— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備對低血鉀病人靜脈輸注氯化鉀，給藥前最優先的評估項目為何？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. Which assessment is the priority before hanging the infusion?
- AReview the client's most recent fasting blood glucose檢視病人最近的空腹血糖
- BCheck the client's current urine output✓ 正解檢查病人目前的尿量
- CVerify the presence of a central venous access確認是否存在中央靜脈通路
- DAssess the client's blood pressure評估病人的血壓
— Explanation · 中文詳解 —
靜脈輸注鉀離子前，必須確保腎功能正常，尿量需大於 30 mL/hr 以防止高血鉀症。鉀離子主要經腎臟排泄，尿量不足時給藥易導致致命性心律不整。C 選項雖建議使用周邊靜脈稀釋或中央管，但非臨床首要的生理監測指標。D、A 選項與此類電解質補充的安全性直接關聯性較低。
The priority assessment before administering intravenous potassium is checking the client's urine output to ensure adequate renal function for excretion. Since potassium is primarily eliminated by the kidneys, insufficient urine output increases the risk of life-threatening hyperkalemia and cardiac arrhythmias.
✦ 台美臨床差異
台美均嚴格執行給藥前評估。美國護理師常需依據醫療照護路徑確認給藥條件；台灣則較強調在醫囑明確範圍內確認尿量紀錄。