— 降低風險 · MEDIUM · MCQ —
護理師準備為病人靜脈輸注氯化鉀，下列哪項措施能確保病人安全？
A nurse is preparing to administer potassium chloride IV piggyback to a client. Which nursing action ensures client safety?
- AAssess urine output before administration✓ 正解給藥前評估尿液排出量
- BPerform an EKG prior to every dose每次給藥前進行心電圖檢查
- CEnsure the concentration does not exceed 10 mEq/100 mL確保濃度不超過 10 mEq/100 mL
- DAdminister the medication via IV push經靜脈推注給藥
— Explanation · 中文詳解 —
鉀離子由腎臟排出，給藥前必須確認尿量至少有 30 mL/h，否則會導致高血鉀。氯化鉀嚴禁直接靜脈推注（IV push），因為會造成心跳驟停。周邊靜脈濃度通常不建議超過 10 mEq/100 mL，但並非所有情況下的首要檢查目標。
Potassium is excreted by the kidneys, and the nurse must confirm that urine output is at least 30 mL/hr before administration; otherwise, hyperkalemia may result. Potassium chloride must never be administered by direct IV push, as this can cause cardiac arrest. Peripheral IV concentrations are generally not recommended to exceed 10 mEq/100 mL, but this is not the primary priority check in every situation.
✦ 台美臨床差異
兩地皆嚴格禁止 IV push 氯化鉀。美國常由藥局預先調配好安全濃度，台灣護理師需確認醫囑濃度是否超過周邊管路承載上限。