# 一位服用clozapine的病人體溫為 38.7 C，喉嚨痛，絕對嗜中性白血球計數為 420/mcL。護理師應採取哪項措施？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522097&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位服用clozapine的病人體溫為 38.7 C，喉嚨痛，絕對嗜中性白血球計數為 420/mcL。護理師應採取哪項措施？

## 選項

1. 給予預定的clozapine，並在年度檢查時重複檢測絕對嗜中性白血球計數。
2. 在考慮感染預防措施之前，鼓勵訪客幫助改善情緒。
3. 給予額外的clozapine劑量，因為發燒會加重精神病。
4. 中斷clozapine並取得緊急感染和嚴重嗜中性白血球低下症的處置醫囑。 **✔ 正確答案**

**正確答案: 4**

## 解析

發燒且絕對嗜中性白血球計數低於 500/mcL 代表嚴重嗜中性白血球低下症，且有嚴重感染的高風險，需要中斷藥物並緊急處置。

## 深入解析

快速解答
在嚴重clozapine嗜中性白血球低下症期間預防致命感染。

為什麼這是正確的
藥品標示指示，對於發燒應中斷藥物並立即評估絕對嗜中性白血球計數；嚴重嗜中性白血球低下症需要專門的監測和處置。

簡單類比或心像
將藥物安全視為呼吸道檢傷分類：識別威脅、中斷暴露、支持生理功能，並確認持久的反應。

記憶點
線索、風險、行動、反應、復發檢查。

NCLEX決策規則
選擇能預防最即時藥物相關危害的措施，同時保留重新評估和升級的空間。

為什麼其他選項是錯誤的
將惡化正常化、增加相互作用藥物或延遲救援的選項，會使安全循環中斷。References
1DailyMed: ClozapineSevere neutropenia, fever interruption, ANC assessment, and infection risk

## 臨床情境

藥物安全審查
核實適應症、當前評估、呼吸和神經系統狀態、藥物相互作用、授權的救援措施以及可測量的後續追蹤。

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