— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師為低血鉀病人輸注靜脈滴注氯化鉀，下列哪項是優先安全措施？
A nurse is administering a dose of IV potassium chloride to a client with hypokalemia. What is the priority safety action?
- ACheck for patency of the IV site before starting the infusion開始輸注前檢查靜脈通路是否通暢
- BAdminister the medication as an IV push injection以靜脈推注方式給藥
- CEnsure the infusion rate does not exceed 10 mEq/hour via peripheral line✓ 正解確保周邊靜脈輸注速率不超過 10 mEq/hour
- DDilute the medication in at least 100 mL of IV fluid將藥物稀釋於至少 100 mL 的靜脈輸注液中
— Explanation · 中文詳解 —
靜脈輸注鉀離子有極高的心律不整風險，必須嚴格控制輸注速度，周邊靜脈通常建議不超過 10 mEq/hr，若需快速補充則需透過中心靜脈導管並監測心電圖。D 雖然重要，但控制速度是防止心跳停止的關鍵；B 為絕對禁止動作；D 為基本原則但非防止致命副作用的重點。
Intravenous potassium administration carries a high risk of fatal cardiac arrhythmias, making strict rate control the priority safety measure. For peripheral lines, the infusion rate should generally not exceed 10 mEq per hour to protect the cardiac conduction system, whereas IV push administration is strictly contraindicated.
✦ 台美臨床差異
美台皆嚴格執行鉀離子輸注規範，但美國常見由護理師依醫囑速率設置幫浦；台灣若需高濃度鉀，通常強烈要求經中心靜脈導管。