Tuesday, December 26, 2023

The nurse is caring for a client with a serum potassium level of 3.5 mEq/L. The client is placed on a cardiac monitor and receives 40 mEq KCL in 1000 ml of 5% dextrose in water IV

  


The nurse is caring for a client with a serum potassium level of 3.5 mEq/L.

The client is placed on a cardiac monitor and receives 40 mEq KCL in 1000 ml of 5% dextrose in water IV. Which of the following EKG patterns indicates to the nurse that the infusions should be discontinued?
  • A. Narrowed QRS complex
  • B. Shortened “PR” interval
  • C. Tall peaked “T” waves
  • D. Prominent “U” waves

Answer: C: Tall peaked T waves

A tall peaked T wave is a sign of hyperkalemia. The healthcare provider should be notified regarding discontinuing the medication.

The EKG pattern that indicates the nurse should discontinue the potassium infusion is: C. Tall peaked “T” waves.

Here's why:

- Potassium (K+):

Plays a crucial role in cardiac function, influencing the electrical activity of the heart.
Low potassium (hypokalemia): Can cause various EKG abnormalities, including widened QRS complex, prolonged PR interval, and flattened T waves.

- High potassium (hyperkalemia):

Can also cause EKG abnormalities, including tall peaked T waves, which are the most characteristic indicator.

- Infusion of potassium:

In this case, the client's potassium level is already low (3.5 mEq/L), and receiving 40 mEq KCL can further elevate it, potentially leading to hyperkalemia.

Therefore, the nurse should discontinue the infusion if the client shows tall peaked T waves on the EKG, as it signifies a potentially dangerous rise in potassium levels.

Here's a breakdown of the other options:

A. Narrowed QRS complex:

This is not a typical sign of hyperkalemia.

B. Shortened “PR” interval:

This is more commonly associated with hypokalemia.

D. Prominent “U” waves:

While these can be seen in some cases of hyperkalemia, they are not the most characteristic or reliable indicator.

Remember:

interpreting EKGs requires a comprehensive understanding of the patient's clinical context and other EKG findings. However, in this specific scenario, the presence of tall peaked T waves is a strong indication for discontinuing the potassium infusion and seeking further medical intervention.