— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備對低鉀血症病人給予靜脈注射氯化鉀，給藥前優先評估的指標為何？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which assessment finding is the priority before proceeding?
- ARespiratory rate呼吸速率
- BSerum creatinine血清肌酸酐
- CUrine output✓ 正解尿量
- DBlood pressure血壓
— Explanation · 中文詳解 —
鉀離子（Potassium）主要經由腎臟代謝。給予氯化鉀（KCl）前，必須確保病人的腎功能正常，特別是尿量（Urine Output）需維持在每小時至少 30 mL，以證明腎臟有足夠的排泄能力。若腎功能受損或無尿，靜脈注射鉀離子將導致致命性的高鉀血症（Hyperkalemia），進而引發嚴重的心律不整甚至心跳停止。
Potassium is primarily excreted by the kidneys, making adequate urine output essential before administration to prevent hyperkalemia. Ensuring the patient produces at least 30 mL per hour confirms sufficient renal function to eliminate excess potassium. Without this verification, administering potassium could lead to life-threatening cardiac arrhythmias.
✦ 台美臨床差異
美國臨床對於靜脈鉀離子給藥的監測極度嚴格，常規要求必須在有心電圖監測（Telemetry）下進行，且對尿量要求更為嚴謹，以防藥物過量。