護理師教導免疫系統受損的病人如何預防感染，應建議病人避免哪些事項？（選所有適合的）
A nurse is educating a client with a compromised immune system about infection prevention. Which of the following should the nurse advise the client to avoid? (Select all that apply.)
- AEating raw or undercooked meats.食用生食或未煮熟的肉類正確答案
- BReceiving live attenuated vaccines.接種活減毒疫苗正確答案
- CVisiting crowded places.造訪擁擠場所正確答案
- DGetting adequate rest.獲得充足休息
- EPracticing good hand hygiene.實踐良好手部衛生
- A食用生食或未煮熟的肉類
- B接種活減毒疫苗
- C造訪擁擠場所
核心概念：免疫系統受損（compromised immune system）的病人（如接受化療者、器官移植者、HIV 感染者、患有免疫缺陷疾病者）對感染的抵抗力顯著下降，極易受到伺機性感染（opportunistic infections）的侵襲。因此，預防感染是其照護的重中之重。 為何正確答案 A, B, C 對： A. 避免生食或未煮熟的肉類（raw or undercooked meats）：這些食物可能含有李斯特菌、沙門氏菌、弓蟲等病原體，免疫受損者感染後可能導致嚴重後果，甚至危及生命。 B. 避免接種活的減毒疫苗（live attenuated vaccines）：這類疫苗（如 MMR、水痘疫苗）含有活性但減弱的病毒，對免疫功能正常者是安全的，但對免疫受損者可能引發真正的感染。 C. 避免前往人群擁擠的場所（visiting crowded places）：這些場所是病原體（特別是呼吸道病毒）高度集中的地方，免疫受損者暴露其中，感染風險大大增加。 為何選項 D, E 錯： D. 確保充足的休息（getting adequate rest）有助於維持和增強免疫系統的功能，是預防感染的重要支持性措施，應鼓勵病人執行。 E. 練習良好的手部衛生（practicing good hand hygiene）是預防感染最基本也最有效的方法，能顯著降低接觸傳播的風險，免疫受損者尤其需要嚴格執行。 臨床推理（Safety / Infection Control）：此題的臨床推理重點是「病人安全」和「感染預防」。對於免疫功能低下的病人，預防措施的嚴格性要求更高，必須識別並避免所有潛在的感染源和高風險暴露。
- A · 正確答案食用生食或未煮熟的肉類
生食或未煮熟的肉類可能含有害細菌和寄生蟲，免疫受損者感染後難以清除，可能引發嚴重疾病，應絕對避免。
- B · 正確答案接種活減毒疫苗
活的減毒疫苗（如 MMR、水痘）對免疫功能低下者可能引發感染，應避免接種，除非在特定情況下經醫師嚴格評估。
- C · 正確答案造訪擁擠場所
人群擁擠的場所是病原體傳播的高風險區域。免疫受損者抵抗力弱，應盡量避免前往，以減少感染機會。
- D獲得充足休息
充足的休息有助於身體恢復和免疫系統的正常運作，是維持健康和預防感染的基礎，應鼓勵病人執行。
- E實踐良好手部衛生
良好的手部衛生是預防感染的最基本措施，對於免疫受損者更是重中之重，能有效阻止病原體傳播。
對於免疫系統受損病人的感染預防建議，美國（CDC）和台灣（疾管署）的指引是基本一致的，都強調避免生食、活疫苗，以及在人群密集場所的防護。美國在針對特定疾病（如癌症化療、器官移植）的病人教育方面可能有更細緻的指引和支持資源。台灣則會結合社區醫療網絡進行推廣。
English explanation
Core concept: Patients with a compromised immune system (such as those on chemotherapy, organ transplant recipients, HIV-infected persons, or those with immunodeficiency disorders) have significantly reduced resistance to infection and are highly susceptible to opportunistic infections. Therefore, infection prevention is the cornerstone of their care. Why the correct answers A, B, C are correct: A. Avoid raw or undercooked meats: these foods may contain Listeria, Salmonella, Toxoplasma, and other pathogens that can cause severe, even life-threatening illness in immunocompromised patients. B. Avoid live attenuated vaccines: these vaccines (such as MMR and varicella) contain live but weakened virus and are safe for immunocompetent individuals, but may cause actual infection in immunocompromised patients. C. Avoid visiting crowded places: these locations have high concentrations of pathogens (especially respiratory viruses); exposure greatly increases infection risk for immunocompromised individuals. Why options D and E are wrong: D. Adequate rest helps maintain and strengthen immune function and is an important supportive measure for infection prevention; patients should be encouraged to follow it. E. Good hand hygiene is the most basic and effective measure for preventing infection, significantly reducing contact transmission risk; it is especially crucial for immunocompromised patients. Clinical reasoning (Safety / Infection Control): the focus is 'patient safety' and 'infection prevention.' For immunocompromised patients, preventive measures must be stricter, and all potential infection sources and high-risk exposures must be identified and avoided.
最近修訂：2026-10-05