病人因急性肺水腫被醫囑處方 furosemide 40 mg IV push。給藥前護理師最高優先的行動為何？
A client is prescribed furosemide 40 mg IV push for acute pulmonary edema. Which nursing action is the highest priority before administration?
- AReview the client's daily weight檢視病人的每日體重
- BMonitor the client's urine output監測病人的尿液排出量
- CCheck the client's blood pressure檢查病人的血壓
- DAssess the client's serum potassium level✓ 正解評估病人的血清鉀濃度
Furosemide 是強效排鉀利尿劑。急性肺水腫病人常因體液超載而需緊急利尿，但在給藥前，必須確認病人的電解質狀況（特別是鉀離子）。若病人已有低血鉀（Hypokalemia），Furosemide 會加重此狀況，進而引發嚴重的心律不整，如尖端扭轉型心室頻脈（Torsades de Pointes）。因此，確認血鉀數值為給藥前的優先安全評估。
Furosemide is a potent potassium-wasting diuretic. Clients with acute pulmonary edema often require urgent diuresis because of fluid overload, but the electrolyte status, particularly the potassium level, must be confirmed before administration. If the client already has hypokalemia, furosemide can worsen it and precipitate serious arrhythmias such as torsades de pointes. Therefore, checking the serum potassium level is the priority safety assessment before administration.