— 生理適應 · MEDIUM · MCQ —
病人被診斷為低血鉀，護理師準備給予靜脈輸注氯化鉀。下列哪項安全措施最重要？
A client is diagnosed with hypokalemia. The nurse prepares to administer a prescribed potassium chloride intravenous infusion. Which safety measure is paramount?
- AEnsure the infusion site is a small peripheral vein in the hand確保輸注部位為手上的小周邊靜脈
- BAdminister the potassium as a rapid IV bolus快速靜脈推注鉀離子
- CCheck the client's urine output before initiating the infusion✓ 正解在開始輸注前檢查病人的尿液排出量
- DDilute the potassium in at least 100 mL of IV solution將鉀離子稀釋於至少 100 mL 的靜脈輸液中
— Explanation · 中文詳解 —
靜脈輸注鉀離子極具風險，必須確保腎功能正常（尿量 > 30 mL/hr）以防止高血鉀毒性。鉀離子具強刺激性，濃度過高或推注極易造成血管炎與心律不整，故必須稀釋並透過中央靜脈或大靜脈給予，且絕對不可直接推注。
Checking the client's urine output is paramount because adequate renal function is necessary to excrete excess potassium and prevent life-threatening hyperkalemia. Potassium chloride is highly irritating to veins and can cause cardiac arrest if administered too rapidly or undiluted, making renal clearance the critical safety prerequisite. Therefore, ensuring the kidneys are functioning properly before initiation is essential.
✦ 台美臨床差異
台灣針對高濃度鉀補充常強制要求由中央靜脈給予；美國則依據醫院輸注幫浦設定與濃度規範進行評估。