An older adult client with a history of heart failure is prescribed oral furosemide daily.… — NCLEX-PN

An older adult client with a history of heart failure is prescribed oral furosemide daily. Upon reviewing the morning laboratory results, the nurse notes a serum potassium level of $2.8 \text{ mEq/L}$ . Which action should the nurse take first?

A
Administer the furosemide as prescribed and document the laboratory result.
B
Assess the client's blood pressure prior to giving the scheduled dose.
Withhold the furosemide dose and report the finding to the registered nurse.Answer
D
Provide a potassium-rich snack and proceed with administering the medication.

Answer

Withhold the furosemide dose and report the finding to the registered nurse.

The client's serum potassium level of

2.8 \text{ mEq/L}

is significantly below the normal range of

3.5

5.0 \text{ mEq/L}

, indicating severe hypokalemia. Furosemide is a potassium-wasting loop diuretic. Administering this medication would further deplete the client's potassium, significantly increasing the risk of life-threatening cardiac dysrhythmias. The safest and most appropriate action to reduce client risk is to withhold the dose and notify the supervising registered nurse or healthcare provider immediately.

Step-by-Step Solution

Identify the normal range for serum potassium.

The normal serum potassium level is between

3.5

and

5.0 \text{ mEq/L}

Establishing the baseline helps determine if the client's laboratory value is abnormal.

Evaluate the client's laboratory result against the normal range.

The client's level of

2.8 \text{ mEq/L}

is significantly below normal, indicating severe hypokalemia.

Recognizing critical laboratory values is a fundamental aspect of client safety and risk reduction.

Analyze the effect of the prescribed medication on the abnormal laboratory value.

Furosemide is a potassium-wasting loop diuretic, meaning it will cause the body to excrete even more potassium.

Understanding medication mechanisms prevents the administration of drugs that will worsen a client's condition.

Determine the safest nursing intervention.

The dose must be withheld and the finding escalated to the registered nurse or healthcare provider.

Prioritizing risk reduction prevents life-threatening complications, such as cardiac dysrhythmias associated with severe hypokalemia.

Key Concept

Laboratory Value Interpretation and Medication Safety

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