NCLEX-RNPharmacological and Parenteral TherapiesEasy
A nurse receives an order to administer potassium chloride 20 mEq IV for a client with hypokalemia. Which action is essential for safe administration of this high-alert medication?
- AMix the potassium chloride with the client's next scheduled IM injection
- BAdminister the full dose as a single IV bolus without dilution
- CAdminister the dose as a rapid IV push over 1-2 minutes
- DDilute the potassium chloride and infuse it via an IV pump at the prescribed rate
Show answer & explanationAnswer & explanation
Correct answer: D. Dilute the potassium chloride and infuse it via an IV pump at the prescribed rate
Potassium chloride is a high-alert medication that must never be given as an IV push or bolus due to the risk of fatal cardiac arrhythmias. It must always be diluted appropriately and infused slowly via an IV pump, typically not exceeding 10 mEq/hour peripherally.
Why the other options are wrong
- A. Potassium chloride is not administered intramuscularly and should never be mixed this way.
- B. Undiluted bolus administration is never appropriate and is extremely dangerous.
- C. IV push administration of potassium chloride can cause fatal cardiac arrest.
IV Potassium Chloride Safety
Potassium chloride is a high-alert drug that must always be diluted and administered via infusion pump; IV push administration can cause fatal arrhythmias.
- Never administer KCl as IV push or bolus
- Maximum peripheral infusion rate typically 10 mEq/hour
- Always use an infusion pump and cardiac monitoring for higher concentrations
Memory trick: 'K+ pushed fast can stop the heart'