護理師準備對低血鉀病人靜脈注射氯化鉀（KCl），下列哪項是必須優先執行的護理行為？
A nurse is preparing to administer potassium chloride (KCl) IV infusion to a client with hypokalemia. Which priority action must the nurse perform?
- AAdminister the dose as an IV bolus push作為靜脈推注劑量給予
- BObtain a baseline ECG reading取得基線心電圖讀數
- CEnsure the concentration does not exceed 40 mEq/L in peripheral lines確保周邊靜脈輸注濃度不超過 40 mEq/L
- DVerify the client's current urine output is at least 30 mL/hr✓ 正解確認病人目前尿量至少為 30 mL/hr
KCl 給藥前最重要的安全檢查是確認腎功能良好，即尿量每小時至少 30 mL。若腎臟無排泄功能，快速輸注 KCl 會導致致命性高血鉀。雖然濃度限制（C）也很重要，但這屬於給藥準備步驟，確認排泄能力是確保生命安全的首要篩選機制。絕對禁止 bolus 給藥（A）。
The most important safety check before administering KCl is to confirm adequate renal function, namely a urine output of at least 30 mL/hour. If the kidneys cannot excrete potassium, rapid KCl infusion can produce lethal hyperkalemia. Although concentration limits (C) are also important, that step is part of medication preparation; verifying excretory capacity is the foremost screen for protecting life. Bolus administration (A) is absolutely contraindicated.
美台對於鉀離子給藥皆有嚴格規範，台灣通常需經由幫浦給藥且須有醫囑明確規範濃度，美國則強調護理師的自主雙重核對流程。