Editing Pharmacology – RN Practice Questions (section)

==Question 6==
A client has a serum potassium of 2.8 mEq/L. The provider orders potassium chloride 40 mEq. Which order should the nurse question?
# Potassium chloride 40 mEq in 500 mL normal saline intravenously over 4 hours through a peripheral line
# Potassium chloride 40 mEq orally in divided doses with food
# Potassium chloride 40 mEq intravenous push over 5 minutes
# Potassium chloride 40 mEq in 250 mL normal saline through a central line over 4 hours with continuous cardiac monitoring

'''Answer:''' 3 (C) Potassium chloride 40 mEq intravenous push over 5 minutes.

''Rationale:'' Concentrated potassium chloride is '''never''' given by intravenous push; doing so causes fatal cardiac arrest. Potassium must always be diluted and infused by pump, generally not faster than 10 mEq per hour peripherally, with higher rates only through central access in a monitored setting per policy. Options 1, 2, and 4 are all acceptable routes and rates. The nurse should also verify adequate urine output before administering potassium.