[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-037":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":26},"nurse-115-2-內外科護理學-037","nurse-115-2-medical-surgical-037",115,2,37,"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？",{"A":14,"B":15,"C":16,"D":17},"回家後不需再使用氧氣","減少水分及鹽分的攝取","活動時出現心跳下降應立即停止活動","可以漸進式增加活動","A",null,[],"本題考點是肺心症的病理生理與居家自我照護重點。依其機轉,慢性肺部疾病造成長期低血氧,引發肺小動脈收縮與肺血管重塑而形成肺動脈高壓,右心後負荷持續增加終致右心衰竭;長期居家氧氣治療可減輕缺氧性肺血管收縮、降低肺動脈壓並延緩病程,故 A 說回家後不需再使用氧氣最不適當。B 適當,右心衰竭導致體液滯留、周邊水腫與肝脾腫大,適度限鈉限水可減輕心臟負荷。C 適當,活動中心跳反而下降代表心臟已無法代償,是停止活動的警訊。D 適當,在耐受範圍內漸進增加活動有助提升運動耐受力與生活品質。","延伸病生理:缺氧性肺血管收縮原本是為了把血流導向通氣良好的肺區,但在慢性瀰漫性肺病中變成全肺血管收縮,壓力長期升高後右心室代償性肥厚再擴大,終於失能,這條路徑就是肺心症的骨幹。右心衰竭表現與左心衰竭剛好分工:右心塞在體循環,呈頸靜脈膨脹、下肢水腫、肝頸靜脈回流徵象與體重上升;左心塞在肺循環,呈端坐呼吸、夜間陣發性呼吸困難與濕囉音。給氧原則上,二氧化碳滯留型病人以低流量控制性給氧維持適度血氧,不以完全正常化為目標,以免削弱缺氧性呼吸驅動。可連結概念:慢性阻塞性肺病、肺動脈高壓、肺部復健與呼吸節律訓練。",[24,27,29,31,33],{"term":25,"count":26},"缺氧性肺血管收縮",1,{"term":28,"count":26},"肺動脈高壓",{"term":30,"count":26},"右心衰竭表徵",{"term":32,"count":26},"長期居家氧氣治療",{"term":34,"count":26},"活動耐受力評估",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-medical-surgical-038","有關良性前列腺肥大的敘述，下列何者正確？",38,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-2-medical-surgical-004","有關出血性腦中風病人的護理措施，下列何者正確？",4,106,{"webId":46,"stem":47,"number":48,"year":49,"session":26},"nurse-107-1-medical-surgical-018","有關下肢截肢手術後的護理措施，下列何者錯誤？",18,107,{"webId":51,"stem":52,"number":53,"year":54,"session":26},"nurse-108-1-medical-surgical-056","有關呼吸性酸中毒之敘述，下列何者正確？",56,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-medical-surgical-020","右側下肢無力需要使用手杖之病人，下列使用方法何者最正確？",20,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-2-medical-surgical-054","下列何者不是造成肺泡通氣不足而導致呼吸衰竭的原因？",54,110,"2026-08-06",1787299037272]