[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-041":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-041","nurse-115-2-medical-surgical-041",115,2,41,"有關腎病症候群病人的護理指導，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"採取低蛋白質及均衡熱量飲食","補充含鈉食物以避免低血鈉","使用利尿劑及限水以控制水腫","鼓勵多下床活動以減輕腎臟負荷","C",null,[],"本題考點是腎病症候群的水腫成因與照護原則。依其病理,腎絲球通透性增加造成大量蛋白尿與低白蛋白血症,血漿膠體滲透壓下降使體液移入組織間隙形成全身性水腫,有效循環容積不足又活化腎素-血管張力素-醛固酮系統,進一步加重鈉水滯留,故以利尿劑配合限水限鈉控制水腫,C 正確。A 錯,蛋白大量流失狀態下應給予適量蛋白質與足夠熱量,過度限制蛋白會加重營養不良與負氮平衡。B 錯,問題在鈉水滯留,應限鈉而非補充含鈉食物。D 錯,水腫明顯時適度臥床平躺有助靜脈回流與尿液排出。","延伸病生理:腎病症候群四大特徵可用一條因果鏈串起——大量蛋白尿造成低白蛋白血症,低白蛋白造成水腫,肝臟代償合成脂蛋白造成高血脂,合稱蛋白尿、低蛋白血症、水腫、高血脂。免疫球蛋白與抗凝蛋白隨尿流失,因此同時有感染與血栓兩大風險,這是照護觀察的重點所在。水腫評估比體重更靈敏的是每日固定時間量測體重加上腹圍與凹陷性水腫分級,並記錄攝入排出量。飲食口訣:限鈉、適量蛋白、足夠熱量、依水腫與尿量調整水分。可連結概念:白蛋白與膠體滲透壓、類固醇治療的副作用監測、腎絲球疾病與腎炎症候群的區別。",[24,27,30,32,34],{"term":25,"count":26},"腎病症候群",7,{"term":28,"count":29},"低白蛋白血症與膠體滲透壓",1,{"term":31,"count":29},"腎素-血管張力素-醛固酮系統",{"term":33,"count":29},"限鈉與利尿劑",{"term":35,"count":29},"適量蛋白質飲食",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-2-medical-surgical-042","有關急性腎盂腎炎病人的敘述，下列何者錯誤？",42,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-2-medical-surgical-008","下列何者為重症肌無力病人最早出現的症狀？",8,106,{"webId":47,"stem":48,"number":49,"year":50,"session":29},"nurse-107-1-medical-surgical-022","有關使用音叉評估聽力喪失之敘述，下列何者錯誤？",22,107,{"webId":52,"stem":53,"number":54,"year":55,"session":29},"nurse-108-1-medical-surgical-060","膀胱癌的初期臨床表徵，下列何者正確？",60,108,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-2-medical-surgical-024","有關美尼爾氏症之敘述，下列何者正確？①可能原因是外耳淋巴液過多 ②症狀為雙側傳導性聽力減退 ③使用血管擴張劑減輕耳鳴症狀 ④藥物治療無效時，可採迷路切除術",24,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-2-medical-surgical-058","護理一位出現肺水腫症狀與徵候的病人，下列措施之順序，何者最適當？①經由鼻導管給與 2 L\u002Fmin 氧氣治療 ②呼叫醫師 ③協助病人採高坐臥 ④準備床邊抽痰用物",58,110,"2026-08-06",1787299037309]