— 照護管理 · HARD · MCQ —
護理師需照顧一群病人，應先進行哪項任務？
A nurse is caring for a group of clients. Which task should the nurse perform first?
- AAdministering scheduled IV antibiotics to a stable client給予穩定客戶定時的靜脈注射抗生素
- BDocumenting care for a client who was recently discharged記錄已出院客戶的照護情形
- CAssisting a postoperative client with ambulation協助術後客戶行走
- DFollowing up on a lab report indicating a potassium level of 2.8 mEq/L✓ 正解追蹤顯示鉀離子濃度為 2.8 mEq/L 的檢驗報告
— Explanation · 中文詳解 —
鉀離子數值 2.8 mEq/L 屬於嚴重的低血鉀（Hypokalemia），這會增加心律不整及致命性心搏過速的風險。此狀況屬於潛在的危急值，必須優先處理。其他選項如抗生素給藥（A）或術後下床（C）雖然重要，但與危急的心電圖變化風險相比，必須放在最後處理。
A potassium level of 2.8 mEq/L indicates severe hypokalemia, which places the client at high risk for life-threatening cardiac arrhythmias. This potential emergency requires immediate intervention, making it the highest priority over routine tasks like administering antibiotics or assisting with ambulation.
✦ 台美臨床差異
台美皆將危急值處理列為最高優先級；美國護理師常需透過 SBAR 與醫師溝通補鉀醫囑。