Difficulty: Medium
Average Score: 95%
Simulated
The client diagnosed with a fluid and electrolyte disturbance in the emergency department is exhibiting peaked T waves on the STAT electrocardiogram. Which interventions should the nurse implement? List in order of priority.
Correct answer
B,C,E,D,A
Rationale
Peaked T waves indicate hyperkalemia. Priority: 1) Check potassium level to confirm; 2) Notify HCP for orders; 3) Administer Kayexalate to lower potassium; 4) Transfer to telemetry for monitoring; 5) Assess cramps, a less urgent symptom.