— 藥理與非經腸給藥 · HARD · MCQ —
病人正在靜脈輸注 20 mEq 氯化鉀於 100 mL 生理食鹽水中,預計 1 小時輸完。護理師應優先採取什麼行動?
A client is receiving an intravenous infusion of potassium chloride 20 mEq in 100 mL of 0.9% Normal Saline over 1 hour. Which action is the priority for the nurse?
- AEnsure the infusion is administered via an infusion pump✓ 正解確保透過輸注幫浦進行輸注
- BVerify the client's potassium level is within normal range確認客戶的鉀離子濃度在正常範圍內
- CAssess the IV site for signs of phlebitis or infiltration評估靜脈注射部位是否有靜脈炎或滲漏跡象
- DMonitor the client's cardiac rhythm continuously持續監測客戶的心律
— Explanation · 中文詳解 —
靜脈輸注鉀離子濃度高且速度快時,必須確保使用輸液幫浦來精確控制速度。鉀離子屬於高警戒藥物,若給藥速度過快可能導致嚴重的心律不整甚至心搏停止。C選項雖重要但不是最危險的;B選項若鉀過高通常不會給藥;D選項雖是監測重點,但確保給藥安全機制(幫浦)為首要安全防護。
Potassium chloride is a high-alert medication that must be administered via an infusion pump to ensure precise control and prevent rapid infusion. Rapid administration can cause fatal arrhythmias, making the use of a pump the primary safety measure over other assessments.
✦ 台美臨床差異
美台兩地對於高警訊藥物均要求必須使用輸液幫浦,並強調雙人核對流程。