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Difficulty: MediumPharmacological Therapies

A client on a medical-surgical unit is scheduled to receive a routine dose of oral furosemide. Prior to administration, the practical nurse (PN) notes that the client's most recent serum potassium level is 2.9 mEq/L2.9\text{ mEq/L}. Which action should the PN take first?

  1. A
    Administer the medication as prescribed and document the laboratory result in the client's chart.
  2. B
    Administer a prescribed intravenous push dose of potassium chloride to correct the deficit.
  3. Withhold the furosemide and immediately notify the supervising registered nurse (RN).Answer
  4. D
    Verify the client's identity using the barcode scanner and proceed with administration.

Answer

The correct action is to withhold the furosemide and notify the registered nurse (RN).
The correct action is to withhold the medication and notify the RN. Furosemide is a loop diuretic that causes potassium depletion. A serum potassium level of 2.9 mEq/L2.9\text{ mEq/L} indicates severe hypokalemia (normal range is typically 3.53.5 to 5.0 mEq/L5.0\text{ mEq/L}). Administering the medication could lower the potassium level further, leading to life-threatening cardiac dysrhythmias. The PN must withhold the dose and escalate this critical finding.

Step-by-Step Solution

1
Evaluate the client's serum potassium laboratory result.
Identify that a potassium level of 2.9 mEq/L2.9\text{ mEq/L} is significantly below the normal range (typically 3.53.5 to 5.0 mEq/L5.0\text{ mEq/L}).
To determine if the client's current physiological status is safe for the prescribed therapy.
2
Determine the pharmacological effect of furosemide.
Recognize that furosemide is a loop diuretic that causes the kidneys to excrete potassium.
To predict how the medication will impact the client's already compromised electrolyte balance.
3
Select the appropriate nursing intervention within the PN scope of practice.
Decide to withhold the medication and escalate the critical finding to the RN or healthcare provider.
To prevent severe hypokalemia, which can lead to life-threatening cardiac dysrhythmias, while operating safely within the PN scope of practice.

Key Concept

Furosemide Administration and Hypokalemia Management
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Topics

Pharmacological Therapies

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