— 降低風險 · HARD · MCQ —
護理師檢視一位接受化學治療病人的檢驗報告。下列哪項發現需要立即通知醫師?
A nurse is reviewing the laboratory results of a client receiving chemotherapy. Which finding requires immediate notification of the provider?
- AAbsolute Neutrophil Count (ANC) 450/mm3✓ 正解絕對中性白血球計數 (ANC) 450/mm3
- BWhite Blood Cell count 4,000/mm3白血球計數 4,000/mm3
- CHemoglobin 10.5 g/dL血色素 10.5 g/dL
- DPlatelets 80,000/mm3血小板計數 80,000/mm3
— Explanation · 中文詳解 —
化療引起的骨髓抑制中,中性球低下症(Neutropenia)最易導致致命性的伺機性感染。ANC 低於 500/mm3 屬於嚴重中性球低下,病人處於敗血症的高風險中,必須立即採取保護性隔離措施並通知醫師評估是否給予升白血球藥物。
Severe neutropenia, indicated by an Absolute Neutrophil Count (ANC) below 500/mm³, places the client at high risk for life-threatening sepsis. This condition is a common and dangerous side effect of chemotherapy-induced bone marrow suppression. Immediate notification of the provider is required to initiate protective isolation and assess the need for interventions like granulocyte colony-stimulating factors.
✦ 台美臨床差異
美國護理師在腫瘤病房對中性球低下採取主動預防協議,台灣醫師對於預防性升白血球藥物使用較為保守。