— 安全與感染控制 · MEDIUM · MCQ —
護理師為一位中性球低下（neutropenic）的病人規劃護理計畫，下列哪項措施正確？
A nurse is planning care for a client who is neutropenic. Which intervention should the nurse include?
- APlace fresh flowers in the client's room to boost mood在病人房間放置鮮花以提升情緒
- BEncourage the client to eat fresh fruits and vegetables鼓勵病人食用新鮮水果和蔬菜
- CAllow visitors with minor upper respiratory symptoms允許有輕微上呼吸道症狀的探視者進入
- DEnsure the client performs meticulous hand hygiene✓ 正解確保病人執行嚴謹的手部衛生
— Explanation · 中文詳解 —
中性球低下（Neutropenia）病人因免疫系統防禦能力嚴重下降，極易發生伺機性感染。護理核心在於採取「防護性隔離（Protective Isolation）」或「反向隔離（Reverse Isolation）」。徹底執行手部衛生是預防外源性微生物傳播最有效且基礎的防護措施。生食蔬果、鮮花及接觸有呼吸道症狀者，皆可能帶有黴菌、細菌或病毒，對免疫低下者構成致命威脅。
For neutropenic clients, meticulous hand hygiene is essential to prevent cross-contamination and infection, whereas fresh flowers, raw produce, and symptomatic visitors should be avoided as they harbor pathogens that pose a severe risk to immunocompromised patients.
✦ 台美臨床差異
美國醫院對於中性球低下（尤其是 ANC < 500/mm³）的防護政策非常嚴格，通常包含『低菌飲食（Low-microbial diet）』，即禁食生冷蔬果。台灣臨床雖也強調防護，但對於飲食限制的嚴謹度依各院感染控制規範而異。