— 藥理與非經腸給藥 · HARD · MCQ —
護理師為低血鉀病人輸注氯化鉀。給藥前最重要的安全措施為何？
A nurse is administering a dose of IV potassium chloride to a client with hypokalemia. What is the priority safety action before starting the infusion?
- AEnsure the IV site is in a large vein確保靜脈注射部位位於大靜脈
- BVerify that the client has adequate urine output✓ 正解確認病人有足夠的尿量
- CAssess the client's current serum potassium level評估病人目前血清鉀濃度
- DDilute the medication in at least 100 mL of normal saline將藥物稀釋於至少 100 mL 之生理鹽水中
— Explanation · 中文詳解 —
鉀離子主要由腎臟排泄，若病人無尿或少尿，輸注鉀離子極易導致致命性高血鉀。即使血鉀低，若腎功能受損，仍需先確認排尿量以評估安全性。其他選項（稀釋、大靜脈、評估數值）雖為必要流程，但排除無尿風險屬保護生命的首要關鍵。
Potassium is excreted primarily by the kidneys. In a patient with anuria or oliguria, infusing potassium can easily lead to lethal hyperkalemia. Even when serum potassium is low, if renal function is impaired, urine output must be verified to ensure safety. The other options (dilution, large vein, evaluating the value) are necessary steps, but ruling out the risk of anuria is the foremost priority to protect life.
✦ 台美臨床差異
台美對高濃度鉀離子給藥皆有嚴格警示，但美國對於單位內輸液幫浦的依賴度更高，台灣臨床常需醫師親自確認尿量紀錄。