— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備對低血鉀病人輸注氯化鉀。護理師最關鍵的執行步驟為何？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. What is the most critical action the nurse must take?
- AEnsure the medication is diluted in a large volume of IV fluid✓ 正解確保藥物已稀釋於大量靜脈輸液袋中
- BAssess the intravenous site for phlebitis評估靜脈穿刺處是否有靜脈炎
- CMonitor the serum potassium level every 2 hours每兩小時監測血清鉀濃度
- DCheck the client's hourly urine output檢查患者的每小時尿量
— Explanation · 中文詳解 —
氯化鉀具有強烈刺激性與心臟毒性，濃度過高或推注速度過快極易造成靜脈炎、組織壞死或心搏停止。因此，輸注前務必稀釋，原則上不超過 10 mEq/hr 的速度給予，並絕對禁止直接靜脈推注（IV Push）。
Potassium chloride is highly irritating and cardiotoxic, and an excessive concentration or too-rapid push can easily cause phlebitis, tissue necrosis, or cardiac arrest. Therefore, it must be diluted before infusion, generally administered at a rate not exceeding 10 mEq/hr, and direct IV push is absolutely contraindicated.
✦ 台美臨床差異
美國護理師常需確認鉀濃度單位換算，台灣臨床常規對於鉀離子給予設有嚴格的滴速與濃度上限警示。