# 鐮狀細胞貧血的個案正在服用羥基脲。今天其絕對嗜中性白血球計數為 1,800/mm3。護理師應採取何種措施？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513821&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

鐮狀細胞貧血的個案正在服用羥基脲。今天其絕對嗜中性白血球計數為 1,800/mm3。護理師應採取何種措施？

## 選項

1. 暫停羥基脲並通知處方醫師進行血球計數和劑量管理。 **✔ 正確答案**
2. 給予羥基脲，因為嗜中性白血球低下是預期的治療終點。
3. 將劑量與鐵劑補充劑一起給予，以提高嗜中性白血球計數。
4. 如果今天暫停用藥，則將下次劑量加倍。

**正確答案: 1**

## 解析

Droxia 藥品標籤將嗜中性白血球計數低於 2,000/mm3 定義為毒性範圍的血球計數，並指示應暫停用藥直至恢復，然後視情況減少劑量。

## 深入解析

快速解答
暫停羥基脲並通知處方醫師，因為嗜中性白血球計數已達標示的毒性範圍。

為什麼這是正確的
羥基脲可能導致嚴重的骨髓抑制。Droxia 劑量表將嗜中性白血球計數低於 2,000/mm3 視為具有毒性，並建議暫停用藥並頻繁重新評估，直到恢復。

簡單類比或心像
血球計數是下次劑量的安全門。當嗜中性白血球的門檻低於標示的閾值時，藥物應暫停。

記憶點
羥基脲加上絕對嗜中性白血球計數低於 2,000/mm3：暫停並重新評估。

NCLEX 決策規則
給藥前應審查目前的完整血球計數。當達到標示的暫停閾值時，應防止進一步暴露並通知授權的處方醫師進行追蹤和劑量管理。

為什麼其他選項是錯誤的
嗜中性白血球低下並非一個可以忽略的目標。鐵劑無法急性糾正藥物相關的嗜中性白血球低下，而將後續劑量加倍會增加毒性。參考資料
1DailyMed: Droxia血球計數閾值和暫時中斷

## 臨床情境

骨髓抑制檢查
追蹤嗜中性白血球、血小板、血紅素、網狀紅血球、感染症狀、上次劑量以及目前的羥基脲治療計畫。

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