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Difficulty: MediumPharmacological and Parenteral Therapies

A nurse is preparing to administer an intravenous (IV) infusion of potassium chloride to a client diagnosed with severe hypokalemia. Which of the following nursing actions are appropriate to ensure safe administration? Select all that apply.

  1. Verify that the client's urine output is at least 30 mL/hr prior to initiating the infusion.Answer
  2. B
    Administer the potassium chloride as a direct intravenous push to rapidly correct the deficit.
  3. Assess the intravenous insertion site for pain, redness, or swelling at least hourly.Answer
  4. D
    Y-site the potassium chloride infusion into a line concurrently transfusing packed red blood cells.
  5. Utilize an electronic infusion pump to control the delivery rate of the medication.Answer

Answer

The correct actions are to verify adequate urine output, assess the IV site frequently, and utilize an electronic infusion pump.
Safe administration of intravenous potassium chloride requires ensuring the client can clear it renally (urine output > 30 mL/hr), controlling the exact rate of infusion with an electronic pump to prevent cardiac arrhythmias, and closely monitoring the IV site because potassium is a severe tissue irritant.

Step-by-Step Solution

1
Review the safety protocols for the administration of high-alert parenteral medications like potassium chloride.
Identify that potassium has a narrow therapeutic margin and requires strict administrative controls.
Rapid or incorrect administration can lead to lethal cardiac arrhythmias.
2
Evaluate the requirement for pre-administration assessment.
Determine that renal function must be assessed.
Because potassium is primarily excreted by the kidneys, administering it to a client with oliguria can quickly cause severe hyperkalemia.
3
Determine the correct method and equipment for intravenous delivery.
Select an electronic infusion pump and frequent site monitoring as mandatory.
A pump prevents accidental rapid infusion (speed shock), and site monitoring prevents tissue damage since potassium is a known vesicant.

Key Concept

Safe Administration of Intravenous Potassium
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Topics

Pharmacological and Parenteral Therapies

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