— 生理適應 · HARD · SATA —
護理師準備為低血鉀病人靜脈注射氯化鉀，哪些步驟對確保安全至關重要？（選所有適合的）
A nurse is preparing to administer potassium chloride intravenously to a client with hypokalemia. Which actions are essential for safety? (Select all that apply.)
- AEnsure the concentration does not exceed 10 mEq/100 mL for peripheral lines✓ 正解確保周邊靜脈輸液的濃度不超過 10 mEq/100 mL
- BAdminister as an IV bolus push to correct levels quickly作為靜脈推注以快速糾正濃度
- CMonitor the infusion site for signs of phlebitis or infiltration✓ 正解監測輸液部位是否有靜脈炎或滲漏跡象
- DUse an infusion pump to control the rate precisely✓ 正解使用輸液幫浦精確控制速率
- EAssess urine output before initiating the infusion✓ 正解開始輸液前評估尿量
— Explanation · 中文詳解 —
氯化鉀具有強烈刺激性，嚴禁靜脈直接推注（Push），否則會導致心律不整甚至心跳停止。靜脈輸注時必須使用輸液幫浦控制速度，且週邊給藥濃度應受限，以防造成血管壞死。給藥前需確保腎功能正常（尿量 > 30 mL/hr），以防止高血鉀症。
Potassium chloride is a vesicant that must never be given as an IV push due to the risk of fatal cardiac arrhythmias. Essential safety measures include monitoring urine output to ensure renal excretion capability, using an infusion pump for precise rate control, and limiting peripheral concentration to prevent tissue necrosis.
✦ 台美臨床差異
美國醫院多嚴格規定 KCL 必須由獨立幫浦給藥，台灣臨床雖然亦然，但護理師需確認給藥路徑為大血管較為優先。