護理師被分配照顧四位病人。下列哪位病人應安置於具有負壓抽風系統的單人病房?
The nurse is assigned to care for four clients. Which client should be placed in a private room with negative pressure airflow?
- AA client with Mycoplasma pneumoniae患有肺炎黴漿菌的病人
- BA client with suspected pulmonary tuberculosis✓ 正解疑似肺結核的病人
- CA client with Legionnaires' disease患有退伍軍人症的病人
- DA client with localized herpes zoster (shingles)患有局部帶狀疱疹的病人
負壓隔離病房(Negative Pressure Room)是空氣預防措施(Airborne Precautions)的核心要求,旨在防止懸浮於空氣中的微小飛沫核(Droplet nuclei)擴散至病房外。核心概念在於區分空氣傳染與飛沫傳染。肺結核(Pulmonary TB)是典型的空氣傳染病,其致病菌體積微小,可長時間懸浮並隨氣流移動,因此必須使用每小時換氣 6-12 次的負壓系統。其餘選項中,退伍軍人症(Legionnaires' disease)不具人傳人特性,不需隔離;肺炎黴漿菌(Mycoplasma)屬於飛沫傳染(Droplet),僅需一般單人房或與同病種共室;局限性帶狀疱疹在免疫正常者僅需標準防護,若為全身性才需空氣預防。臨床安全原則強調「正確分類傳染途徑」,以分配稀有的負壓資源並保護其他病患與員工。
A client with suspected pulmonary tuberculosis requires a private room with negative pressure airflow to prevent the spread of airborne droplet nuclei. Unlike diseases transmitted by large droplets or contact, tuberculosis pathogens remain suspended in the air, necessitating specialized ventilation to protect healthcare workers and other patients.
美國 NCLEX 考試極度強調隔離分類(Airborne/Droplet/Contact),護理師必須能即時判斷。台灣臨床上對負壓房的使用有時受限於病床數,但在法律規定上,法定傳染病如 TB 的負壓隔離規範與美國 CDC 準則高度一致。