— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備為低血鉀病人靜脈注射氯化鉀 (KCl)。在開始輸注前,哪項評估最為重要?
A nurse is preparing to administer IV potassium chloride (KCl) to a client with hypokalemia. Which assessment is most important before initiating the infusion?
- AReview the client's white blood cell count檢視客戶的白血球計數
- BCheck the client's blood pressure檢查客戶的血壓
- CVerify the client's urine output✓ 正解確認客戶的尿量
- DAssess the IV site for infiltration評估靜脈注射部位是否有滲出
— Explanation · 中文詳解 —
靜脈給予 KCl 極易導致高血鉀危象,腎臟排泄功能是給藥前的必要評估。若病人無尿或少尿(<0.5 mL/kg/hr),鉀離子無法排出恐引發致命的心律不整。其他選項雖為常規護理,但與鉀離子給藥的致死風險相比,腎功能狀態的安全性優先級最高。
Verifying urine output is critical because adequate renal function is required to excrete excess potassium and prevent life-threatening hyperkalemia. If the patient has oliguria or anuria, potassium administration could lead to fatal cardiac arrhythmias.
✦ 台美臨床差異
美台臨床均視尿量為 KCl 給藥前提,但美國護理師常有給藥前自主核對尿量的權力與流程規範。