— 藥理與非經腸給藥 · HARD · MCQ —
一位病人正接受靜脈輸注 40 mEq 氯化鉀於 100 mL 生理食鹽水中。在掛上此藥物前，護理師的首要行動是什麼？
A client is receiving an intravenous infusion of potassium chloride 40 mEq in 100 mL of 0.9% Normal Saline. What is the nurse's priority action before hanging this medication?
- AVerify the potassium level in the most recent laboratory report✓ 正解查閱最近檢驗報告中的鉀離子數值
- BCheck the peripheral IV site for patency檢查周邊靜脈通路是否通暢
- CAssess the client's hourly urine output評估病人的每小時尿量
- DEnsure the medication is labeled as a high-alert medication確保藥物標示為高警訊藥物
— Explanation · 中文詳解 —
給予鉀離子前，確認血鉀濃度以避免高血鉀症致心律不整是首要安全步驟。40 mEq 屬高劑量，且鉀離子不得由靜脈推注（IV push）。A（尿量）雖重要但次於確認血鉀濃度，B（管路）在掛藥前已是常規檢查，D（標籤）為行政安全步驟。
Before administering intravenous potassium, the nurse must verify the client's current serum potassium level to prevent hyperkalemia, which can lead to life-threatening dysrhythmias. Since 40 mEq is a high dose, confirming the indication is the priority safety step over checking IV patency or urine output.
✦ 台美臨床差異
美國醫院針對高劑量補鉀有極嚴格的獨立雙人核對與給藥限制，台灣亦有類似高警訊規範，但人力配比不同。