護理師準備為低血鉀病人靜脈注射氯化鉀（KCl）。為確保給藥安全，護理師應採取哪些措施？（選所有適合的）
The nurse is preparing to administer intravenous potassium chloride (KCl) to a client with hypokalemia. Which actions should the nurse take to ensure safe administration? (Select all that apply.)
- AAdminister the KCl via IV push over 1-2 minutes.於 1-2 分鐘內經靜脈推注給藥 KCl。
- BConfirm the client's urine output is at least 30 mL/hr.✓ 正解確認病人尿量至少為 30 mL/hr。
- CEnsure the concentration does not exceed 10 mEq/100 mL for peripheral lines.✓ 正解確保周邊靜脈給藥濃度不超過 10 mEq/100 mL。
- DUse an infusion pump to deliver the medication.✓ 正解使用輸液幫浦給藥。
- EInvert the IV bag several times to mix the KCl before hanging.✓ 正解掛上 IV 袋前，將 KCl 混合均勻，反覆倒置 IV 袋數次。
靜脈注射 KCl 是臨床高風險行為，必須嚴格遵守安全指引。首先，絕對不可 IV Push（A），這會導致心跳驟停。安全要求包括：1. 確認腎功能（B），鉀經腎臟排出，若無尿或少尿會導致高血鉀。2. 稀釋濃度（C），周邊靜脈建議不超過 10 mEq/100mL 以減少靜脈炎。3. 嚴格控制速度（D），必須使用輸液幫浦，通常不超過 10 mEq/hr。4. 確保混合均勻（E），KCl 密度較大，若不翻轉藥袋，藥物會沈澱在底部導致注入濃度不均。這些步驟都是為了降低「人為給藥錯誤」導致的致命性心律不整風險。
Intravenous KCl is a clinically high-risk practice and must strictly adhere to safety guidelines. First, IV push is absolutely prohibited (A), as it can cause cardiac arrest. Safety requirements include: 1. Verify renal function (B); since potassium is excreted by the kidneys, anuria or oliguria can lead to hyperkalemia. 2. Dilute the concentration (C); for peripheral IV administration, concentrations should not exceed 10 mEq/100 mL to reduce phlebitis. 3. Strictly control the rate (D); an infusion pump must be used, and the rate should generally not exceed 10 mEq/hr. 4. Ensure thorough mixing (E); KCl is denser than IV fluid, and if the bag is not inverted, the medication will settle at the bottom, resulting in uneven concentrations during infusion. All of these steps are designed to reduce the risk of fatal arrhythmias caused by human medication-administration errors.
美國醫院將 KCl 列為「High-alert Medication」，通常由藥劑部預先配製好藥袋，護理師不得自行加藥入袋。台灣部分醫院仍由護理師在病房自行抽藥加入點滴袋，因此「翻轉混勻（Invert）」這個步驟在台灣護理實務中更顯重要，是預防意外高濃度補鉀的關鍵。