A nurse is caring for a client who is receiving IV dextrose 5% in 0.9% sodium chloride at 75 mL/hr. When the nurse checks the client's IV bag at 0700, 300 mL remain in the bag.

At what time should the nurse hang a new bag of IV fluid? (Use the military format, four-digit number to enter the time.)

Choice A rationale:

Checking for a positive Chvostek’s sign is not relevant. This sign is associated with hypocalcemia, not with the lab values provided.

Choice B rationale:

The nurse should request a potassium replacement. The normal range for potassium is 3.5-5.0 mEq/L. A level of 3.0 mEq/L is low, indicating hypokalemia.

Choice C rationale:

Administering glucagon IM is not appropriate. The glucose level is within the normal range (70-110 mg/dL), so there is no need for glucagon.

Choice D rationale:

Discontinuing the TPN infusion is not the first action. The nurse should address the abnormal lab value (low potassium) first.

Choice A rationale:

Discarding any partial doses found in the cabinet in the sharps container is not the correct procedure. Partial doses should be wasted in the presence of another nurse.

Choice B rationale:

Verifying that the amounts of each medication counted match the amounts on the inventory record is the correct procedure. This ensures accurate accounting of controlled substances.

Choice C rationale:

Setting aside any controlled substances the nurse plans to give during her shift is not the correct procedure. Medications should be removed from the secure cabinet as needed.

Choice D rationale:

Co-signing any notations of wasting controlled substances on the previous shift is not the correct procedure. Wasting should be witnessed and co-signed at the time it occurs.