護理師照護一名嗜中性球減少症（Neutropenia）病人。護理師應在衛教計畫中包含哪些內容？（選所有適合的）
A nurse is caring for a client with neutropenia. Which of the following instructions should the nurse include in the client's teaching plan? (Select all that apply.)
- AAvoid eating raw fruits and vegetables that cannot be peeled.✓ 正解避免食用無法剝皮的生鮮水果和蔬菜。
- BAvoid large crowds and people who are sick.✓ 正解避免前往人群擁擠處及接觸生病的人。
- CChange the water in flower vases daily.每天更換花瓶中的水。
- DWash hands frequently with antibacterial soap.✓ 正解頻繁使用抗菌肥皂洗手。
- EPerform thorough oral hygiene after every meal.✓ 正解每餐後進行徹底的口腔清潔。
嗜中性球減少症病人處於高度感染風險（保護性隔離狀態）。核心概念是『減少環境致病原暴露』。避免生食（A）是因為未經剝皮的蔬果可能攜帶土壤中的細菌或黴菌。避開人群（B）能減少呼吸道病毒感染機會。頻繁洗手（D）是預防接觸傳染最有效方式。口腔衛生（E）則能預防口腔內共生菌轉變為機會性感染，因為口腔黏膜破損是常見的病原入口。選項 C 是錯誤的，嗜中性球減少症病房應『禁絕』鮮花與盆栽，因為水與土壤中含有大量綠膿桿菌等病原體，僅更換花瓶水是不夠的，必須完全移除。護理師需指導病人及其家屬如何建立一個低菌的居家環境。
Clients with neutropenia are at high risk for infection (a state of protective isolation). The core concept is to "reduce exposure to environmental pathogens." Avoiding raw foods (A) is recommended because unpeeled fruits and vegetables may carry bacteria or fungi from the soil. Avoiding crowds (B) reduces the risk of respiratory viral infection. Frequent hand hygiene (D) is the most effective way to prevent contact transmission. Oral hygiene (E) prevents the conversion of normal oral flora into opportunistic infection, since oral mucosal breakdown is a common portal of entry. Option C is incorrect; fresh flowers and potted plants must be banned from the room of a neutropenic client, because the water and soil contain large numbers of pathogens such as Pseudomonas aeruginosa, and merely changing the vase water is not sufficient—they must be removed entirely. The nurse must teach the client and family how to establish a low-microbial home environment.
美國 NCLEX 考試中，Neutropenic Diet（低菌飲食）是經典考點，雖然現代臨床證據對其必要性有爭論，但考試仍傾向於保守的安全教學。台灣部分化療中心已放寬對剝皮水果的限制，但在國外執照考試中，『無花、無生食』仍是必須遵守的黃金準則。