病人正接受靜脈輸注 20 mEq 氯化鉀於 100 mL 生理食鹽水中，預計一小時輸完。下列哪項評估結果要求護理師立即停止輸注？
A client is receiving an IV infusion of Potassium Chloride 20 mEq in 100 mL of 0.9% Normal Saline over 1 hour. Which assessment finding requires the nurse to immediately stop the infusion?
- ASerum potassium level of 4.2 mEq/L血清鉀濃度為 4.2 mEq/L
- BECG shows peaked T-waves and widened QRS complex✓ 正解心電圖顯示 T 波尖峰及 QRS 波群變寬
- CPatient reports mild burning sensation at the IV site病人報告靜脈注射部位有輕微灼熱感
- DPatient reports nausea and abdominal cramping病人報告噁心和腹部痙攣
高鉀血症會嚴重影響心肌電生理，導致心律不整及致命心臟停搏。心電圖出現尖形 T 波與 QRS 波寬大，代表鉀離子毒性已達影響心肌的危險程度，必須立即停止鉀離子輸入並聯繫醫療小組。C 選項雖有刺激性，但可調整流速或換血管；B 為正常範圍；C 為常見副作用，暫停檢查即可，嚴重程度不及心臟毒性。
Hyperkalemia profoundly disturbs myocardial electrophysiology and can produce arrhythmias and fatal cardiac arrest. The appearance of peaked T-waves and a widened QRS complex on ECG indicates that potassium toxicity has reached a level that affects the myocardium; the infusion must be stopped immediately and the medical team notified. Option C is irritating but can be managed by adjusting the infusion rate or changing the IV site; A is within the normal range; and D is a common side effect that can be addressed by pausing and observation — its severity is far below that of cardiac toxicity.
美台臨床對於高濃度鉀離子輸注的監測一致，皆強調心電圖變化與血管保護的重要性。