— 藥理與非經腸給藥 · MEDIUM · MCQ —
病患正透過靜脈輸注補充 20 mEq 氯化鉀。下列何者為護理師的首要考量？
A client is receiving an intravenous infusion of potassium chloride 20 mEq. Which action is the priority for the nurse?
- ACheck the client's most recent serum creatinine檢查病人最近的血清肌酸酐值
- BEnsure the client has voided at least 30 mL/hr確保病人每小時至少排尿 30 mL
- CVerify the concentration and rate of infusion✓ 正解確認輸注濃度與速率
- DMonitor the insertion site for phlebitis監測穿刺部位是否有靜脈炎
— Explanation · 中文詳解 —
靜脈輸注鉀離子最大的風險是高血鉀引發的心律不整，因此「濃度」與「輸注速率」是預防致死性心律不整的最關鍵因子。給藥前必須確保濃度安全且滴速不超過安全建議量。雖然腎功能（尿量）重要，但若輸注濃度錯誤，會直接導致心臟驟停。
The priority action is to verify the concentration and infusion rate because rapid administration or high concentrations of potassium can cause fatal cardiac arrhythmias. While monitoring renal function and urine output is important for potassium excretion, ensuring safe delivery parameters is the immediate priority to prevent life-threatening toxicity.
✦ 台美臨床差異
美國醫院多由藥局配製好鉀離子輸注液；台灣病房護理師常需自行抽取針劑稀釋，增加操作風險，故三讀五對尤為重要。