— 安全與感染控制 · MEDIUM · MCQ —
評估病人是否有感染時，下列哪項臨床發現最能代表全身性感染？
When assessing a client for infection, which clinical finding is most indicative of a systemic infection?
- APurulent drainage from a surgical incision手術切口有膿性分泌物
- BLocalized redness and swelling at the site of an IV catheter靜脈導管處局部紅腫
- CPain at the site of a minor abrasion輕微擦傷處疼痛
- DElevated white blood cell (WBC) count with a 'left shift'✓ 正解白血球計數升高並出現左移
— Explanation · 中文詳解 —
全身性感染（Sepsis）常伴隨白血球增多及左移現象（即未成熟白血球比例上升），代表骨髓正大量產生免疫細胞對抗侵入的病原體。其餘選項皆為局部發炎反應，通常侷限在特定傷口或區域，尚未演變成全身性系統症狀。
Systemic infection (sepsis) is often accompanied by leukocytosis with a left shift (i.e., an increased proportion of immature white blood cells), indicating that the bone marrow is producing immune cells in large numbers to fight off invading pathogens. The other options reflect localized inflammatory responses, generally confined to a specific wound or area, and have not yet progressed to systemic involvement.
✦ 台美臨床差異
台灣醫囑中常使用「左移」描述血液檢查，美國臨床亦普遍依據此指標判斷敗血症風險。