[{"data":1,"prerenderedAt":68},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-043":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":37,"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-043","nurse-115-2-medical-surgical-043",115,2,43,"有關抗利尿不當症候群（SIADH）的臨床表徵，下列何者正確？①血鈉 128 mEq\u002FL ②尿鈉 40 mEq\u002FL ③尿比重 1.050 ④血漿滲透壓 350 mOsmo\u002Fkg ⑤尿液滲透壓 50 mOsmo\u002Fkg",{"A":14,"B":15,"C":16,"D":17},"①②③","②③④","③④⑤","①④⑤","A",null,[],"本題考點是抗利尿激素不當分泌症候群的檢驗數值方向。依其機轉,過量抗利尿激素使腎集尿管過度回收水分,造成體液滯留與稀釋性低血鈉,同時尿液被高度濃縮:①血鈉 128 mEq\u002FL 屬低血鈉,②尿鈉上升反映鈉隨濃縮尿排出且腎並未保鈉,③尿比重升高表示尿液濃縮,三者皆符合,故選 A。④錯,血液被水稀釋,血漿滲透壓應低於正常下限而非升高到 350 mOsm\u002Fkg,該數值反屬脫水或高滲狀態。⑤錯,尿液滲透壓在此症應高於血漿,50 mOsm\u002Fkg 的極稀尿是無法濃縮尿液的尿崩症表現,方向完全相反。","延伸病生理:此症與尿崩症是抗利尿激素的兩個極端,對照記憶最有效。抗利尿激素過多者水留在體內,呈體重增加、尿少而濃、血鈉低、血漿滲透壓低、尿滲透壓高;抗利尿激素不足者水大量流失,呈多尿而稀、血鈉高、血漿滲透壓高、尿滲透壓低。一句口訣:水留下來血就變淡、尿就變濃。低血鈉的臨床表現由輕到重是噁心、頭痛、倦怠、意識混亂到抽搐,關鍵在腦細胞水腫,故照護重點是限水與神經學觀察,矯正速度過快另有風險。常見成因包括中樞神經病變、肺部疾病與惡性腫瘤的異位分泌,以及部分藥物。可連結概念:血漿與尿液滲透壓對照、體液容積評估、鈉離子矯正原則。",[24,27,30,33,35],{"term":25,"count":26},"稀釋性低血鈉",8,{"term":28,"count":29},"尿比重",4,{"term":31,"count":32},"抗利尿激素不當分泌症候群",1,{"term":34,"count":32},"血漿與尿液滲透壓對照",{"term":36,"count":32},"尿崩症對比",[38,42,47,52,57,62],{"webId":39,"stem":40,"number":41,"year":9,"session":10},"nurse-115-2-medical-surgical-044","有關低血糖的敘述，下列何者錯誤？",44,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-106-2-medical-surgical-010","有關肛門瘻管手術治療後之合併症，下列何者最少見？",10,106,{"webId":48,"stem":49,"number":50,"year":51,"session":32},"nurse-107-1-medical-surgical-024","下列何者不是接受扁桃腺切除術之禁忌？",24,107,{"webId":53,"stem":54,"number":55,"year":56,"session":32},"nurse-108-1-medical-surgical-062","有關病人血清鉀為 7.0 mEq\u002FL 之處置，下列何者錯誤？",62,108,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-109-2-medical-surgical-026","僧帽瓣逆流或狹窄的病人，易出現下列何種症狀？①呼吸困難 ②下肢水腫 ③端坐呼吸 ④咳嗽 ⑤肝腫大",26,109,{"webId":63,"stem":64,"number":65,"year":66,"session":10},"nurse-110-2-medical-surgical-060","急性腎衰竭病人血清鉀為 7.2 mEq\u002FL，下列處置何者正確？①靜脈注射中長效胰島素及 5%葡萄糖溶液 ②口服或灌腸給予 Kayexalate ③靜脈注射重碳酸鈉 ④鼓勵多食用香蕉、柳丁",60,110,"2026-08-06",1787299037325]