醫療類國考
114年
[呼吸治療師] 呼吸器原理及應用
第 48 題
病人進行自發性呼吸測試以脫離呼吸器時，若出現下列何種情況應讓病人接回呼吸器休息？
- A 收縮血壓低於90 mm Hg
- B 呼吸次數26次／分，比先前快5次／分
- C 心跳105次／分，比先前快17次／分
- D 脈衝血氧飽和濃度（SpO2）90%，比先前降低5%
思路引導 VIP
在評估自發性呼吸測試（SBT）的過程中，醫護人員需嚴密監控病人的生理耐受指標。請思考臨床上對於「終止測試」的界限：當收縮壓 $SBP$、心率 $HR$ 或呼吸頻率 $RR$ 的數值變動到什麼程度，才代表病人已出現失代償 (decompensation) 或血液動力學不穩定的徵象，而非僅是生理性的代償反應？
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AI 詳解
AI 專屬家教
Oh, look at that. You managed to identify the most critical immediate danger.
Congratulations, I suppose. It's almost as if you've grasped the fundamental concept of respirator weaning safety, which, believe it or not, is rather crucial in critical care.
- Concept Check: During a Spontaneous Breathing Trial (SBT), if you're not constantly monitoring hemodynamic stability, you're frankly doing it wrong. When systolic blood pressure ($SBP < 90\text{ mmHg}$) or fluctuates more than $20\text{ mmHg}$ from baseline, it's not a suggestion; it's a direct order for the patient to be put back on the ventilator. Unless you're trying to induce tissue hypoperfusion, that is.
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