護理師照護一名嗜中性白血球減少症 (Neutropenia) 的病人。病房內應排除下列哪項？
The nurse is caring for a client with neutropenia. Which of the following should be excluded from the client's room?
- AAlcohol-based hand sanitizer含酒精的乾洗手液
- BFresh flowers in a vase✓ 正解花瓶中的鮮花
- CA blood pressure cuff血壓計袖帶
- DBottled water瓶裝水
核心概念是保護免疫受損病人的安全。嗜中性白血球減少症（Neutropenia）病人（通常指絕對嗜中性白血球計數 ANC < 1000/mm³）缺乏抵抗病原體的能力。鮮花、植物及其花瓶中的積水是綠膿桿菌（Pseudomonas aeruginosa）與各種黴菌（如 Aspergillus）的溫床。這些環境中的機會性致病菌對普通人無害，但對缺乏白血球的病人來說可能是致命的來源。因此，建立一個「低微生物環境」是護理照護的首要任務，必須排除所有潛在的生物污染源。
The core concept is protecting immunocompromised clients. Neutropenic clients (typically ANC <1000/mm³) lack pathogen defenses. Fresh flowers and the standing water in vases harbor Pseudomonas aeruginosa and various fungi (e.g., Aspergillus). These opportunistic pathogens are harmless to healthy individuals but potentially lethal to neutropenic clients. Establishing a 'low-microbial environment' is a primary nursing duty—all potential biological contamination sources must be excluded.
美國醫院對於「Neutropenic Precautions」有非常標準化的清單，包括禁止生食、鮮花、甚至某些含皮的水果（如草莓）。台灣臨床雖也有此概念，但執行嚴格程度可能因醫院而異。NCLEX 考試中，「鮮花」與「生食」是必考的排除項目。