# 急診門診成人個案有 3 週咳嗽、夜間盜汗、體重下降與帶血痰。護理師第一步應做什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393558&lang=zh-tw  
> language: zh-TW  
> subject: Standard/Transmission-Based Precautions/Surgical Asepsis  
> category: SIPC

## 題目

急診門診成人個案有 3 週咳嗽、夜間盜汗、體重下降與帶血痰。護理師第一步應做什麼？

## 選項

1. 以接觸隔離安置於單人房。
2. 進房前請個案脫下口罩以採集痰液。
3. 讓個案戴上外科口罩，並移至空氣感染隔離室。 **✔ 正確答案**
4. 開始飛沫隔離並保持診間門打開。

**正確答案: 3**

## 解析

症狀提示可能有感染性肺結核。優先是源頭控制與空氣隔離：讓個案戴口罩，並在可行時移至空氣感染隔離室。單用接觸或飛沫隔離無法控制空氣中飛沫核。

## 深入解析

臨床判斷
辨識可能的空氣傳播疾病，先保護他人，再安置到正確隔離環境。

記憶重點
TB：源頭戴口罩、空氣隔離、工作人員戴呼吸防護。

## 臨床情境

實務指引
CDC TB 感染控制強調迅速偵測感染性 TB、空氣隔離，以及治療疑似或確診 TB。

注意
肺結核不可把飛沫隔離當成空氣隔離。

## 重要概念

- **結核病** — 由 Mycobacterium tuberculosis 引起的空氣傳播感染，可能有久咳、夜汗、體重減輕與咳血。
- **空氣隔離** — 針對可懸浮於空氣之病原體所採取的隔離與呼吸防護措施。
- **N95 呼吸防護具** — 醫護人員用於降低 TB 飛沫核等空氣粒子暴露的密合式呼吸防護具。

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