— 降低風險 · HARD · MCQ —
護理師準備給予病人氯化鉀 20 mEq IV push。護理師應採取何種行動？
A nurse is preparing to administer potassium chloride 20 mEq IV push. What action should the nurse take?
- ADilute the medication with 50 mL of normal saline and hang以 50 mL 生理食鹽水稀釋藥物並掛瓶
- BAdminister the medication as ordered over 1 minute於 1 分鐘內按指示給藥
- CVerify the order with another nurse before administration給藥前與另一位護理師核對處方
- DClarify the order with the provider, as IV push potassium is contraindicated✓ 正解與醫師澄清處方，因為靜脈推注氯化鉀屬禁忌
— Explanation · 中文詳解 —
氯化鉀嚴禁直接靜脈推注（IV push），因為這會導致心律不整及心跳停止。鉀離子必須經過稀釋且以慢速輸注。護理師需拒絕給藥並向醫師確認處方。B 會致命；C 雖然給藥需雙重核對，但此處方本身即錯誤；A 雖然需稀釋，但必須通過輸液泵緩慢輸注，而非直接推注。
Potassium chloride is strictly contraindicated for IV push administration because it can cause fatal cardiac arrhythmias and arrest. The nurse must clarify the order with the provider, as potassium must always be diluted and administered slowly via an infusion pump.
✦ 台美臨床差異
台美臨床上氯化鉀靜脈推注皆為絕對禁止行為，護理師具備拒絕執行危險醫囑的權責。