護理師準備對低血鉀病人靜脈輸注氯化鉀。下列何者為最需確認的安全措施？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. What is the most important safety precaution the nurse should verify?
- AThe medication is diluted properly藥物已適當稀釋
- BThe client has a patent peripheral IV line病人周邊靜脈導管通暢
- CThe infusion pump is set to a rate no faster than 10 mEq/hr輸注幫浦設定速率不超過 10 mEq/hr
- DThe client has adequate urine output✓ 正解病人有足夠的尿液排出量
靜脈輸注鉀離子具高風險，因腎臟為排除鉀離子的主要器官，若病人發生無尿或少尿（<30 mL/hr），輸注將導致高血鉀危象與心律不整。雖然稀釋（A）與流速（C）亦為重要安全準則，但若腎功能衰竭，即使正確輸注仍會造成致命性後果，故評估排尿情形為先決條件。
Intravenous potassium administration carries high risk because the kidneys are the primary organs for potassium excretion. If the client is anuric or oliguric (<30 mL/hr), infusion can lead to hyperkalemic crisis and cardiac dysrhythmias. Although proper dilution (A) and infusion rate (C) are also important safety standards, even a correctly administered infusion can result in fatal outcomes if renal function is impaired. Assessment of urine output is therefore the prerequisite safety check.
美台皆嚴格監控鉀離子輸注，但在台灣臨床常要求使用中心靜脈導管（CV line）給予較高濃度的鉀，美國則根據導管位置與 protocol 決定。