護理師準備給予一位病人 20 mEq 氯化鉀 IV 小瓶點滴。哪項動作應優先執行？
A nurse is preparing to administer potassium chloride 20 mEq IV piggyback to a client. Which action should the nurse take first?
- AEnsure the client has adequate urine output✓ 正解確認病人有足夠的尿量
- BVerify the concentration of the IV solution with another nurse與另一位護理師核對靜脈輸液的濃度
- CAssess the patency of the IV site評估靜脈穿刺點的通暢性
- DCheck the client's most recent serum potassium level檢查病人最近的血清鉀濃度
鉀離子（Potassium）主要經由腎臟排泄，若病人有少尿（Oliguria）或無尿（Anuria）情形，給予靜脈注射鉀離子將導致血鉀迅速飆升，引發致命性的心律不整（如心室顫動）。因此，確保腎功能正常與尿量充足是給予鉀離子前最關鍵的安全篩檢。雖然核對濃度與評估 IV 位點亦屬給藥安全範疇，但若腎臟無法代謝鉀，無論濃度多正確，後果皆不堪設想。
Potassium is primarily excreted by the kidneys, so ensuring adequate urine output is the critical first step before administration to prevent life-threatening hyperkalemia. While verifying concentration and IV site patency are important safety measures, assessing renal function takes priority because impaired kidney function can lead to fatal cardiac arrhythmias regardless of other precautions.
美國臨床醫囑中，鉀離子通常以 IV Piggyback 給藥且濃度嚴格限制（如不超過 10 mEq/hr），護理師必須熟悉醫院針對高警訊藥物（High-Alert Medication）的雙重核對（Double Check）流程。