— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備為低血鉀病人靜脈輸注氯化鉀。下列哪項護理措施是必要的？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which nursing action is essential?
- AFlush the line with dextrose 5% in water before administration給藥前以5%葡萄糖液沖洗導管
- BEnsure the concentration does not exceed 10 mEq/100 mL for peripheral lines✓ 正解確保周邊靜脈輸注濃度不超過10 mEq/100 mL
- CAdminister the medication via IV push經靜脈推注給藥
- DMonitor for respiratory depression監測呼吸抑制情形
— Explanation · 中文詳解 —
氯化鉀具有極強刺激性，嚴禁靜脈直接推注（IV Push），否則會導致心跳驟停。周邊靜脈給藥建議濃度不得超過 10 mEq/100 mL，若需高濃度則應建立中央靜脈導管。A選項 dextrose 可能刺激胰島素分泌導致鉀離子進一步下降，故不宜。
Potassium chloride is highly irritating, and direct IV push is strictly prohibited because it can cause cardiac arrest. For peripheral administration, the recommended concentration must not exceed 10 mEq per 100 mL; higher concentrations require a central venous catheter. Option A is inappropriate, because dextrose stimulates insulin secretion and can drive potassium into cells, further lowering the serum level.
✦ 台美臨床差異
台美兩地對氯化鉀給藥皆要求嚴格的過濾與稀釋規範，特別是禁止靜脈推注的標示與雙人核對流程一致。