關登革熱之敘述，下列何者錯誤？",80,106,{"webId":46,"stem":47,"number":48,"year":49,"session":28},"nurse-107-1-medical-surgical-014","有關 C 型肝炎的治療，下列何者正確？",14,107,{"webId":51,"stem":52,"number":53,"year":54,"session":28},"nurse-108-1-medical-surgical-052","肺結核病人若無法遵從醫師所開立的醫囑規則服藥時之護理措施，下列何者最適當？",52,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-medical-surgical-016","病人主訴「餓的時候疼痛，常常半夜痛醒」，下列何者為其最大可能之診斷？",16,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-2-medical-surgical-050","有關愛滋病的傳染途徑，下列何者錯誤？",50,110,"2026-08-06",1787299037233]