A nurse receives a laboratory report for a client indicating an elevated potassium (K+) level. When notifying the provider, the nurse should expect to perform which of the following actions first?

Choice A rationale An elevated potassium level (hyperkalemia), defined as serum potassium >5.0 mEq/L, can cause severe cardiac excitability changes, leading to peaked T waves, a widened QRS complex, and potentially life-threatening ventricular dysrhythmias, such as ventricular fibrillation. Initiating continuous cardiac monitoring is the most immediate priority action to promptly detect and manage these dangerous electrical instability changes. Choice B rationale Consulting with a dietician to adjust the diet is a non-pharmacological, long-term intervention for managing hyperkalemia. While essential for sustained management, this action does not address the immediate, life-threatening risk of cardiac dysrhythmias associated with an acute, elevated potassium level and is therefore not the first priority. Choice C rationale Instructing the client to avoid high-potassium foods like bananas is a component of dietary management, which is a key part of long-term care but not the immediate priority. Acute hyperkalemia requires prompt interventions to shift potassium back into cells or promote its excretion to protect the heart. The normal range for serum potassium is 3.5 to 5.0 mEq/L. Choice D rationale Initiation of IV fluids alone (like normal saline) is generally not the primary or most effective initial treatment for hyperkalemia. While sometimes used in conjunction with loop diuretics, definitive urgent treatment involves giving calcium gluconate to stabilize the myocardium, and then insulin/dextrose or albuterol to shift potassium into cells.