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Difficulty: EasyReduction of Risk Potential

While reviewing morning laboratory data for a client prescribed furosemide, a practical nurse observes a serum potassium level of 2.8 mEq/L (2.8 mmol/L). What is the most appropriate initial action by the nurse?

  1. Report the laboratory finding to the registered nurse immediately.Answer
  2. B
    Record the value in the electronic health record and proceed with routine care.
  3. C
    Administer the scheduled morning dose of furosemide as prescribed.
  4. D
    Initiate an intravenous potassium replacement protocol independently.

Answer

The practical nurse must report the laboratory finding to the registered nurse immediately.
A serum potassium level of 2.8 mEq/L is considered hypokalemia (normal range: 3.5 to 5.0 mEq/L). Furosemide is a potassium-wasting diuretic that can further lower these levels. Within the legal scope of practice, the practical nurse must immediately report this critical laboratory value to the registered nurse or healthcare provider so the diuretic can be held and appropriate potassium replacement prescribed.

Step-by-Step Solution

1
Identify the normal range for serum potassium.
The expected normal range for serum potassium is 3.5 to 5.0 mEq/L.
Establishing the baseline is necessary to determine if the client's current value is abnormal.
2
Analyze the client's laboratory value.
The client's level of 2.8 mEq/L indicates severe hypokalemia.
Hypokalemia poses a high risk for life-threatening cardiac dysrhythmias and requires prompt intervention.
3
Determine the appropriate nursing action within the practical nurse scope of practice.
The finding must be immediately escalated to the registered nurse or healthcare provider.
A critical lab value requires medical evaluation and possible medication adjustments that fall under RN or provider responsibility.

Key Concept

Identifying critical laboratory values and escalating them appropriately
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Topics

Reduction of Risk Potential

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