— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備為低血鉀病人靜脈輸注氯化鉀，給藥前最優先的評估項目為何？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which assessment is the highest priority before administration?
- ACheck of peripheral pulses檢查周邊脈搏
- BEvaluation of blood pressure評估血壓
- CAssessment of urine output✓ 正解評估尿量
- DInspection of the IV site檢查靜脈穿刺部位
— Explanation · 中文詳解 —
靜脈輸注氯化鉀（KCl）具有高度風險，因為鉀離子是細胞內主要陽離子，過高或過低皆會影響心肌電生理。給藥前最重要的評估是尿量，因為鉀離子主要透過腎臟代謝。若病人尿量不足（<30 mL/hr），代表腎功能排泄能力受損，此時給予鉀離子極易導致高血鉀（Hyperkalemia），進而引發致命性心律不整（如室顫）。
IV potassium chloride is high-risk because potassium is the primary intracellular cation and abnormal levels affect cardiac electrophysiology. Before administration, the priority assessment is urine output, since potassium is excreted primarily by the kidneys. Inadequate output (<30 mL/hr) indicates impaired excretion and can rapidly cause hyperkalemia and fatal dysrhythmias (e.g., ventricular fibrillation).