— 藥理與非經腸給藥 · HARD · MCQ —
病人獲醫囑給予靜脈注射氯化鉀 20 mEq。護理師首要採取的安全措施為何？
A client is prescribed intravenous potassium chloride 20 mEq. Which action by the nurse is the priority safety measure?
- AEnsure the infusion rate does not exceed 10 mEq/hour✓ 正解確保輸注速率不超過每小時10 mEq
- BDilute the medication in at least 100 mL of normal saline將藥物稀釋於至少100 mL的生理鹽水中
- CAssess the client's current potassium serum level評估病人目前的血清鉀濃度
- DVerify the presence of a patent peripheral IV line確認外周靜脈通路暢通
— Explanation · 中文詳解 —
靜脈給予鉀離子最嚴重的併發症是心律不整。為了預防高血鉀導致心臟驟停，必須嚴格限制給藥速度，通常不得超過 10-20 mEq/h，且禁止推注。雖然稀釋、確認管路與監測血鉀也很重要，但輸注速度控制是防止致命性心律不整的最直接防護。
The most serious complication of intravenous potassium administration is cardiac dysrhythmia. To prevent cardiac arrest from hyperkalemia, the infusion rate must be strictly limited, typically not exceeding 10-20 mEq/hr, and IV push is prohibited. Although dilution, verifying line patency, and monitoring serum potassium are also important, controlling the infusion rate is the most direct safeguard against fatal dysrhythmias.
✦ 台美臨床差異
美台臨床皆嚴禁鉀離子推注，台灣醫院通常須透過自動輸注幫浦（Pump）設定速率以確保符合 10 mEq/h 規範。