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健康促進與維護 · MEDIUM · MCQ

一位26歲懷孕18週的個案接受常規產前照護。回顧她的電子病歷顯示,她懷孕前的身體質量指數(BMI)為 21.3(正常體重區間)。她緊張地指著體重計問:「我婆婆一直強迫我吃額外的餐點,說這樣寶寶才會長得大,但我很擔心。在整個懷孕期間,我到底『實際上』應該安全地增加多少總體重?」根據國家產科指引,護理師應衛教此個案正確的增重範圍為何?

A 26-year-old client at 18 weeks' gestation receives routine prenatal care. A review of her electronic health record indicates that her pre-pregnancy Body Mass Index (BMI) was 21.3 (normal weight). She nervously points at the scale and asks, "My mother-in-law keeps forcing me to eat extra meals so the baby grows big, but I'm worried. How much total weight am I actually supposed to safely gain over this entire pregnancy?" Based on national obstetric guidelines, what is the correct weight gain range the nurse should teach this client?

  • A11 to 20 lbs (5.0 to 9.1 kg)
    11 至 20 磅(5.0 至 9.1 公斤)
  • B25 to 35 lbs (11.3 to 15.9 kg)✓ 正解
    25 至 35 磅(11.3 至 15.9 公斤)
  • C28 to 40 lbs (12.7 to 18.1 kg)
    28 至 40 磅(12.7 至 18.1 公斤)
  • D15 to 25 lbs (6.8 to 11.3 kg)
    15 至 25 磅(6.8 至 11.3 公斤)
Explanation · 中文詳解

本題測驗基於孕前 BMI 的正常孕期總體重增加(Gestational Weight Gain)標準。根據各國婦產科醫學會 (包括 ACOG) 頒布的嚴格標準,孕婦該胖多少完全取決於她「懷孕前的身形」。該產婦孕前 BMI 為 21.3,屬於正常體重 (Normal weight: BMI 18.5-24.9)。對於這類正常區間的婦女,整個孕期的健康增重總額應落在 25 至 35 磅(約 11.3 至 15.9 公斤)之間。(選項B正確)。選項C 28 到 40 磅(12.7-18 公斤)是針對體重過輕 (Underweight, BMI <18.5) 產婦的標準。選項D 15 到 25 磅(6.8-11.3 公斤)是針對過重 (Overweight, BMI 25-29.9) 產婦的標準。選項A 11 到 20 磅(5-9 公斤)則是針對肥胖 (Obese, BMI ≥30) 產婦的嚴格限制標準。教導病患過量進食以求養大胎兒是錯誤傳統,會增加妊娠糖尿病與剖腹產風險。

For a client with a normal pre-pregnancy BMI of 18.5–24.9, the Institute of Medicine recommends a total weight gain of 25 to 35 pounds (11.3 to 15.9 kg) during pregnancy. This range supports healthy fetal growth and maternal health without increasing the risk of complications associated with excessive weight gain.

✦ 台美臨床差異

美國的體重增重標準主要以英制「磅 (lbs)」計算,但其對應公斤與台灣國健署頒布的版本(11.5-16 kg,因翻譯四捨五入些微差距)是完全互通的。考試中數字區間記憶必備。

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