— 藥理與非經腸給藥 · HARD · MCQ —
護理師正為病人進行靜脈注射氯化鉀（KCl）。下列哪項行動優先順序最高？
A nurse is administering a dose of IV potassium chloride to a client. Which action is the highest priority?
- AMonitor the infusion site for phlebitis監測靜脈注射部位是否有靜脈炎
- BCheck the client's urine output before administration✓ 正解給藥前檢查客戶的尿量
- CEnsure the medication is diluted in an IV bag確保藥物已稀釋於靜脈輸液袋中
- DVerify the patient's identity using two identifiers使用兩種識別方式驗證病人身份
— Explanation · 中文詳解 —
給予鉀離子前，確保腎功能正常（尿量至少 0.5 mL/kg/hr）是絕對優先事項，因鉀離子主要透過腎臟代謝，若無尿會引發致命高血鉀。雖然身分核對與稀釋也很重要，但在排除禁忌症方面，腎功能評估是給藥前的臨床核心決定因素。
Before administering potassium, ensuring normal renal function (urine output of at least 0.5 mL/kg/hr) is the absolute priority, because potassium is primarily excreted through the kidneys; in anuric clients, administration can lead to fatal hyperkalemia. Although identity verification and dilution are important, evaluation of renal function is the central clinical determinant before administration when ruling out contraindications.
✦ 台美臨床差異
台灣醫院對高濃度鉀離子給藥常有獨立的給藥單或雙人核對機制，美國同樣嚴格規範。