— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備對低血鉀病人執行靜脈輸注氯化鉀。給藥前最需確認哪項評估結果？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which assessment finding is most important to confirm before initiating the infusion?
- APresence of a visible P-wave on ECG心電圖上可見 P 波
- BClient reports no nausea or vomiting病人主訴無噁心或嘔吐
- CUrine output of at least 30 mL/hr✓ 正解每小時尿量至少 30 mL
- DSerum magnesium level within normal limits血清鎂濃度在正常範圍內
— Explanation · 中文詳解 —
靜脈輸注鉀離子（Potassium chloride, KCl）具有極高的風險。鉀離子主要經由腎臟排泄，若病人存在腎功能衰竭或尿量過少，鉀離子會在體內快速蓄積，導致致命的高血鉀症（Hyperkalemia），進而引發心律不整（如心室顫動）。因此，給藥前確認腎功能良好（尿量 >30 mL/hr）是絕對的 safety priority。
IV potassium chloride (KCl) carries high risk. Potassium is primarily excreted by the kidneys; in renal failure or oliguria, potassium accumulates rapidly causing life-threatening hyperkalemia and arrhythmias (e.g., ventricular fibrillation). Therefore confirming adequate renal function (urine output >30 mL/hr) is an absolute safety priority before administration.