護理師準備靜脈輸注氯化鉀,應執行哪些安全措施?(選所有適合的)
A nurse is preparing to administer potassium chloride intravenously. Which safety interventions must the nurse implement? (Select all that apply.)
- AVerify the concentration does not exceed 10 mEq/100 mL for peripheral lines✓ 正解確認周邊靜脈輸注的濃度不超過 10 mEq/100 mL
- BAdminister the infusion via an infusion pump✓ 正解透過輸注幫浦給藥
- CAdminister the medication as an IV bolus push作為靜脈推注給藥
- DAssess the intravenous site for signs of phlebitis✓ 正解評估靜脈注射部位是否有靜脈炎跡象
- EMonitor the client's cardiac rhythm continuously✓ 正解持續監測病人之心律
靜脈輸注鉀離子具高度危險性,嚴禁直接推注 (Bolus)。必須使用輸液泵確保速率穩定,周邊靜脈濃度通常限制在 10 mEq/100 mL,且因鉀離子具強刺激性,需密切觀察是否外滲導致靜脈炎,並同時透過心電圖監測是否有高血鉀引發的心律不整。
Intravenous infusion of potassium is highly hazardous, and direct IV push is strictly prohibited. An infusion pump must be used to ensure a stable rate, and the concentration in peripheral lines is typically limited to 10 mEq/100 mL. Because potassium is strongly irritating, the IV site must be closely monitored for infiltration that can cause phlebitis, and cardiac rhythm must be monitored simultaneously to detect arrhythmias caused by hyperkalemia.
美國採取雙人核對制 (Double check) 較嚴格;台灣醫療體系在藥物分裝與輸注標準化上正持續強化,但臨床執行效率仍視單位人力而定。