— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備為低血鉀病人靜脈輸注氯化鉀，最重要的安全措施為何？
A nurse is preparing to administer intravenous potassium chloride to a client with hypokalemia. What is the most critical safety action?
- AVerify the presence of urine output before administration✓ 正解給藥前確認有尿液排出
- BDilute the medication properly before infusion輸注前正確稀釋藥物
- CCheck the client's current serum potassium level again再次檢查病人目前的血清鉀濃度
- DEnsure the infusion rate does not exceed 10 mEq/hr via peripheral line確保周邊靜脈輸注速率不超過每小時 10 mEq
— Explanation · 中文詳解 —
給予鉀離子補充前，必須確認腎臟排泄功能正常。若病人無尿（anuria）或嚴重寡尿，貿然給鉀會導致高血鉀危象與致命性心律不整。選項 B 與 D 雖為必要程序，但優先級在於評估病人是否有能力處理負荷，否則輸注後的鉀離子無法排出體外，風險最高。
Verifying urine output is the priority because adequate renal function is required to excrete potassium; administering potassium to a client with renal impairment or anuria can lead to fatal hyperkalemia. While dilution and rate control are important safety measures, they are secondary to ensuring the kidneys can handle the potassium load.
✦ 台美臨床差異
台美均強調腎功能評估；但在台灣病房，護理師需確認醫囑劑量與稀釋比例是否符合該院嚴格的給藥指引。