護理師檢閱一位接受化學治療病人的實驗室報告。下列哪項發現需立即回報醫師？
A nurse is reviewing the laboratory results for a client receiving chemotherapy. Which finding should the nurse report to the provider immediately?
- AWhite blood cell count 4,500/mm³白血球計數 4,500/mm³
- BPlatelet count 95,000/mm³血小板計數 95,000/mm³
- CAbsolute Neutrophil Count (ANC) 450/mm³✓ 正解絕對嗜中性白血球計數 (ANC) 450/mm³
- DHemoglobin 11.2 g/dL血紅素 11.2 g/dL
化療病人若 ANC 低於 500/mm³，屬於嚴重的嗜中性白血球減少症，病人正處於極高風險的伺機性感染狀態，任何輕微感染都可能迅速惡化為敗血症，因此必須立即採取保護隔離措施並通知醫師安排抗生素治療。其他選項雖異常但尚未達到立即危及生命的緊急臨界值。
An absolute neutrophil count (ANC) below 500/mm³ indicates severe neutropenia, placing the client at extremely high risk for life-threatening opportunistic infections and sepsis. This finding requires immediate reporting to the provider for protective isolation measures and potential antibiotic therapy. While other values may be abnormal, they do not pose the same immediate threat to the client's survival.
美方對於 Neutropenic precautions 的執行相當嚴格且多由護理師主動發起，台灣臨床常需醫師口頭醫囑後才正式啟動保護隔離措施。