— 降低風險 · MEDIUM · MCQ —
護理師準備為病人靜脈輸注氯化鉀。為確保病人安全，下列哪項動作為優先？
A nurse is preparing to administer intravenous potassium chloride to a client. Which action is the priority to ensure client safety?
- AAdminister the potassium as a rapid IV push快速靜脈推注氯化鉀
- BCheck the client's urine output before initiating the infusion✓ 正解在開始輸注前檢查個案的尿量
- CVerify the patient has a patent peripheral IV line only僅確認病患具有暢通的周邊靜脈通路
- DAdd the potassium to the IV bag only after it is hung在靜脈袋掛起後再加入氯化鉀
— Explanation · 中文詳解 —
鉀離子透過腎臟排泄，若病人無尿或少尿（<30 mL/hr），輸注鉀離子極易導致高血鉀，進而引發致命性心律不整。給藥前確認腎功能與尿量是護理師的安全底線。鉀離子嚴禁 IV push，且必須稀釋並透過輸液幫浦給予。
Potassium is excreted primarily by the kidneys; thus, checking urine output is critical before administration to prevent hyperkalemia, which can lead to fatal cardiac arrhythmias. Intravenous potassium must never be given as a rapid push and should always be diluted and administered via infusion pump to ensure client safety.
✦ 台美臨床差異
台美皆嚴格規範鉀離子濃度與輸注速率，台灣醫院常要求由藥師預先調配並貼上警示標籤以確保安全。