— 藥理與非經腸給藥 · HARD · MCQ —
病人獲醫囑給予靜脈注射氯化鉀 20 mEq。護理師優先採取哪項行動？
A client is prescribed intravenous potassium chloride 20 mEq. Which action by the nurse is the priority?
- ACheck the client's serum creatinine level檢查病人的血清肌酸酐值
- BAdminister the dose as an IV push over 2 minutes在2分鐘內以靜脈推注方式給藥
- CAssess the peripheral IV site for patency and redness評估周邊靜脈穿刺部位的暢通性與紅腫
- DVerify the medication is diluted in at least 100 mL of fluid✓ 正解確認藥物已稀釋於至少100 mL的液體中
— Explanation · 中文詳解 —
靜脈輸注氯化鉀具高風險，濃度過高或輸注過快會造成血管痛及致命性心律不整。藥物必須稀釋後才可給予，且最大輸注速度通常為 10 mEq/hr。選項 B 的推注方式會導致心跳停止，是致命性的錯誤；選項 A 與 C 雖為必要評估，但確保輸注濃度安全才是給藥安全的第一防線。
Intravenous potassium chloride is high-risk; excessive concentration or rate of infusion causes vascular pain and lethal cardiac dysrhythmias. The drug must be diluted before administration, with a maximum infusion rate typically of 10 mEq/hr. Option B (IV push) would cause cardiac arrest and is a lethal error; options A and C are necessary assessments, but verifying safe infusion concentration is the first line of defense in medication safety.
✦ 台美臨床差異
台美臨床均嚴禁鉀離子推注，但台灣醫院對於高濃度鉀離子給藥常設有雙人核對與幫浦設定限制，美國則更依賴護理師的給藥判斷。