— 藥理與非經腸給藥 · HARD · MCQ —
病人獲醫囑給予靜脈注射氯化鉀 20 mEq。護理師採取哪項行動對病人安全至關重要？
A client is prescribed intravenous potassium chloride (KCl) 20 mEq. Which action by the nurse is essential for safety?
- AAssess deep tendon reflexes before starting開始輸注前評估深部腱反射
- BDilute the medication in at least 100 mL of fluid將藥物稀釋於至少 100 mL 的液體中
- CAdminister the medication via IV push經靜脈推注給藥
- DEnsure the infusion rate does not exceed 10 mEq/hour✓ 正解確保輸注速率不超過 10 mEq/小時
— Explanation · 中文詳解 —
KCl 是高警戒藥物，靜脈給藥絕對不可直接靜脈推注（IV push），會導致心律不整甚至心搏停止。週邊靜脈輸注速度限制在每小時 10 mEq 以防血管刺激與心臟毒性。A 選項的反射測試用於評估鎂離子過高，與鉀離子無直接關聯。
Intravenous potassium chloride is a high-alert medication that must never be administered via IV push, as rapid injection can cause fatal cardiac arrhythmias or arrest. To ensure safety during peripheral infusion, the rate must not exceed 10 mEq per hour to prevent severe vascular irritation and cardiac toxicity. Deep tendon reflex assessment is relevant for magnesium levels, not potassium administration.
✦ 台美臨床差異
美台臨床皆高度重視鉀離子輸注安全，但美國通常使用智慧幫浦預設劑量上限，台灣則需由雙人查對並嚴格控速。