NCLEX-PN® ExaminationReduction of Risk PotentialHard
An LPN is reviewing the laboratory results for a client with chronic kidney disease. Which finding is most important to report to the registered nurse (RN) or healthcare provider immediately?
- APotassium 6.2 mEq/L
- BCreatinine 2.0 mg/dL
- CHemoglobin 11.5 g/dL
- DBlood Glucose 140 mg/dL
Show answer & explanationAnswer & explanation
Correct answer: A. Potassium 6.2 mEq/L
A potassium level of 6.2 mEq/L is significantly elevated (hyperkalemia) and is a critical finding, especially in a client with chronic kidney disease. Severe hyperkalemia can lead to life-threatening cardiac arrhythmias and requires immediate medical intervention.
Why the other options are wrong
- B. Creatinine 2.0 mg/dL is elevated, consistent with chronic kidney disease, but it's a chronic indicator of kidney function, not an acute emergency requiring immediate report over hyperkalemia.
- C. Hemoglobin of 11.5 g/dL is slightly low but common in chronic kidney disease and not an immediate life-threatening concern.
- D. Blood glucose of 140 mg/dL is elevated but not critically high for immediate reporting unless the client has severe symptoms of hyperglycemia or is in a diabetic crisis.
Hyperkalemia
An elevated potassium level in the blood (typically >5.0 mEq/L), which can cause serious cardiac and neuromuscular complications.
- Common in kidney failure, acidosis, crush injuries, certain medications (e.g., ACE inhibitors)
- Symptoms: muscle weakness, fatigue, paresthesias, cardiac dysrhythmias
- Treatment: IV calcium gluconate, insulin/glucose, diuretics, potassium binders, dialysis
Memory trick: Don't Delay, Report Today!