# 一位個案在9天前接受細胞毒性化學治療，口腔溫度為38.5°C，絕對嗜中性球計數為360/mm³。完成緊急處置計畫。 > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=395558&lang=zh-tw > language: zh-TW > subject: Medical Emergencies > category: PA ## 題目 一位個案在9天前接受細胞毒性化學治療，口腔溫度為38.5°C，絕對嗜中性球計數為360/mm³。完成緊急處置計畫。 這些發現顯示::선택::發燒性嗜中性球減少症預期的化學治療疲憊過敏性鼻炎無併發症的脫水。護理師應::선택::等待最終培養鑑定結果後才行動立即執行醫囑培養，不延遲抗菌治療在收集檢體前給予活性病毒疫苗讓個案出院接受常規飲食衛教，然後::선택::延遲治療直到出現化膿性引流液對每位個案僅以抗真菌藥作為立即治療於檢傷後1小時內給予醫囑的經驗性廣效抗假單胞菌抗生素於下次排定的門診回診時重新測量體溫。 ## 解析 發燒合併嚴重嗜中性球減少即為發燒性嗜中性球減少症，即使尚未出現低血壓也可能快速惡化。應立即執行醫囑的培養，包括適當的導管及周邊檢體，但不應延遲經驗性治療。於檢傷後1小時內給予醫囑的廣效抗假單胞菌抗生素，並持續密切監測敗血症及血流動力學惡化。 ## 深入解析 正確答案 識別發燒性嗜中性球減少症，執行醫囑培養但不延遲治療，並於1小時內給予醫囑的經驗性抗假單胞菌抗生素。 為何符合 嚴重嗜中性球減少可能掩蓋局部感染徵象。血壓穩定並不代表此發燒屬於低風險。 臨床圖像 培養有助於識別致病菌，但抗菌治療的計時從檢傷開始，因為病情可能快速惡化。 記憶連結 立即培養，但絕不因培養而延遲首劑抗生素。 NCLEX 規則 將發燒合併嚴重嗜中性球減少視為腫瘤急症處理，即使初始生命徵象穩定仍須監測敗血症。 其他選項為何錯誤 等待最終培養結果或可見化膿會延遲治療。抗真菌藥單一治療、常規追蹤或活性疫苗無法解決立即的細菌感染風險。 參考資料 1ASCO/IDSA 發燒與嗜中性球減少指引 22026 NCLEX-RN 測驗計畫 ## 臨床情境 個案在腫瘤科檢傷分類，血壓穩定且置有中心靜脈導管。醫囑的培養及經驗性抗菌治療可立即開始。 ## 重要概念 - **Neutropenic Fever** — 嗜中性白血球低的個案發燒，需要緊急感染評估。 - **Absolute Neutrophil Count** — 衡量嗜中性白血球對抗細菌感染的防禦能力。 - **Broad-Spectrum Antibiotic** — 在培養結果出來之前，選擇用於覆蓋可能病原體的抗菌劑。 ## 相同主題題目 - [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=zh-tw) - [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=zh-tw) - [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=zh-tw) - [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=zh-tw) - [A 68-year-old client is admitted to the emergency department with suspected sepsis from a …](https://mymerci.kr/pages/nclex_q.php?qn_id=363987&lang=zh-tw) - [A nurse is caring for an adult client in the emergency department who is suspected to have…](https://mymerci.kr/pages/nclex_q.php?qn_id=363993&lang=zh-tw) - [A nurse is teaching a 72-year-old client with chronic heart failure (reduced ejection frac…](https://mymerci.kr/pages/nclex_q.php?qn_id=366202&lang=zh-tw) - [A nurse is caring for an adult client admitted with diabetic ketoacidosis. Laboratory resu…](https://mymerci.kr/pages/nclex_q.php?qn_id=366294&lang=zh-tw) ## 以其他語言閱讀 - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=395558&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=395558&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=395558&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=395558&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=395558&lang=vi) --- More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw) _僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_