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降低風險 · HARD · SATA

護理師準備靜脈輸注氯化鉀。下列哪些是正確的護理措施?(選所有適合的)

A nurse is preparing to administer potassium chloride IV to a client. Which actions should the nurse take? (Select all that apply.)

  • AVerify the concentration does not exceed 10 mEq/100 mL for peripheral lines✓ 正解
    確認周邊靜脈輸注濃度不超過 10 mEq/100 mL
  • BAdminister the infusion via an electronic pump✓ 正解
    使用電子幫浦輸注
  • CAssess for vein phlebitis at the injection site✓ 正解
    評估注射部位是否有靜脈炎
  • DAdminister IV push to ensure rapid correction
    靜脈推注以確保快速糾正
  • EAssess urine output before initiating the infusion✓ 正解
    開始輸注前評估尿量
Explanation · 中文詳解

鉀離子靜脈輸注風險極高。需用幫浦控速避免心律不整;確認排尿量以確保腎功能正常(排除高血鉀風險);周邊靜脈濃度限制是為了避免血管硬化與疼痛;觀察靜脈炎是必備評估。嚴禁 IV Push,這會導致致命性的心臟停止。

Potassium chloride is a vesicant that can cause severe tissue damage and fatal arrhythmias if administered too rapidly or via IV push. Therefore, it must be infused through an electronic pump to ensure precise control, and peripheral concentrations should generally not exceed 10 mEq/100 mL to minimize vein irritation. Additionally, assessing urine output is critical to ensure adequate renal function for potassium excretion, and monitoring for phlebitis helps detect local complications early.

✦ 台美臨床差異

美台對於鉀離子輸注的嚴格監控一致,但美國護理資訊系統(EHR)針對鉀離子給藥設有強制性安全警示。

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