[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-039":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-039","nurse-115-2-medical-surgical-039",115,2,39,"有關血液透析病人動靜脈瘻管的敘述，下列何者最適當？",{"A":14,"B":15,"C":16,"D":17},"聽診動靜脈瘻管有嘈音（bruit）表示有阻塞情形","動靜脈瘻管術後 1 週後才可開始握球運動","動靜脈瘻管術後 6～8 週才可使用於血液透析","動靜脈瘻管術後 3 個月才可開始提重物","C",null,[],"本題考點是血液透析動靜脈瘻管的成熟時間與照護原則。依瘻管生理,將動脈與靜脈直接接合後,高壓動脈血流入靜脈使靜脈管壁增厚、管徑擴張並形成足夠血流量,此成熟過程一般需術後六至八週,才能承受反覆穿刺與透析所需流速,故 C 最適當。A 錯,聽診到嘈音並觸摸到震顫代表血流通暢,反之嘈音與震顫減弱或消失才提示狹窄或阻塞。B 錯,握球等前臂運動在傷口穩定後即可漸進開始以促進靜脈擴張,並非須滿一週才准。D 錯,瘻管側肢體應長期避免提重物、量血壓、抽血與過緊束縛,而非三個月後就無限制。","延伸原理:瘻管是把靜脈訓練成可反覆穿刺的通路,其成熟看三個指標——管徑夠粗、血流量夠大、位置夠淺易穿刺,常以觸摸震顫與聽診嘈音作床邊評估。人工血管移植的成熟時間較短(約二至四週),但感染與血栓風險高於自體瘻管,這也是自體瘻管仍為首選的理由。照護口訣:摸得到震顫、聽得到嘈音就是通;患肢不量壓、不抽血、不提重、不壓迫。長期併發症要分辨盜血症候群(遠端手指冰冷、疼痛、發白,因血流被分流)與靜脈高壓(手部持續腫脹)。可連結概念:透析充分性評估、腎友體液與飲食控制、暫時性中心靜脈導管的取捨。",[24,26,29,31,33],{"term":25,"count":10},"握球運動",{"term":27,"count":28},"動靜脈瘻管成熟期",1,{"term":30,"count":28},"震顫與嘈音評估",{"term":32,"count":28},"患肢照護限制",{"term":34,"count":28},"血液透析血流需求",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-medical-surgical-040","有關接受膀胱鏡檢查病人的護理指導，下列何者不適當？",40,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-2-medical-surgical-006","評估大腦各葉與腦幹功能常用之診斷檢查，下列何者正確？",6,106,{"webId":46,"stem":47,"number":48,"year":49,"session":28},"nurse-107-1-medical-surgical-020","有關骨質疏鬆症的臨床現象，下列敘述何者錯誤？",20,107,{"webId":51,"stem":52,"number":53,"year":54,"session":28},"nurse-108-1-medical-surgical-058","慢性阻塞性肺部疾病病人最早出現的肺功能變化為下列何者？",58,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-medical-surgical-022","有關聽力喪失可聽見的音量敘述，下列何者錯誤？",22,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-2-medical-surgical-056","有關肋膜積水進行放液時，若一次超過 1,200 c.c.，可能會發生下列何種現象？",56,110,"2026-08-06",1787299037289]