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藥理與非經腸給藥 · EASY · MCQ

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
Explanation · 中文詳解

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.

✦ 台美臨床差異

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。

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