ATI Nur 110 Med Surg (adult And Wellness) Proctored Exam
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ATI Nur 110 Med Surg (adult And Wellness) Proctored Exam
A nurse is preparing to administer prescribed intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L. Which of the following actions should the nurse plan to include? (Select All that Apply.)
Select all that apply
Explanation
Choice A rationale Severe hypokalemia, defined as a serum potassium level below 2.5 mEq/L (normal range 3.5 to 5.0 mEq/L), significantly alters the resting membrane potential of cardiac myocytes. This electrolyte imbalance increases myocardial excitability and can lead to life-threatening dysrhythmias such as ventricular tachycardia, fibrillation, or heart block. Continuous cardiac monitoring is essential during intravenous replacement to detect early signs of potassium toxicity or worsening cardiac conduction issues, ensuring immediate clinical intervention if needed. Choice B rationale Intravenous potassium chloride must never be administered by bolus or rapid push due to the high risk of immediate cardiac arrest. The standard concentration for peripheral administration is typically 10 mEq/100 mL, and it should be diluted in a larger volume of compatible fluid, such as 500 mL or 1000 mL, to prevent severe vein irritation and sclerosis. Infusion rates must not exceed 10 to 20 mEq per hour to ensure safe systemic distribution. Choice C rationale Frequent monitoring of serum potassium levels is critical during replacement therapy to evaluate the effectiveness of the intervention and prevent overcorrection leading to hyperkalemia. Because potassium is primarily an intracellular cation, serum levels may not immediately reflect total body stores. Repeating the lab work after the infusion helps determine if the patient has returned to the safe physiological range of 3.5 to 5.0 mEq/L and guides the necessity for further supplementation. Choice D rationale Potassium is primarily excreted by the kidneys, and adequate renal function is vital for preventing the accumulation of the cation in the extracellular fluid. If a patient is oliguric or has a urine output less than 30 mL/hr, administering intravenous potassium can quickly lead to hyperkalemia and cardiac arrest. Assessing kidney function through urine output and creatinine levels ensures that the body can safely process and eliminate the supplemental dose being administered intravenously. Choice E rationale Patient education regarding dietary intake is a core component of managing chronic hypokalemia and preventing future episodes. Foods such as bananas, spinach, potatoes, and oranges are rich in potassium and help maintain homeostatic levels naturally. Instructing the client on these sources empowers them to manage their condition through nutrition, reducing the long-term reliance on pharmacological supplements and minimizing the risk of recurrent low serum levels below the 3.5 mEq/L threshold.