— 降低風險 · MEDIUM · MCQ —
護理師照護一位疑似感染傷口的病人。下列哪項為優先行動？
A nurse is caring for a client with a suspected infectious wound. Which action is priority?
- AObtain a wound culture✓ 正解取得傷口培養
- BChange the dressing更換敷料
- CClean the wound with sterile saline以無菌生理食鹽水清潔傷口
- DApply an antibiotic ointment塗抹抗生素藥膏
— Explanation · 中文詳解 —
當傷口出現紅、腫、熱、痛或膿性分泌物等感染徵象時，護理師的優先行動是採集檢體進行傷口培養（Wound culture）。這是為了在未經抗生素干擾前，取得最真實的病原菌資訊，以利醫師選擇合適的抗生素治療。在取得培養前，若先進行清潔或塗抹藥膏，會導致採樣結果失真（False negative），影響治療方向。
The priority action is to obtain a wound culture before cleaning the wound or applying antibiotics to ensure accurate identification of the causative organism. Performing these interventions first could contaminate the sample or reduce bacterial yield, leading to ineffective antibiotic selection.