[{"data":1,"prerenderedAt":68},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-036":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":38,"lastmod":67},"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-036","nurse-115-2-medical-surgical-036",115,2,36,"下列何者是急性呼吸窘迫症候群（ARDS）早期的重要徵象？",{"A":14,"B":15,"C":16,"D":17},"二氧化碳升高","低血氧且對氧氣治療反應不佳","代謝性酸中毒","嚴重的電解質不平衡","B",null,[],"本題考點是急性呼吸窘迫症候群的核心診斷特徵。依其病理機轉,肺泡與微血管膜受發炎介質破壞造成通透性增高的非心因性肺水腫,加上表面張力素不足使肺泡塌陷,產生大量肺內分流:血液流經未通氣的肺泡而完全未經氧合,提高吸入氧濃度也無法改善,因此對氧氣治療反應不佳的頑固性低血氧是早期關鍵徵象,故選 B。A 錯,早期因缺氧刺激而過度換氣,二氧化碳偏低,數值升高屬晚期呼吸肌疲乏與呼吸衰竭。C 錯,代謝性酸中毒須到組織灌流嚴重不足才出現。D 錯,嚴重電解質不平衡並非此症候群的特徵表現。","延伸病生理:肺內分流與一般換氣灌流不均的差別,正是氧氣治療是否有效的分水嶺。分流時肺泡完全無通氣,提高氧濃度救不到那部分血液,所以治療策略轉向重新打開塌陷肺泡並維持其張開,例如正壓通氣與吐氣末正壓,以及採低潮氣容積避免肺過度膨脹傷害。臨床設計此考點,是要考生分辨低血氧的機轉而非只記症狀。血氧與二氧化碳的時序口訣:早期低氧又低碳酸(過度換氣),晚期低氧加高碳酸(失去代償),看到二氧化碳開始上升就是惡化訊號。可連結概念:表面張力素功能、肺順應性下降、俯臥擺位的生理基礎、急性肺損傷的誘發因素如敗血症與外傷。",[24,27,30,33,36],{"term":25,"count":26},"非心因性肺水腫",6,{"term":28,"count":29},"急性呼吸窘迫症候群",4,{"term":31,"count":32},"肺內分流",3,{"term":34,"count":35},"頑固性低血氧",1,{"term":37,"count":35},"呼吸性鹼中毒早期表現",[39,43,47,52,57,62],{"webId":40,"stem":41,"number":42,"year":9,"session":10},"nurse-115-2-medical-surgical-037","宋先生為肺心症病人，對於他出院居家護理指導，下列何者不適當？",37,{"webId":44,"stem":45,"number":32,"year":46,"session":10},"nurse-106-2-medical-surgical-003","有關脊髓損傷導致自主神經反射過度之敘述，下列何者正確？",106,{"webId":48,"stem":49,"number":50,"year":51,"session":35},"nurse-107-1-medical-surgical-017","有關骨髓炎常見之症狀，下列何者錯誤？",17,107,{"webId":53,"stem":54,"number":55,"year":56,"session":35},"nurse-108-1-medical-surgical-055","觀察到胸腔水下引流的水封瓶內持續有小量氣泡時之處置，下列何者正確？",55,108,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-109-2-medical-surgical-019","下列何者為退化性關節炎的高危險群？①BMI 35 kg\u002Fm 2 ②長期服用腎上腺皮質類固醇 ③重複性右膝受傷史 ④停經後婦女",19,109,{"webId":63,"stem":64,"number":65,"year":66,"session":10},"nurse-110-2-medical-surgical-053","接受胸腔放液後的病人，下列何者最需緊急處理？",53,110,"2026-08-06",1787299037267]