A nurse is caring for a client with severe hypokalemia. The provider places an order for IV potassium chloride (KCI) 60 mEq x1 now. Which action should the nurse take when caring for this client?

Discontinue cardiac monitoring during the infusion.

Administer KCI as a rapid IV bolus.

Only give the KCI via a central venous line.

Infuse the KCI at a rate of 10 mEq/hour.

Answer and Explanation

The Correct Answer is C

A) Discontinue cardiac monitoring during the infusion:

Discontinuing cardiac monitoring during the infusion of potassium chloride is unsafe. Potassium infusions can significantly impact cardiac function, so continuous cardiac monitoring is necessary to detect any arrhythmias or other complications.

B) Administer KCI as a rapid IV bolus:

Administering potassium chloride as a rapid IV bolus is contraindicated due to the risk of severe adverse effects, including cardiac arrest. Potassium should be infused slowly to avoid complications.

C) Only give the KCI via a central venous line:

Potassium chloride is ideally administered through a central venous line because it is irritating to veins and can cause damage if given through a peripheral line. A central line reduces the risk of irritation and allows for safer infusion of potassium.

D) Infuse the KCI at a rate of 10 mEq/hour:

Infusing potassium chloride at a rate of 10 mEq/hour is generally too slow for an emergency situation requiring immediate correction of severe hypokalemia. For more urgent cases, higher rates may be required, but only under strict medical supervision to avoid complications.

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Correct Answer is C

Explanation

A) Dysphagia: While dysphagia (difficulty swallowing) can occur in individuals with long-term alcohol use, especially if there is coexisting neurological damage or esophageal disorders, it is not specifically associated with vomiting and diarrhea in the context of this scenario. The primary concern here involves electrolyte imbalances.

B) Hypoactive deep tendon reflexes (DTR): Hypoactive DTRs are typically associated with hypermagnesemia rather than hypomagnesemia. In this case, the client's condition is more likely to lead to electrolyte deficiencies, including hypomagnesemia, due to vomiting, diarrhea, and poor nutritional intake.

C) Hypomagnesemia: Chronic alcohol use often results in nutritional deficiencies, and vomiting and diarrhea can further exacerbate this by depleting electrolytes. Hypomagnesemia is a common finding in long-term alcoholics due to poor dietary intake, gastrointestinal losses, and renal losses. This can lead to symptoms such as muscle weakness, tremors, and altered mental status. Hypomagnesemia is particularly concerning because it can affect cardiovascular stability and neuromuscular function.

D) Positive Chvostek sign: A positive Chvostek sign is indicative of hypocalcemia, which can occur secondary to hypomagnesemia. However, it is not as directly associated with chronic alcoholism as hypomagnesemia itself. The positive Chvostek sign involves a facial muscle spasm in response to tapping the facial nerve and indicates neuromuscular irritability due to low calcium levels. While related, the primary electrolyte imbalance expected here is hypomagnesemia.

A. Hyperactive bowel sounds B. Increased blood clots C. Hyperactive deep tendon reflexes D. Positive Chvostek’s sign

Correct Answer is B

Explanation

A) Hyperactive bowel sounds: Hypercalcemia typically leads to decreased gastrointestinal motility, not increased. Clients with elevated calcium levels may experience constipation, abdominal pain, or ileus due to the relaxing effect of calcium on smooth muscle. Therefore, hyperactive bowel sounds are not a common finding in hypercalcemia.

B) Increased blood clots: Hypercalcemia can promote a hypercoagulable state, increasing the risk of thromboembolic events. This occurs because high calcium levels can enhance platelet aggregation and increase the coagulability of blood. Therefore, a client with elevated serum calcium may have an increased risk of developing blood clots.

C) Hyperactive deep tendon reflexes: Hypercalcemia generally leads to reduced neuromuscular excitability, which may manifest as decreased or absent deep tendon reflexes, muscle weakness, and lethargy. Hyperactive reflexes are more commonly associated with hypocalcemia, which causes increased neuromuscular excitability.

D) Positive Chvostek’s sign: Chvostek's sign is a clinical indicator of hypocalcemia, not hypercalcemia. It involves twitching of the facial muscles in response to tapping the facial nerve and is due to increased neuromuscular excitability caused by low calcium levels. Hypercalcemia, conversely, does not typically present with a positive Chvostek’s sign.

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﻿A nurse is caring for a client with severe hypokalemia. The provider places an order for IV potassium chloride (KCI) 60 mEq x1 now. Which action should the nurse take when caring for this client?

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