Question

The nurse just received an urgent laboratory value on a patient in renal failure. The potassium level is 6.3. The telemetry monitor is showing peaked T waves. Which prescription from the primary health care provider should be implemented first?

A. Administer regular insulin intravenously (IV)
B. Restrict dietary potassium intake to 40 meq daily
C. Administer kayexalate enema
D. Educate the patient on dietary restriction of potassium

Answer 1

To treat a patient with hyperkalemia and peaked T waves urgently, the initial action should be to administer regular insulin intravenously, as it swiftly helps decrease high serum potassium levels by driving it into cells.

Step-by-step explanation:

Given the urgent laboratory value indicating a patient in renal failure has a high potassium level of 6.3 mEq/L, combined with the presence of peaked T waves on the telemetry monitor, immediate treatment is critical to reduce the risk of life-threatening complications such as cardiac arrhythmias.

The most appropriate initial prescription to implement among the options given would be to administer regular insulin intravenously (IV). This is because insulin facilitates the uptake of glucose into the cells, which is accompanied by potassium, helping to lower serum potassium levels quickly by moving it from the extracellular fluid (ECF) into the intracellular fluid (ICF). This action may help to prevent the abnormal electrical activity seen in hyperkalemia that can lead to cardiac arrest.