NCLEX-RNReduction of Risk PotentialMedium

A client receiving furosemide for heart failure reports leg cramps and generalized weakness. The serum potassium level is 2.9 mEq/L (normal 3.5–5.0 mEq/L). Which action should the nurse take?

  1. AInstruct the client to perform a Valsalva maneuver to slow the heart rate
  2. BEncourage the client to eat foods high in sodium
  3. CNotify the health care provider and anticipate an order for potassium replacement
  4. DRestrict the client's fluid intake to reduce swelling
Show answer & explanation

Correct answer: C. Notify the health care provider and anticipate an order for potassium replacement

A potassium level of 2.9 mEq/L is significantly below normal and places the client at risk for life-threatening cardiac dysrhythmias, especially with diuretic therapy. The nurse should notify the provider for potassium replacement and initiate cardiac monitoring.

Why the other options are wrong

  • A. Valsalva maneuver is unrelated to correcting hypokalemia and could trigger dysrhythmias.
  • B. Sodium intake does not address potassium loss and may worsen fluid retention in heart failure.
  • D. Fluid restriction does not correct the electrolyte imbalance.

Hypokalemia

Serum potassium below 3.5 mEq/L, often caused by diuretics, vomiting, or diarrhea, leading to muscle weakness and cardiac dysrhythmia risk.

  • Normal range: 3.5–5.0 mEq/L
  • Loop diuretics (e.g., furosemide) promote potassium loss
  • ECG changes include flattened T waves and U waves

Memory trick: Low K = Low energy, Weak muscles, Flat T waves

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