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Difficulty: EasyReduction of Risk Potential

A practical nurse is reviewing the morning laboratory results for a client who receives a daily dose of furosemide. Which of the following laboratory findings presents the greatest physiological risk to the client and requires immediate notification to the registered nurse?

  1. Serum potassium of 2.82.8 mEq/L (2.82.8 mmol/L)Answer
  2. B
    Blood urea nitrogen (BUN) of 1616 mg/dL (5.75.7 mmol/L)
  3. C
    Serum sodium of 139139 mEq/L (139139 mmol/L)
  4. D
    Serum magnesium of 1.91.9 mEq/L (0.780.78 mmol/L)

Answer

Serum potassium of 2.8 mEq/L (2.8 mmol/L)
Furosemide is a potassium-wasting loop diuretic. A serum potassium level of 2.8 mEq/L is significantly below the normal range of 3.5 to 5.0 mEq/L. Hypokalemia can lead to severe muscle weakness and life-threatening cardiac dysrhythmias, making this the highest priority finding that must be immediately reported to the registered nurse for prompt intervention.

Step-by-Step Solution

1
Identify the primary mechanism and risks associated with the client's prescribed medication.
Furosemide is a loop diuretic known to cause the excretion of water, sodium, and significantly, potassium.
Understanding the medication's expected side effects guides the nurse on which specific laboratory values to monitor most closely.
2
Evaluate each laboratory option against expected normal adult reference ranges.
The potassium level of 2.8 mEq/L is well below the normal range (3.5-5.0 mEq/L). The BUN, sodium, and magnesium levels are all within their respective normal limits.
The practical nurse must be able to rapidly differentiate between normal expected findings and abnormal critical values to ensure client safety.
3
Determine the required nursing action for the abnormal finding.
The abnormally low potassium level (hypokalemia) must be reported to the registered nurse immediately.
Severe hypokalemia can trigger lethal cardiac dysrhythmias, making it the highest priority finding that requires urgent medical intervention.

Key Concept

Identifying critical laboratory values and escalating abnormal findings associated with high-risk medications to reduce client harm.
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Topics

Reduction of Risk Potential

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