護理師準備給予靜脈輸注氯化鉀（KCl），哪項安全措施是優先事項？
A nurse is preparing to administer potassium chloride (KCl) IV infusion. Which of the following safety actions is the priority?
- ACheck for urinary output of at least 30 mL/hr✓ 正解確認尿量至少每小時 30 mL
- BMonitor for cardiac rhythm changes every hour每小時監測心律變化
- CVerify the presence of a central venous catheter確認存在中心靜脈導管
- DEnsure the concentration does not exceed 10 mEq/100 mL確保濃度不超過 10 mEq/100 mL
鉀離子主要經由腎臟排泄，若病人無尿或少尿（<30 mL/hr），給予靜脈輸注 KCl 可能導致高血鉀危象，引發致命性心律不整。因此在給藥前確認腎功能與尿量是預防危險的關鍵首要步驟。其他選項如濃度限制或監測心律雖重要，但需建立在腎功能正常且排尿有產出的前提下。
Potassium is excreted primarily by the kidneys. If the client is anuric or oliguric (<30 mL/hr), IV infusion of KCl may cause a hyperkalemic crisis with potentially lethal arrhythmias. Therefore, confirming renal function and urine output prior to administration is the critical first step in preventing harm. Other measures, such as concentration limits or cardiac rhythm monitoring, are also important but are predicated on normal renal function and adequate urine output.
兩地均嚴禁 KCl 直接靜脈推注（IV Push），皆須經由輸液幫浦給予並確認尿量。