— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備對低血鉀病人給予靜脈鉀離子，給藥前優先評估項目為何？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which assessment finding is the priority before initiation?
- ABlood pressure of 110/70 mmHg血壓 110/70 mmHg
- BPresence of a patent peripheral IV line存在暢通的周邊靜脈留置針
- CPotassium level of 3.2 mEq/L鉀離子濃度 3.2 mEq/L
- DUrine output of 20 mL/hr over the last 4 hours✓ 正解過去 4 小時內尿量為 20 mL/hr
— Explanation · 中文詳解 —
靜脈輸注鉀離子（Potassium Chloride, KCl）屬於高警訊藥物（High-alert medication）。給藥前最關鍵的生理指標是腎功能，因為鉀離子主要透過腎臟代謝，若病人無尿或少尿（< 30 mL/hr），輸鉀會導致血鉀濃度迅速飆升，引發致命性心律不整（如室性心搏過速）。因此，確認腎臟排泄功能是給藥前的必要步驟。
Intravenous potassium chloride is a high-alert medication that requires adequate renal function for safe excretion. Since potassium is primarily eliminated through the kidneys, monitoring urine output is critical to prevent hyperkalemia, which can lead to fatal dysrhythmias. A urine output of less than 30 mL/hr indicates potential renal impairment, making this the priority assessment before administration.