護理師給予口服鉀離子。適當的給藥方式為何？
A nurse is administering a dose of oral potassium. What is the appropriate administration method?
- AGive with juice only僅與果汁一起服用
- BCrush the extended-release tablet壓碎緩釋錠
- CMix with a full glass of water✓ 正解與一杯滿的水混合
- DGive on an empty stomach空腹服用
口服鉀離子製劑（如 Potassium Chloride）對胃腸道黏膜具有強烈的化學刺激性，直接吞服極易導致黏膜潰瘍、出血或穿孔。臨床給藥的核心原則是「稀釋」以降低局部濃度。正確做法是將藥物與至少 120-240ml 的水或果汁混合，以確保藥物能被充分溶解並迅速進入胃部，減少在食道或胃黏膜的滯留時間。此外，緩釋型（Extended-Release, ER）劑型具有特殊的包膜設計，旨在緩慢釋放藥物，若將其研磨或咀嚼，會破壞其釋放機制，導致鉀離子瞬間大量釋放，引發嚴重的高血鉀症（Hyperkalemia）及極度嚴重的腸道損傷。
Oral potassium supplements should be mixed with a full glass of water or juice to dilute the medication and prevent gastric mucosal irritation or ulceration. Extended-release tablets must never be crushed or chewed, as this destroys the coating and can lead to rapid drug release, causing severe gastrointestinal injury or hyperkalemia. Administering the medication with adequate fluid ensures safe delivery to the stomach.
台美臨床對於口服鉀離子的給藥規範一致，皆強調「不可研磨」與「充分稀釋」。但在美國醫院，護理師需特別注意確認藥物是否為液體劑型（Potassium oral solution），液體劑型同樣要求混入足量液體中給藥，以減輕味覺不適與黏膜刺激。