一位病人診斷為全身性帶狀疱疹 (Disseminated Herpes Zoster)。護理師應執行哪種隔離防護？
A client is diagnosed with Disseminated Herpes Zoster. Which isolation precautions should the nurse implement?
- AStandard precautions only僅標準防護
- BDroplet and contact precautions飛沫與接觸防護
- CAirborne and contact precautions✓ 正解空氣與接觸防護
- DContact precautions only僅接觸防護
帶狀疱疹 (Herpes Zoster) 的隔離等級取決於其表現形式。局限性 (Localized) 帶狀疱疹在覆蓋傷口的情況下僅需標準防護；但全身性 (Disseminated) 帶狀疱疹則意味著病毒可能透過空氣傳播。因此，正確答案 C 必須同時啟動空氣傳播防護 (Airborne Precautions) 與接觸傳播防護 (Contact Precautions)，直到所有水泡結痂。臨床思路上，應將此類病人安置在負壓房，護理師需佩戴 N95 呼吸器並穿戴隔離衣手套。
Disseminated herpes zoster requires both airborne and contact precautions because the virus can be transmitted via airborne droplet nuclei and direct contact with lesions. Unlike localized shingles, which only needs standard precautions if lesions are covered, disseminated infection poses a risk of inhalation transmission. The client should be placed in a negative-pressure room, and healthcare providers must wear N95 respirators and gowns.
在美國 NCLEX 考試中，對於免疫抑制 (Immunocompromised) 病人出現的帶狀疱疹，無論是否全身性，通常都傾向採取最嚴格的隔離措施。台灣臨床對於 Disseminated 的定義與防護等級與美方一致，但 N95 的落實情境需視病人免疫狀態而定。