病人因急性肺水腫被醫囑處方 furosemide 40 mg IV push。護理師在給藥前應優先採取哪項措施？
A client is prescribed furosemide 40 mg IV push for acute pulmonary edema. Which action should the nurse take before administration?
- AAssess the client's potassium level✓ 正解評估病人的鉀離子濃度
- BEnsure the client has a patent peripheral IV line確保病人有暢通的周邊靜脈導管
- CMonitor the client's blood glucose監測病人的血糖
- DCheck for a history of penicillin allergy檢查是否有盤尼西林過敏史
Furosemide 為強力 loop diuretic，會大量排出鉀離子，造成低血鉀引發致命心律不整風險，因此 NCLEX 主流教材將「給藥前評估血鉀」（A）列為首要安全評估動作。臨床上「確認 IV 通暢」（B）也是給藥的物理前提，兩者實務上應同時執行；本題在 NCLEX 標準作答中以「藥物相關安全評估」（K+）為最具特異性的優先順序。其他選項：盤尼西林過敏與 furosemide 無交互關聯；血糖監測非利尿劑首要關注事項。
Furosemide is a potent loop diuretic that causes significant potassium excretion, with hypokalemia potentially triggering life-threatening arrhythmias. NCLEX-aligned mainstream texts therefore list 'assessing serum potassium prior to administration' (A) as the priority safety assessment. Clinically, 'verifying IV patency' (B) is also a physical prerequisite for administration, and the two are performed concurrently; however, in NCLEX-standard answers, the drug-specific safety assessment (K+) is the most specific priority. Other options: penicillin allergy has no interaction with furosemide; blood glucose monitoring is not a primary concern for diuretics.
美台皆須執行給藥三讀五對，但美國對於利尿劑給藥前的電解質篩檢流程更為嚴格，常由護理師主動於電子病歷確認。