A nurse is caring for a client who has a prescription for potassium chloride (KCL) 20 mEq PO daily. The nurse reviews the client's most recent laboratory results and finds the client's potassium level is 5.2 mEq/L (3.5 to 5 mEq/L). Which of the following actions should the nurse take?

Choice A rationale Removing a prescription order is strictly outside the legal scope of nursing practice. Only a licensed healthcare provider with prescribing authority, such as a physician or nurse practitioner, can officially cancel or discontinue a medication order. While the potassium level of 5.2 mEq/L is above the normal range of 3.5 to 5.0 mEq/L, the nurse must collaborate with the provider rather than independently altering the medical record or treatment plan. Choice B rationale The nurse must notify the provider when laboratory results fall outside the expected reference range, especially before administering a supplement that could worsen the condition. A potassium level of 5.2 mEq/L indicates hyperkalemia. Administering 20 mEq of potassium chloride to a patient who is already above the normal limit of 5.0 mEq/L increases the risk of cardiac arrhythmias or cardiac arrest. Communication ensures patient safety and allows for order modification. Choice C rationale Verifying results with the laboratory is typically reserved for instances where the clinical presentation of the patient does not match the reported values or if a specimen error is suspected, such as hemolysis. While a hemolyzed sample can falsely elevate potassium, the first priority in a clinical setting when a high value is reported is to withhold the medication and inform the provider to ensure the patient does not receive a dangerous dose. Choice D rationale Giving the medication as prescribed would be a medication error and a violation of nursing safety standards. Since the client's potassium level is 5.2 mEq/L, which exceeds the normal maximum of 5.0 mEq/L, adding more exogenous potassium would exacerbate the hyperkalemia. The nurse has a professional responsibility to recognize that the clinical indication for the supplement is currently absent and that administration could lead to severe physiological harm or death.