— 降低風險 · MEDIUM · MCQ —
護理師準備經由靜脈點滴給予病人 20 mEq 氯化鉀。下列何項行動對於確保病人安全至關重要？
A nurse is preparing to administer potassium chloride 20 mEq via IV piggyback to a client. Which action is essential to ensure client safety?
- ADilute the medication in 500 mL of normal saline將藥物稀釋於 500 mL 生理鹽水中
- BAdminister the medication as an IV bolus以靜脈推注方式給藥
- CVerify the presence of a central venous catheter確認存在中心靜脈導管
- 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 —
鉀離子具有強烈刺激性與心臟毒性，絕對禁止直接 IV 推注（bolus）。常規靜脈輸注速度建議在周邊靜脈維持每小時 10 mEq，若需更高濃度或速度，必須經由中心靜脈管並嚴密監測心電圖，以防致命性心律不整。
Potassium chloride is highly irritating to veins and can cause fatal cardiac arrhythmias if administered too rapidly or undiluted. Therefore, the infusion rate must not exceed 10 mEq per hour for peripheral administration to ensure client safety.
✦ 台美臨床差異
美國護理師常有權限依據 protocol 調整點滴速度；台灣此類給藥多嚴格遵循醫囑，且對高濃度鉀離子警示極高。