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Difficulty: MediumPharmacological Therapies

While reviewing the morning chart for a client treated for heart failure, a practical nurse notes a serum potassium result of 3.03.0 mEq/L (reference range: 3.53.5 to 5.05.0 mEq/L). The medication record indicates upcoming scheduled doses of oral furosemide and oral potassium chloride. Which step is most appropriate for the nurse to take?

  1. Hold the furosemide dose, give the potassium chloride supplement, and alert the supervising registered nurse.Answer
  2. B
    Give both scheduled medications since the prescribed potassium will naturally resolve the electrolyte deficit.
  3. C
    Agree to a provider's telephone request to deliver a rapid bolus of intravenous potassium.
  4. D
    Bypass the electronic barcode verification process to expedite the delivery of the diuretic.

Answer

The nurse must withhold the furosemide, administer the potassium chloride, and notify the registered nurse.
Holding the furosemide prevents further depletion of the client's already low potassium levels. Administering the potassium chloride addresses the deficit, and notifying the registered nurse ensures proper escalation of a critical laboratory finding.

Step-by-Step Solution

1
Evaluate the morning laboratory results against normal reference ranges.
The client's serum potassium is 3.03.0 mEq/L, which indicates hypokalemia (normal is 3.53.5 to 5.05.0 mEq/L).
Identifying abnormal laboratory values is essential before administering medications that affect fluid and electrolyte balance.
2
Analyze the pharmacological effects of the scheduled medications on the abnormal lab value.
Furosemide is a loop diuretic that causes the kidneys to excrete potassium, which would worsen the hypokalemia. Potassium chloride will help correct the deficit.
Understanding the mechanism of action prevents the administration of a drug that could cause immediate client harm.
3
Determine the appropriate nursing intervention within the practical nurse scope of practice.
The nurse must hold the furosemide, proceed with the potassium supplement, and report the abnormal finding to the registered nurse.
Practical nurses must advocate for client safety by withholding harmful medications and escalating critical clinical data.

Key Concept

Monitoring adverse effects of pharmacological therapies and safe medication administration.
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Topics

Pharmacological Therapies

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