— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備對低血鉀病人靜脈輸注氯化鉀。下列何項行動對於確保病人安全最為關鍵？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which nursing action is most critical to ensure patient safety?
- AEnsure the infusion rate does not exceed 10 mEq per hour via peripheral line確保周邊輸注速率不超過每小時 10 mEq
- BAssess the client's urine output before initiating the infusion✓ 正解開始輸注前評估病人的尿量
- CMonitor the infusion site every 30 minutes for signs of infiltration每 30 分鐘監測輸注部位是否有滲漏跡象
- DVerify that the medication is diluted in at least 100 mL of IV fluid確認藥物已稀釋於至少 100 mL 的靜脈輸注液中
— Explanation · 中文詳解 —
給予氯化鉀前，護理師必須確認病人有足夠的腎臟功能排泄鉀離子。若無尿或少尿，過量補鉀極易導致高血鉀致死性心律不整。雖然稀釋和控制輸注速率亦非常重要，但在臨床決策邏輯中，確認腎功能排泄能力是給藥前的首要生理指標，防止急性鉀中毒。
Assessing urine output is the critical priority before administering IV potassium to ensure adequate renal excretion capability. Without sufficient kidney function, potassium accumulation can lead to life-threatening hyperkalemia and cardiac arrhythmias, making this assessment essential for patient safety.
✦ 台美臨床差異
台美兩地皆要求輸注前確認尿量，但在美國，若無尿，護理師可直接拒絕給藥；台灣護理師通常會先通知醫師確認後才停止執行。