[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-045":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-045","nurse-115-2-medical-surgical-045",115,2,45,"副甲狀腺切除術後易發生下列何種現象？",{"A":14,"B":15,"C":16,"D":17},"低血磷","低血鈣","低血糖","低血鉀","B",null,[],"本題考點是副甲狀腺激素對鈣磷代謝的調節方向。依生理機轉,副甲狀腺激素促進骨骼釋出鈣、增加腎小管對鈣的回收並抑制磷的回收使磷由尿排出,同時活化維生素 D 以提升腸道鈣吸收;副甲狀腺切除後激素驟減,上述作用同時消失,血鈣下降而血磷相對上升,故答案為 B。A 錯,方向恰好相反,失去排磷作用會造成高血磷而非低血磷。C 錯,血糖主要由胰島素與升糖素等調控,與副甲狀腺激素無直接關係。D 錯,血鉀濃度主要受醛固酮、體液酸鹼值與腎臟排泄影響。術後低血鈣可由口周麻木、手足痙攣與肌肉抽動等神經肌肉興奮性升高的表現辨識。","延伸機轉:鈣與磷在血中呈相反消長,副甲狀腺激素是升鈣降磷、降鈣素是降鈣、活性維生素 D 是同時促進鈣磷吸收,三者構成鈣平衡的調控三角。低血鈣造成神經肌肉興奮性上升的原理,是細胞外鈣減少使鈉通道閾值下降,神經更易自發放電,因此出現特有的兩個徵象:輕敲耳前顏面神經引起同側面部肌肉抽動,以及上臂加壓後出現手部痙攣姿勢。此考點也連到甲狀腺手術,因腺體毗鄰,甲狀腺全切除可能誤傷副甲狀腺而出現同樣的低血鈣;另需與喉返神經受損造成的聲音沙啞區分。可連結概念:降鈣素與維生素 D 作用、高血鈣的骨痛與結石表現、慢性腎病的鈣磷失衡。",[24,27,29,31,34],{"term":25,"count":26},"神經肌肉興奮性",3,{"term":28,"count":10},"術後低血鈣",{"term":30,"count":10},"維生素 D 活化",{"term":32,"count":33},"副甲狀腺激素",1,{"term":35,"count":33},"鈣磷相反消長",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-2-medical-surgical-046","有關第 1 型與第 2 型糖尿病比較之敘述，下列何者錯誤？",46,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-2-medical-surgical-012","有關食道癌的敘述，下列何者錯誤？",12,106,{"webId":47,"stem":48,"number":49,"year":50,"session":33},"nurse-107-1-medical-surgical-026","有關低血壓的治療，下列敘述何者錯誤？",26,107,{"webId":52,"stem":53,"number":54,"year":55,"session":33},"nurse-108-1-medical-surgical-064","有關腎病症候群病人之處置，下列何者錯誤？",64,108,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-2-medical-surgical-028","造成心因性休克的主要原因，不包括下列何者？",28,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-2-medical-surgical-062","有關膀胱癌進行尿路改道手術後之照護，下列何者正確？",62,110,"2026-08-06",1787299037342]