— 藥理與非經腸給藥 · HARD · MCQ —
護理師為低血鉀病人靜脈輸注氯化鉀。下列何者為優先的安全處置？
A nurse is administering a dose of intravenous potassium chloride to a client with hypokalemia. What is the priority safety action?
- AAssess the peripheral IV site for signs of phlebitis評估周邊靜脈穿刺處是否有靜脈炎跡象
- BCheck the serum potassium level before hanging the bag掛上輸液袋前檢查血清鉀濃度
- CMonitor the client's intake and output every hour每小時監測個案的攝入量與排出量
- DEnsure the medication is diluted and administered via an infusion pump✓ 正解確保藥物已稀釋並透過輸注幫浦給藥
— Explanation · 中文詳解 —
氯化鉀具有高度刺激性，嚴禁靜脈推注（IV push），必須稀釋後透過輸液幫浦定量給藥，以防心律不整及組織壞死。確認濃度與滴速是預防致死性併發症的核心，相比之下，評估 IV 部位或檢查數據雖重要，但預防給藥錯誤帶來的立即性生命危險為護理優先級首位。
Potassium chloride is highly irritating to veins and can cause fatal arrhythmias if administered too rapidly or undiluted. Therefore, the priority safety action is to ensure the medication is properly diluted and infused via a controlled pump to prevent tissue necrosis and cardiac complications.
✦ 台美臨床差異
美國護理師常需透過幫浦設定輸注，台灣臨床對於高濃度鉀離子給藥限制更嚴格，通常需經由中心靜脈導管，且需嚴格雙人核對。