— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備對低血鉀病人輸注靜脈注射氯化鉀（KCl）。下列哪項評估為最高優先級？
A nurse is preparing to administer IV potassium chloride (KCl) to a client with hypokalemia. Which assessment is the highest priority?
- AChecking the peripheral IV insertion site for patency檢查周邊靜脈注射插管處的通暢性
- BAssessing the client's current potassium level評估病人目前的血鉀濃度
- CMonitoring the heart rate for bradycardia監測心率是否有心搏過緩
- DVerifying the hourly urine output✓ 正解確認每小時尿量
— Explanation · 中文詳解 —
KCl 具有強烈腎臟排泄依賴性，若病人尿量不足（<30 mL/hr），輸注 KCl 極易導致高血鉀致命性心律不整。雖然 A 也很重要（避免滲漏導致組織壞死），但相較於全身性心臟毒性，確保腎臟排泄功能是給藥前的臨床安全基準。
KCl is highly dependent on renal excretion. If urine output is inadequate (<30 mL/hr), infusing KCl can quickly cause life-threatening hyperkalemia and dysrhythmias. While IV site patency (A) is also important to prevent tissue necrosis, ensuring renal function is the foundational systemic safety check before administration.
✦ 台美臨床差異
台美臨床皆嚴格要求 KCl 不可推注（push），需稀釋並透過幫浦給予，且尿量評估為給藥 SOP 核心。