A client has a pyloric obstruction and reports sudden muscle weakness. What action by the nurse takes priority?
a. Document the findings in the chart.
b. Request an electrocardiogram (ECG).
c. Facilitate a serum potassium test.
d. Place the client on bedrest.
ANS: B
Pyloric stenosis can lead to hypokalemia, which is manifested by muscle weakness. The nurse first obtains an ECG because potassium imbalances can lead to cardiac dysrhythmias. A potassium level is also warranted, as is placing the client on bedrest for safety. Documentation should be thorough, but none of these actions takes priority over the ECG.
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