— 藥理與非經腸給藥 · HARD · MCQ —
病人正在進行氯化鉀靜脈輸注，護理師應優先執行哪項措施？
A client is receiving an intravenous infusion of potassium chloride. Which intervention should the nurse prioritize?
- AMonitor the site for phlebitis監測注射部位是否有靜脈炎
- BVerify the dilution concentration確認稀釋濃度
- CObtain a baseline EKG取得基線心電圖 (EKG)
- DAssess the client's urine output✓ 正解評估病人的尿液排出量
— Explanation · 中文詳解 —
鉀離子主要由腎臟排泄。給予靜脈鉀之前，必須確保腎功能正常（尿量足夠），否則會導致高血鉀症，引發致命心律不整。雖然靜脈給藥需注意血管刺激（Phlebitis）與濃度（Dilution），但若腎功能衰竭，給藥後的代謝排除障礙危險性最高。
Potassium is primarily excreted by the kidneys. Before administering intravenous potassium, normal renal function (adequate urine output) must be confirmed; otherwise hyperkalemia may develop and trigger fatal arrhythmias. Although IV administration requires attention to vascular irritation (phlebitis) and dilution, the greatest risk is impaired metabolic clearance in renal failure.
✦ 台美臨床差異
美國護理師常依據病房 protocol 直接核對尿量數據；台灣則多需與醫師確認檢驗值（如 Cr/BUN）。