護理師準備給予靜脈注射氯化鉀 (KCl)。哪項措施是確保病人安全的必要條件？
A nurse is preparing to administer IV potassium chloride (KCl). Which action is required to ensure client safety?
- ACheck the client's blood pressure every 5 minutes每 5 分鐘測量病人的血壓
- BAdminister the medication via IV push經靜脈推注給藥
- CDilute the medication in 500 mL of normal saline將藥物稀釋於 500 mL 之生理鹽水中
- DEnsure the concentration does not exceed 10 mEq/100 mL for peripheral infusion✓ 正解確保周邊輸注之濃度不超過 10 mEq/100 mL
靜脈輸注鉀離子（KCl）具有極高風險，因鉀離子會直接刺激心肌傳導系統。KCl 絕對禁止直接靜脈推注（IV push），否則會導致致命的心律不整與心跳停止。臨床上，周邊靜脈輸注濃度應限制在 10 mEq/100 mL 以內，以避免化學性靜脈炎（Chemical Phlebitis）與組織壞死。護理重點在於給藥途徑的安全性、輸注速度的控制（通常不超過 10-20 mEq/hr），以及給藥前確認病人的尿量充足，確保腎臟功能足以排除代謝鉀離子。
IV potassium chloride (KCl) infusion carries extremely high risk because potassium directly stimulates the cardiac conduction system. KCl is absolutely prohibited as a direct IV push; otherwise it causes fatal arrhythmias and cardiac arrest. Clinically, peripheral infusion concentration should be limited to no more than 10 mEq/100 mL to prevent chemical phlebitis and tissue necrosis. Nursing focus is on the safety of the route of administration, control of infusion rate (typically no more than 10-20 mEq/hr), and verifying adequate urine output before administration to ensure renal function can excrete and metabolize the potassium.
在美國臨床，KCl 輸注濃度與速度有嚴格的護理規範。若需給予高濃度或快速輸注（如 >10 mEq/hr），通常要求必須建立中央靜脈導管（Central line）並進行持續性心電圖監測，許多醫院政策禁止護理師在未經特殊培訓或儀器監測下進行高濃度鉀離子輸注。