護理師準備經由靜脈注射氯化鉀(KCl)。應採取哪些安全預防措施?(選所有適合的)
The nurse is preparing to administer potassium chloride IV. Which safety precautions should the nurse take? (Select all that apply.)
- AVerify the concentration does not exceed 10 mEq/100 mL✓ 正解確認濃度不超過 10 mEq/100 mL
- BAdminister as an IV bolus push to ensure rapid effect作為靜脈推注以確保快速療效
- CUse an infusion pump to control the rate✓ 正解使用輸注泵控制速率
- DMonitor for infiltration as it is a vesicant✓ 正解監測是否有滲出,因為它是水泡性藥物
- EEnsure the client has adequate urine output✓ 正解確保病人有足夠的尿量
氯化鉀(KCl)是高警訊藥物(High-alert medication),因其對心肌電生理的直接影響,給藥錯誤極易導致致命性心律不整。護理師必須嚴格遵守給藥安全原則:絕不進行靜脈推注(IV Push)以防血鉀瞬間過高引發心跳停止;必須使用輸液泵以確保流速恆定;監測注射部位防止外滲,因 KCl 對血管具強刺激性(Vesicant),外滲可能導致組織壞死;給藥前需評估腎功能與排尿量,確保排泄能力,防止體內鉀蓄積。
Potassium chloride is a high-alert medication that must never be given as an IV push due to the risk of fatal cardiac arrhythmias. Safety measures include using an infusion pump for precise rate control, verifying adequate urine output prior to administration, and monitoring for infiltration since potassium is a vesicant.
在美國臨床,KCl 給藥規定極其嚴格,通常需經由中心靜脈導管(CVC)或預混袋給予,且護理師需確保排尿量達到特定標準(通常為 0.5 mL/kg/hr)才可給藥,與台灣臨床依醫師醫囑給予的習慣相比,美國護理師對給藥前的評估責任更為明確且具法規性。