— 降低風險 · MEDIUM · MCQ —
護理師準備為病人靜脈注射氯化鉀（KCl），哪項行動是確保安全所必需的？
A nurse is preparing to administer IV potassium chloride (KCl) to a client. Which action is essential to ensure patient safety?
- AEnsure the concentration does not exceed 10 mEq/100 mL確保濃度不超過 10 mEq/100 mL
- BKeep the IV rate at 50 mEq/hr to correct hypokalemia quickly將靜脈注射速率維持在 50 mEq/hr 以快速糾正低血鉀
- CVerify the patient has adequate urine output✓ 正解確認病人有足夠的尿量
- DAdminister the medication via IV push經靜脈推注給藥
— Explanation · 中文詳解 —
鉀離子排泄的主要途徑為腎臟，若病人無尿或少尿，注射鉀離子極易引發高血鉀及致命性心律不整。因此，在給藥前確認排尿狀況是預防醫源性高血鉀的最重要指標。其他選項中，鉀離子絕不可直接靜脈推注（IV Push），且給藥速率有嚴格上限。
Verifying adequate urine output is critical before administering IV potassium because the kidneys are responsible for its excretion; renal insufficiency can lead to fatal hyperkalemia. Potassium must never be given via IV push, and infusion rates are strictly limited to prevent cardiac arrhythmias and vein irritation.
✦ 台美臨床差異
美國護理師常具備給藥權限調整速率，台灣則嚴格遵守醫囑給藥，對於鉀離子給藥的監控雙方均有高度標準化程序。