資深 RN 監督新護理師。新手準備了一劑高濃度的靜脈氯化鉀 (KCl)，並準備直接靜脈推注 (IV push)。監督 RN 最恰當的行動為何？
An experienced registered nurse (RN) is supervising a newly licensed RN. The new RN prepares a heavy dose of concentrated intravenous potassium chloride (KCl) and attaches it directly to the IV port to inject it rapidly via IV push. What is the appropriate action by the supervising RN?
- APlace a cold pack over the IV site to prevent burning.在靜脈注射部位放置冰敷包以防止灼傷。
- BTell the RN to dilute the potassium before pushing.告知護理師在推注前稀釋鉀離子。
- CIntervene instantly because IV push potassium causes lethal cardiac arrest.✓ 正解立即介入，因為靜脈推注鉀離子會導致致命性心臟停搏。
- DPraise the RN for efficiency.讚揚護理師的效率。
本題核心概念為靜脈給藥安全，特別是高風險藥物氯化鉀 (Potassium Chloride, KCl) 的給藥規範。氯化鉀是醫院中常見的「高警訊藥物 (High-alert medication)」，因其潛在的致命性而需極度謹慎。靜脈推注 (IV push) 高濃度的 KCl 會導致心臟傳導系統功能障礙，進而引發心律不整（如心室顫動）甚至心臟驟停。因此，任何情況下都嚴禁將濃縮 KCl 直接靜脈推注。資深護理師必須立即介入，糾正新護理師的危險行為，以保障病患生命安全。臨床上，KCl 必須稀釋後以緩慢靜脈輸注 (IV infusion) 的方式給予，且通常需使用輸液幫浦 (infusion pump) 精確控制速率。
The supervising RN must intervene immediately because intravenous push of concentrated potassium chloride can cause fatal cardiac arrest due to rapid hyperkalemia. Potassium chloride is a high-alert medication that must always be diluted and administered via controlled infusion, never as a direct bolus.
IV Push KCl = 謀殺。