腫瘤診所檢傷護理師接到正在接受誘導化療病人來電。病人主訴全身關節痛、疲倦，目前居家體溫 38.4°C。護理師最重要的指令為何？
An oncology clinic triage nurse receives a phone call from a client receiving induction chemotherapy. The client reports generalized joint pain, fatigue, and a current home temperature of 38.4°C (101.1°F). What is the nurse's most important instruction?
- ASchedule a routine outpatient visit within 48 hours.安排常規門診就醫，48小時內完成。
- BGo to the emergency department immediately for evaluation.✓ 正解立即前往急診接受評估。
- CTake over-the-counter acetaminophen to reduce the fever and rest.服用非處方醋氨酚（acetaminophen）以降燒並休息。
- DStay at home in bed; if fever persists more than 24 hours, call the clinic.留在家中卧床；若發燒持續超過24小時，再聯繫診所。
化療後發燒 ≥ 38°C 必須假設為「中性球低下發燒（Febrile Neutropenia）」直到證實為止 — 這是腫瘤急症。 選項 B 正確：必須立即到急診抽血培養並在 1 小時內給予 IV 廣效抗生素。每延遲 1 小時，敗血症死亡率上升 7-8%。 選項 C 錯誤：自行服用退燒藥會掩蓋發燒徵象、延誤抗生素，可能致命。 選項 D 錯誤：在家觀察 24 小時等同於不作為。 選項 A 錯誤：48 小時後就診來不及。
A fever ≥ 38°C in a chemotherapy client must be treated as febrile neutropenia until proven otherwise—an oncologic emergency. B is correct: Immediate ED visit for blood cultures and IV broad-spectrum antibiotics within 1 hour. Each hour of antibiotic delay increases sepsis mortality by 7-8%. C is incorrect: Acetaminophen masks fever and delays antibiotics—potentially lethal. D is incorrect: 24-hour home observation is dangerous inaction. A is incorrect: 48-hour delay is far too late.
化療病人打電話到診所說發燒，唯一的標準回答就是：「立刻去急診 (Go to ER immediately)」。全世界標準。