A client has a serum potassium level of 2.9 mEq/L. Which action prescribed by the health care provider should the nurse take first?
A.
Ask the patient about home insulin doses
B.
Administer IV potassium supplements
C.
Place the patient on a cardiac monitor
D.
Start an insulin infusion at 0.1 units/kg/h
The correct answer and Explanation is :
The correct action to take first is C. Place the patient on a cardiac monitor.
Explanation:
Potassium is a crucial electrolyte involved in many physiological functions, including maintaining normal cardiac rhythm. A serum potassium level of 2.9 mEq/L is significantly below the normal range (3.5-5.0 mEq/L), indicating hypokalemia. This condition can have severe consequences, including cardiac arrhythmias, which can be life-threatening.
- Cardiac Monitoring: Placing the patient on a cardiac monitor is the immediate priority because hypokalemia can cause dangerous cardiac arrhythmias, including ventricular tachycardia and ventricular fibrillation. Continuous monitoring will help detect any arrhythmias or other cardiac issues that may arise due to low potassium levels.
- Administering Potassium: While administering IV potassium supplements is crucial for correcting the hypokalemia, it should be done after ensuring that the patient is being closely monitored. Potassium should be replaced carefully to avoid complications like hyperkalemia or cardiac complications. The healthcare provider’s orders typically include monitoring the patient’s cardiac status during potassium replacement therapy.
- Insulin and Potassium: Asking about home insulin doses (Option A) and starting an insulin infusion (Option D) are not immediately relevant for addressing the acute issue of hypokalemia. Insulin can affect potassium levels, but the priority is stabilizing the patient’s cardiac status and addressing the hypokalemia directly with potassium supplements.
In summary, the immediate concern in a patient with severe hypokalemia is to monitor for potential cardiac issues, so placing the patient on a cardiac monitor is the first and most critical action. This ensures that any arrhythmias or other cardiac problems are detected promptly, allowing for timely intervention.