— 藥理與非經腸給藥 · HARD · MCQ —
病人被開立靜脈注射氯化鉀 20 mEq。給藥前最重要的評估是什麼？
A client is prescribed intravenous potassium chloride 20 mEq. Which assessment is the highest priority before administration?
- APeripheral IV site integrity周邊靜脈注射部位完整性
- BUrine output✓ 正解尿液排出量
- CSerum glucose level血清葡萄糖濃度
- DBlood pressure and heart rate血壓和心率
— Explanation · 中文詳解 —
靜脈給予鉀離子前，必須確保腎功能正常，因鉀離子主要透過腎臟代謝。若無尿或尿量不足，給予鉀離子極易導致致命性高血鉀。雖然 IV 滲漏（A）很重要，但與電解質致死性心律不整風險相比，確認代謝排泄路徑優先。
Before administering IV potassium chloride, the nurse must verify adequate renal function because potassium is excreted primarily by the kidneys. Anuria or inadequate urine output can cause fatal hyperkalemia. Although IV site integrity (A) is important, confirming the metabolic clearance pathway is the higher priority to prevent lethal arrhythmia.
✦ 台美臨床差異
美台臨床均強調給鉀前確認尿量，惟美國護理師常依據 Protocol 獨立判斷是否停藥，台灣則多需聯繫醫師確認。