一位心衰竭病人被開立靜脈注射呋塞米(furosemide)。在給藥前,護理師優先評估的臨床指標為何?
A client is prescribed intravenous furosemide for severe heart failure. Before administering the medication, which finding is the priority for the nurse to assess?
- ABlood glucose level血糖值
- BSerum potassium level✓ 正解血清鉀濃度
- CBlood pressure血壓
- DSerum creatinine level血清肌酸酐濃度
Furosemide 是一種高效迴路利尿劑(Loop diuretic),其藥理機轉為抑制腎臟亨利氏環(Loop of Henle)對鈉、氯的再吸收,同時會促進鉀離子隨尿液排出。低血鉀(Hypokalemia)會增加毛地黃毒性,並誘發致命性心律不整(如室性心搏過速)。因此,給藥前確認鉀離子濃度是確保病人安全的核心護理評估。
Furosemide is a loop diuretic that promotes the excretion of potassium, creating a significant risk for hypokalemia. Low serum potassium levels can lead to life-threatening cardiac arrhythmias and increase the risk of digitalis toxicity. Therefore, assessing the serum potassium level is the priority intervention before administration to ensure client safety.
台美臨床對於 Furosemide 給藥前的血鉀評估標準一致,但在美國,若血鉀值低於 3.5 mEq/L,護理師通常會依據醫院的 'Protocol' 先暫停給藥並通知醫師,且常規會同時監測 'Magnesium'(鎂離子),因低鎂常伴隨低鉀。