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Difficulty: MediumPharmacological Therapies

During the morning medication pass, a client with pulmonary edema is scheduled to receive a 4040 mg oral dose of furosemide. The medication drawer contains 2020 mg scored tablets. The client's most recent basic metabolic panel reveals a serum potassium concentration of 2.82.8 mEq/L (2.82.8 mmol/L). Which action should the practical nurse (PN) take?

  1. Withhold the furosemide and immediately report the laboratory findings to the registered nurse (RN).Answer
  2. B
    Administer 22 tablets of furosemide after scanning the client's identification band.
  3. C
    Administer 0.50.5 tablets of the medication to adjust for the client's current laboratory values.
  4. D
    Administer a prescribed intravenous push dose of potassium chloride to correct the electrolyte deficit.

Answer

The correct action is to withhold the furosemide and immediately report the laboratory findings to the registered nurse (RN).
Furosemide is a loop diuretic that promotes the renal excretion of potassium. A serum potassium level of 2.82.8 mEq/L indicates severe hypokalemia, as the normal reference range is generally 3.53.5 to 5.05.0 mEq/L. Administering a potassium-wasting medication to a client in this state could precipitate life-threatening cardiac dysrhythmias. Safe nursing practice dictates that the PN must recognize this critical finding, withhold the scheduled dose, and promptly notify the supervising RN or healthcare provider to ensure client safety.

Step-by-Step Solution

1
Evaluate the client's prescribed medication and corresponding laboratory values.
The client is scheduled to receive furosemide, a loop diuretic known to deplete potassium, while having a critically low serum potassium level of 2.82.8 mEq/L.
Safe medication administration requires understanding the drug's mechanism of action and its potential impact on the client's current physiological state.
2
Determine the safety risk of administering the medication.
Administering a potassium-wasting diuretic to a client with severe hypokalemia increases the risk of life-threatening cardiac dysrhythmias.
Preventing adverse drug events is a primary responsibility in nursing care.
3
Select the appropriate intervention within the PN scope of practice.
The PN must withhold the unsafe medication and communicate the critical laboratory findings to the RN or provider for further orders.
The PN plays a vital role in data collection and patient safety but must escalate findings that require changes to the medical plan of care.

Key Concept

Pre-administration assessment and recognizing critical laboratory values within the practical nursing scope of practice.
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Topics

Pharmacological Therapies

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