# 確診Clostridioides difficile(C. diff)感染病人入院 — 大量水樣腹瀉、腹痛、糞便毒素檢測陽性。護理師應執行哪些感染預防措施？請選擇所有適用項目。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374937&lang=zh-tw  
> language: zh-TW  
> subject: Safety and Infection Prevention and Control  
> category: SIPC

## 題目

確診Clostridioides difficile(C. diff)感染病人入院 — 大量水樣腹瀉、腹痛、糞便毒素檢測陽性。護理師應執行哪些感染預防措施？請選擇所有適用項目。

1

病程期間及腹瀉消除後48小時，將病人安置於單人房(或與其他C. diff病人集中)接觸隔離。

2

環境清潔使用殺芽胞劑(如含漂白水之產品)及病人專用器材。

3

病人接觸前後使用含酒精乾洗手液，因其更快且對C. diff效果相同。

4

於每次病人接觸前後及脫除PPE後使用肥皂與水(非含酒精乾洗手液) — 酒精無法殺C. diff芽胞。

5

每次入室著隔離衣與手套；離開前脫除PPE。

## 解析

C. difficile隔離：單人房接觸隔離(或集中)、肥皂與水手部衛生(酒精無法殺芽胞)、殺芽胞劑(漂白水)清潔、入室時隔離衣與手套。選項5錯誤 — 含酒精乾洗手液對C. diff芽胞無效；需肥皂與水。腹瀉消除後48小時持續隔離。

## 深入解析

C. diff為最常考之NCLEX手部衛生例外：酒精無法殺C. diff芽胞。肥皂與水以摩擦機械性去除芽胞。諾羅病毒亦須肥皂與水。其他形成芽胞之菌(B. anthracis)與肉眼可見髒污之手亦為例外。記憶：C. diff/諾羅/髒手用肥皂；其他用酒精皆可。

## 臨床情境

**確診C. difficile感染之成人** — 大量水樣腹瀉、腹痛、發燒、糞便毒素檢測陽性、WBC 18,000。單位遵循CDC C. diff隔離流程。

## 重要概念

- **Clostridioides difficile(C. diff)** — 產毒素之形成芽胞菌引起抗生素相關性腸炎；芽胞耐酒精；經糞口途徑傳播。
- **C. diff之肥皂與水** — 以摩擦機械性去除芽胞；含酒精乾洗手液無法殺芽胞；C. diff與諾羅病毒必須使用。
- **殺芽胞劑清潔** — 含漂白水(1:10稀釋)之清潔劑為必須；四級銨與標準消毒劑無法殺芽胞。

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