— 藥理與非經腸給藥 · HARD · MCQ —
病人獲醫囑給予靜脈輸注氯化鉀 20 mEq。護理師為確保病人安全，最重要的行動為何？
A client is prescribed intravenous potassium chloride 20 mEq. Which nursing action is essential to ensure client safety?
- AVerify the concentration and dilution✓ 正解確認濃度與稀釋比例
- BAdminister as an IV bolus push作為靜脈推注給藥
- CPerform the administration using a gravity drip使用重力滴注進行給藥
- DMonitor the infusion site only upon completion僅在輸注完成後監測給藥部位
— Explanation · 中文詳解 —
靜脈輸注鉀離子具高風險，濃度過高或速度過快會導致心律不整甚至心跳停止。執行前務必確認輸注濃度、稀釋比例及輸注速率（通常不超過 10 mEq/hr，除非有嚴格監測）。絕不可直接 Push，必須透過輸注幫浦（Pump）以精確控制流量，並嚴密監測注射部位有無滲漏導致血管壞死。
Intravenous potassium chloride carries a high risk of causing fatal arrhythmias if administered incorrectly. It is strictly contraindicated to administer potassium via IV push; it must always be diluted and infused slowly using an infusion pump to control the rate. Nurses must verify the concentration and monitor the infusion site closely to prevent extravasation, which can cause severe tissue necrosis.
✦ 台美臨床差異
美台臨床皆嚴禁鉀離子靜脈推注，但台灣對給藥安全審核制度（Double check）較為嚴格，需雙人核對後方可設定幫浦。