護理師準備對低血鉀病人輸注氯化鉀。給藥前最優先的評估為何？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which assessment is the priority before starting the infusion?
- AReviewing the client's most recent serum potassium level檢視病人最近的血清鉀離子濃度
- BVerifying the presence of a cardiac monitor確認是否有心電圖監測器
- CAssessing the peripheral intravenous site for infiltration評估周邊靜脈注射部位是否有滲漏
- DChecking the hourly urine output✓ 正解檢查每小時尿量
氯化鉀（Potassium Chloride, KCl）是高警訊藥物（High-alert medication）。鉀離子主要透過腎臟代謝，給藥前必須確認腎功能穩定。若尿量不足（<30 mL/hr），意味著鉀離子排泄受阻，持續輸注將導致高血鉀，進而引發嚴重心律不整甚至心搏停止。臨床優先順序為評估腎臟排泄功能，確保安全給藥。
Potassium chloride (KCl) is a high-alert medication. Potassium is primarily eliminated through the kidneys, so renal function must be confirmed stable before administration. If urine output is insufficient (<30 mL/hr), potassium excretion is impaired, and continued infusion will result in hyperkalemia, which can produce severe arrhythmias and even cardiac arrest. The clinical priority is therefore to assess renal excretory function in order to ensure safe administration.
美國臨床對於靜脈輸注鉀離子的濃度與速度限制非常嚴格（通常周邊靜脈不得超過 10 mEq/hr），且必須使用輸液幫浦（IV Pump）給藥，台灣臨床亦同，但美方護理師對高警訊藥物的雙人核對與尿量監測要求更為嚴謹。