對於服用氨甲蝶呤（Methotrexate）的病人，下列哪項指導為優先？
Which of these instructions is priority for a client on methotrexate?
- AIncrease fluid intake增加水分攝取
- BAvoid crowds✓ 正解避免前往人群聚集處
- CIncrease sun exposure增加日曬暴露
- DTake with iron supplements與鐵劑補充品一起服用
氨甲蝶呤（Methotrexate）是一種葉酸拮抗劑，常作為免疫抑制劑或抗癌藥物使用。其嚴重的副作用包括骨髓抑制（導致嗜中性白血球減少），因此病人極易遭受感染。衛教重點應優先強調預防感染的措施，如避免前往擁擠場所。此外，需監測肝腎功能與黏膜潰瘍，水分補充雖重要，但相較於預防致命感染，避開病原體暴露為優先目標。
Methotrexate is a folate antagonist commonly used as an immunosuppressant or antineoplastic agent. Its serious adverse effects include bone marrow suppression (causing neutropenia), which makes clients highly vulnerable to infection. Teaching should therefore prioritize infection-prevention measures such as avoiding crowded settings. In addition, hepatic and renal function and mucosal ulcers should be monitored. Adequate hydration is also important, but avoiding pathogen exposure takes priority over fluid intake in preventing life-threatening infection.