— 藥理與非經腸給藥 · HARD · MCQ —
病人獲醫囑開立呋塞米（furosemide）40 mg 靜脈注射。護理師發現病人血鉀濃度為 3.1 mEq/L。護理師應採取何種行動？
A client is prescribed furosemide 40 mg IV push. The nurse notes the client's potassium level is 3.1 mEq/L. What action should the nurse take?
- AAdminister the dose as ordered按醫囑給藥
- BAssess the client's blood pressure before administration給藥前評估病人的血壓
- CAdminister the dose with a potassium supplement搭配鉀補充劑給藥
- DHold the dose and notify the provider✓ 正解暫停給藥並通知醫師
— Explanation · 中文詳解 —
呋塞米為強效排鉀利尿劑，使用前若病人血鉀已低於正常值（3.5-5.0 mEq/L），可能引發致命性的心律不整。護理師需遵循「安全優先」原則，暫停給藥並回報醫療團隊，由醫師評估是否補充鉀離子或調整治療計畫，不得擅自給予補鉀藥物或執行醫囑。
Furosemide is a potent loop diuretic that promotes significant potassium excretion, which can exacerbate existing hypokalemia and precipitate life-threatening cardiac arrhythmias. Because the client's potassium level is critically low at 3.1 mEq/L, the nurse must prioritize safety by withholding the medication and notifying the provider to prevent severe electrolyte imbalance.
✦ 台美臨床差異
美國護理師依 protocol 判斷停藥權限較大；台灣受限於藥師法及評鑑，對於藥物停用仍需經醫師書面同意或電話確認。