NCLEX-RNPharmacological and Parenteral TherapiesEasy
A client with a history of heart failure is prescribed furosemide 40 mg PO daily. The nurse notes the client's serum potassium level is 3.2 mEq/L. Which action should the nurse take FIRST?
- AEncourage the client to consume potassium-rich foods immediately.
- BAdminister the furosemide as prescribed and notify the provider.
- CWithhold the furosemide and notify the provider.
- DAdminister a potassium supplement and then the furosemide.
Show answer & explanationAnswer & explanation
Correct answer: C. Withhold the furosemide and notify the provider.
Furosemide is a loop diuretic that can cause hypokalemia. A serum potassium level of 3.2 mEq/L is below the normal range (3.5-5.0 mEq/L) and administering furosemide would further decrease it, potentially leading to dangerous cardiac arrhythmias. Therefore, the nurse should withhold the medication and notify the provider.
Why the other options are wrong
- A. While consuming potassium-rich foods is beneficial, it is not an immediate solution for an already low potassium level and does not address the immediate risk of administering furosemide.
- B. Administering furosemide would worsen hypokalemia, increasing the risk of cardiac arrhythmias.
- D. A potassium supplement requires a provider's order, and administering it without one is outside the nurse's scope of practice. Also, it might not be safe to administer furosemide even after a supplement without provider guidance.
Furosemide and Hypokalemia
Furosemide, a loop diuretic, promotes potassium excretion, increasing the risk of hypokalemia (low potassium). Administering furosemide to a client with existing hypokalemia can exacerbate the condition and lead to life-threatening arrhythmias.
- Furosemide is a loop diuretic.
- It causes potassium excretion.
- Hypokalemia can lead to cardiac arrhythmias.
- Normal serum potassium is 3.5-5.0 mEq/L.
Memory trick: Furosemide flushes, but don't flush out potassium first!