護理師正準備為低血鉀病人靜脈輸注氯化鉀。給藥前最優先的評估為何？
A nurse is administering a dose of IV potassium chloride to a client with hypokalemia. What is the priority assessment before starting the infusion?
- AChecking the patency of the intravenous site檢查靜脈注射部位的通暢性
- BObtaining a recent serum potassium level取得最近的血清鉀離子濃度
- CVerifying the dose with another registered nurse由另一位註冊護理師核對劑量
- DEnsuring the client has adequate urine output✓ 正解確保病人有足夠的尿液排出量
靜脈輸注鉀離子前，確保腎臟功能正常即有足夠尿量（通常建議 >30 mL/hr）是防止醫源性高血鉀致命性心律不整的關鍵，因為鉀離子主要由腎臟排除，若無排尿恐造成鉀離子滯留。這是給予鉀離子前最關鍵的生理評估。其他步驟（如確認管路、雙重核對）皆為給藥安全流程，但在 KCl 輸注中，尿量是決定是否能安全輸注鉀離子的生理前提。
Ensuring adequate urine output is the priority assessment because potassium is primarily excreted by the kidneys; oliguria or anuria can lead to life-threatening hyperkalemia. While verifying the dose and checking IV patency are important safety steps, confirming renal function is the critical physiological prerequisite for safe administration. Recent potassium levels are relevant but do not replace the need to assess current excretory capacity.