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安全與感染控制 · HARD · SATA

護理師照顧一位活動性肺結核(TB)病人。當病人必須被傳送到放射科執行檢查時,需要哪些措施?(選所有適合的)

The nurse is caring for a client with active Tuberculosis (TB). Which actions are required when the client must be transported to the radiology department? (Select all that apply.)

  • AThe client wears a surgical mask✓ 正解
    病人佩戴外科口罩
  • BThe nurse wears an N95 respirator during transport
    護理師在傳送過程中佩戴 N95 呼吸器
  • CThe radiology staff are notified in advance✓ 正解
    事先通知放射科人員
  • DThe client wears an N95 respirator
    病人佩戴 N95 呼吸器
  • EThe client's route is cleared of other people
    清空病人的路線以排除其他人
Explanation · 中文詳解

肺結核(TB)的病人外送(Transport)是感染管制的高風險環節。核心概念在於:隔離源頭。病人配戴外科口罩(A)已足以過濾大部分排出的飛沫核,減少環境污染。不需要讓病人戴 N95(D),因為 N95 是為了過濾吸入的微粒,且病人呼吸功能可能已受損,N95 會增加呼吸做功與不適。放射科人員必須提前知會(C),以便他們準備獨立診間並在檢查後進行適當的空氣靜置。至於護理師,如果在密閉且無負壓的傳送車內,通常需戴 N95,但 NCLEX 的標準答案中,若病人已戴外科口罩,護理師在開放空間的傳送過程中不一定被強制要求戴 N95(視細節而定,但 A 與 C 是絕對正確)。清空路徑(E)在現代感控中並不實際,只要病人有適當遮蔽即可。

When transporting a client with active tuberculosis, the primary goal is to contain respiratory secretions at the source by having the client wear a surgical mask. The radiology department must be notified in advance to prepare an airborne infection isolation room and minimize exposure to others. Clients should not wear N95 respirators as they may impede breathing, and clearing the entire route is not a standard requirement if the client is masked.

✦ 台美臨床差異

美國 CDC 準則明確指出「病人戴外科口罩即可外送」。台灣臨床實務上,有時會要求病人戴上更高級的口罩,或在傳送車上罩上塑膠罩,但 NCLEX 考試時應以 CDC 的外科口罩(Surgical mask)為準。

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