護理師準備給予一位病人靜脈注射 20 mEq 的氯化鉀。下列哪項措施對安全給藥至關重要？
A nurse is preparing to administer potassium chloride 20 mEq IV piggyback to a client. Which of the following actions is essential for safe administration?
- ARefrigerate the medication before administration給藥前冷藏藥物
- BDilute the medication in at least 100 mL of fluid✓ 正解將藥物稀釋於至少 100 mL 的液體中
- CVerify that the IV site is patent and has blood return確認靜脈通路暢通且有血液回流
- DAdminister the dose as a rapid IV push作為快速靜脈推注給藥
氯化鉀（KCl）是高警訊藥物（High-alert medication）。其靜脈輸注必須經過稀釋，因為高濃度的鉀離子會直接刺激血管壁導致靜脈炎，若滲漏至周邊組織更會引起嚴重的組織壞死。此外，快速推注會導致血鉀過高，引起致命性心律不整。臨床安全給藥原則是確保藥物被充分稀釋，並透過輸液泵浦（IV pump）控制速度。
Potassium chloride (KCl) is a high-alert medication. Intravenous administration must be diluted, because highly concentrated potassium directly irritates the vessel wall, causing phlebitis, and extravasation into peripheral tissue causes severe tissue necrosis. In addition, rapid IV push leads to acute hyperkalemia and lethal arrhythmias. The clinical safety principle is to ensure adequate dilution and to control the infusion rate using an IV pump.
美國醫院通常嚴格規定 KCl 必須由輸液泵浦輸注，且不得作為 IV push 給藥。許多機構甚至規定 KCl 必須以預混好的輸液袋（Premixed bag）給予，以減少護理師自行稀釋時發生錯誤的風險。