— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備對低血鉀病人輸注氯化鉀。下列哪項評估結果需要立即處置？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which assessment finding requires immediate intervention?
- ABlood pressure of 110/70 mmHg血壓 110/70 mmHg
- BSerum potassium level of 3.2 mEq/L血清鉀濃度 3.2 mEq/L
- CUrine output of 15 mL/hr over the past 2 hours✓ 正解過去兩小時的尿量為 15 mL/hr
- DPresence of a peripheral IV catheter in the left forearm左前臂存在周邊靜脈導管
— Explanation · 中文詳解 —
靜脈輸注鉀離子前，必須確保腎功能正常（尿量 >30 mL/hr），以防高血鉀導致致命性心律不整。若尿量過少，鉀離子無法排出，會迅速累積導致心臟驟停。選項 B 為治療適應症；C 若為靜脈留置針應評估有無滲漏；D 在正常範圍內，無需優先處理。
Inadequate urine output indicates potential renal impairment, which prevents the excretion of administered potassium and raises the risk of life-threatening hyperkalemia. Since the kidneys are responsible for potassium balance, a low output requires immediate intervention before or during infusion to prevent cardiac arrest. Normal blood pressure and serum levels do not pose the same acute risk.
✦ 台美臨床差異
美台臨床對於給鉀的腎功能監測標準皆極為嚴格，均要求確認尿量。