A client with intestinal obstruction has a nasogastric tube to low intermittent suction and is receiving an intravenous (IV) infusion of lactated Ringer’s at 100 mL/hour.
Which finding is most important for the nurse to report to the healthcare provider? Reference Range: Potassium (3.5 to 5 mEq/L (3.5 to 5 mmol/L).
A.
24-hour intake at the current infusion rate.
B.
Serum potassium level of 3.1 mEq/L (3.1 mmol/L).
C.
Gastric output of 900 mL in the last 24 hours.
D.
Increased blood urea nitrogen (BUN).
E.
Increased blood urea nitrogen (BUN).
The correct answer and Explanation is :
The most important finding for the nurse to report to the healthcare provider is:
B. Serum potassium level of 3.1 mEq/L (3.1 mmol/L).
Explanation:
- Serum Potassium Level:
- Normal Range: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L).
- Clinical Significance: A serum potassium level of 3.1 mEq/L is below the normal range and indicates hypokalemia. Potassium is crucial for proper muscle and nerve function, and imbalances can lead to serious complications such as arrhythmias, muscle weakness, and impaired cardiac function. Given that the client is on a nasogastric tube and likely losing potassium through gastric secretions, it is critical to address this imbalance promptly.
- 24-hour Intake:
- This finding provides information on fluid balance but is less immediately critical compared to electrolyte imbalances. While important for assessing hydration status, it does not address the acute risks associated with electrolyte disturbances.
- Gastric Output:
- Gastric output of 900 mL in the last 24 hours indicates significant gastric secretions, but the focus should be on the electrolyte status rather than output alone. This output, combined with a low potassium level, could be contributing to the hypokalemia but is not as urgent to report immediately as the potassium level itself.
- Increased BUN:
- Increased blood urea nitrogen (BUN) may suggest dehydration or kidney dysfunction. While this finding can be important, it is less urgent than addressing a dangerously low potassium level. Elevated BUN needs to be assessed, but hypokalemia poses immediate risks to the client’s health that need urgent intervention.
In summary, hypokalemia (serum potassium level of 3.1 mEq/L) is a critical finding that needs to be reported immediately to the healthcare provider because of its potential to cause severe and life-threatening complications.