— 藥理與非經腸給藥 · HARD · MCQ —
病人因嚴重低血鉀被開立靜脈注射氯化鉀。給藥前護理師的首要行動為何？
A client is prescribed intravenous potassium chloride (KCl) for severe hypokalemia. What is the nurse's priority action before initiating the infusion?
- AConfirm that the client has adequate urine output✓ 正解確認病人有足夠的尿液排出量
- BEnsure the concentration is no greater than 10 mEq/100 mL確保濃度不超過 10 mEq/100 mL
- CVerify the presence of a patent peripheral intravenous site確認周邊靜脈通路暢通
- DAssess the client's current blood pressure and heart rate評估病人當前的血壓和心跳
— Explanation · 中文詳解 —
靜脈輸注鉀離子時，腎臟排泄功能至關重要。若尿量不足（<30 mL/hr），鉀離子會快速蓄積導致高血鉀，進而誘發致命性心律不整。因此在補充鉀離子前，必須先確保腎臟有能力調節鉀的平衡，這是臨床給藥的安全防線。
For IV potassium, renal excretion is critical. If urine output is insufficient (<30 mL/hr), potassium rapidly accumulates, causing hyperkalemia and life-threatening arrhythmias. Therefore, before potassium replacement, confirm the kidneys can regulate potassium balance—this is the clinical safety guardrail.
✦ 台美臨床差異
台美臨床皆嚴格要求鉀離子必須經由幫浦給藥且確認腎功能，但美國護理師常需更嚴格執行濃度限制設定。