The nurse is caring for a newly admitted patient who has severe gastroenteritis. The patient's electrolytes reveal a serum sodium level of 140 mEq/L and a serum potassium level of 3.5 mEq/L
The nurse receives an order for intravenous 5% dextrose and normal saline with 20 mEq/L potassium chloride to infuse at 125 mL per hour. Which action is necessary prior to administering this fluid?
a. Evaluate the patient's urine output.
b. Contact the provider to order arterial blood gases.
c. Request an order for an initial potassium bolus.
d. Suggest a diet low in sodium and potassium.
ANS: A
If the patient is receiving potassium and the urine output is <25 mL/hr or <600 mL/d, potassium accumulation may occur. Patients with a low urine output should not receive IV potassium. Arterial blood gases are not necessary prior to IV potassium administration. Potassium should never be given as a bolus. Patients should be put on a potassium-enriched diet when foods are tolerated.
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