病人診斷為帶狀疱疹且有全身性病灶。護理師應執行哪些防護措施？（選所有適合的）
A client is diagnosed with shingles (Herpes Zoster) with disseminated lesions. Which precautions should the nurse implement? (Select all that apply.)
- AStandard precautions✓ 正解標準防護措施
- BContact precautions✓ 正解接觸防護措施
- CAirborne precautions✓ 正解空氣傳播防護措施
- DDroplet precautions飛沫防護措施
- EPrivate room with negative pressure✓ 正解負壓隔離病房
帶狀疱疹（Herpes Zoster），俗稱皮蛇，是由水痘帶狀疱疹病毒（Varicella-Zoster Virus, VZV）再活化引起的。一般而言，局部性帶狀疱疹在皮疹結痂後傳染性降低，通常只需要接觸隔離。然而，當病灶廣泛分佈於身體多個皮節（disseminated lesions）時，其傳播方式會類似於水痘，透過空氣傳播。這對免疫功能低下或未曾感染水痘的人群構成極大風險。因此，護理師必須正確判斷其傳播途徑，並採取最嚴格的隔離防護措施。 正確的隔離措施不僅保護其他病人，也保護醫護人員和訪客。對於播散性帶狀疱疹，同時採取接觸和空氣傳播隔離是確保安全的關鍵。這項決策體現了護理師對感染控制原則的深刻理解和臨床判斷能力，是病人安全管理的重要組成部分。
Herpes zoster (commonly known as shingles) is caused by reactivation of the Varicella-Zoster Virus (VZV). Generally, localized herpes zoster becomes less contagious after the rash has crusted over and typically requires only contact precautions. However, when lesions are widely distributed across multiple dermatomes (disseminated lesions), the transmission mode resembles that of chickenpox, with airborne spread. This poses a serious risk to immunocompromised individuals or those who have never had chickenpox. Therefore, the nurse must accurately determine the route of transmission and implement the strictest isolation precautions. Proper isolation measures protect not only other clients but also healthcare personnel and visitors. For disseminated herpes zoster, simultaneously implementing contact and airborne precautions is key to ensuring safety. This decision reflects the nurse's deep understanding of infection control principles and clinical judgment and is an important component of patient safety management.
對於播散性帶狀疱疹（disseminated Herpes Zoster）的感染控制措施，台灣和美國的指南是高度一致的。兩地都要求採取同時結合接觸隔離和空氣傳播隔離的策略，並將病人安置於負壓隔離病房。這是基於水痘帶狀疱疹病毒（VZV）的傳播特性，尤其是在免疫功能低下或病灶廣泛的情況下。因此，NCLEX 考試中關於此類疾病隔離的知識，對於台灣護理師在美國執業是直接適用的，沒有顯著的臨床做法差異。