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Zorluk: OrtaPharmacological and Parenteral Therapies

A client's morning laboratory results reveal a serum potassium level of 2.62.6 mEq/L. The healthcare provider prescribes 4040 mEq of intravenous potassium chloride (KCl) in 100100 mL of 0.9%0.9\% sodium chloride to be infused over 11 hour. The client has a continuous infusion of 5%5\% dextrose in water running at 5050 mL/hr through a 2020-gauge peripheral catheter in the left hand. Which of the following actions should the nurse take?

  1. Contact the healthcare provider to question the prescribed infusion rate and route.Cevap
  2. B
    Administer the medication directly as a slow intravenous push over 1010 minutes.
  3. C
    Pause the primary dextrose infusion to prevent mixing incompatible solutions in the peripheral line.
  4. D
    Assess the peripheral intravenous site every 1515 minutes for phlebitis during the infusion.

Cevap

Contact the healthcare provider to question the prescribed infusion rate and route.
The correct action is to contact the healthcare provider to question the prescribed infusion rate and route. Intravenous potassium chloride (KCl) is a high-alert medication with strict administration guidelines. The maximum recommended rate for IV potassium administration through a peripheral line is typically 10 mEq/hr to prevent severe vein irritation and life-threatening cardiac arrhythmias. An order for 40 mEq over 1 hour is dangerously fast. Such high doses generally require a central venous catheter, an infusion pump, and continuous cardiac monitoring. Therefore, the nurse must withhold the medication and clarify the unsafe prescription.

Adım Adım Çözüm

1
Evaluate the prescribed medication, dose, route, and rate.
The prescription is for 40 mEq of potassium chloride to be given intravenously over 1 hour via a peripheral line.
Nurses must verify the safety of all medication orders before administration.
2
Compare the prescription against safety standards for intravenous potassium.
The maximum safe rate for peripheral IV potassium is generally 10 mEq/hr. A central venous catheter is required for higher concentrations, and rates rarely exceed 20 mEq/hr without intensive care cardiac monitoring.
Rapid infusion of potassium can cause fatal arrhythmias and severe venous irritation.
3
Determine the priority nursing action.
The prescription is unsafe. The nurse must not administer the medication and must contact the prescriber.
The nurse has a legal and ethical duty to refuse to administer an unsafe order and to seek immediate clarification.

Anahtar Kavram

Safe administration of intravenous potassium chloride
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Pharmacological and Parenteral Therapies

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