A client with acute renal injury (AKI) weighs 110.3 pounds (50 kg) and has a potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?

Reference Range:
Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

a) The client's age: The client is 70 years old, which puts her at a higher risk of having a stroke or other cardiovascular problems. Stroke is a medical emergency that requires prompt treatment to prevent brain damage and disability.

b) The client's facial droop: The client has a noticeable facial droop, which is a sign of facial nerve weakness or paralysis. This can be caused by a stroke, Bell's palsy, or other neurological conditions. Facial droop can affect the client's ability to speak, eat, and express emotions.

c) The client's garbled speech: The client has garbled speech, which means she has difficulty producing or understanding words. This can be caused by a stroke, brain injury, or other disorders that affect the language areas of the brain. Garbled speech can impair the client's communication and cognition.

d) The client's alcohol consumption: The client had a few drinks at a seafood restaurant, which may have interacted with her medications or medical conditions. Alcohol can increase the risk of bleeding, lower blood pressure, and worsen dehydration. Alcohol can also impair the client's judgment and coordination.

e) The client's seafood intake: The client ate seafood at a restaurant, which may have triggered an allergic reaction or food poisoning. Seafood allergies can cause symptoms such as hives, swelling, breathing difficulties, and anaphylaxis. Food poisoning can cause symptoms such as nausea, vomiting, diarrhea, and dehydration.

1. The client is most likely experiencing compartment syndrome, which is a condition where increased pressure within a closed space compromises blood flow and tissue perfusion. Compartment syndrome can occur after a fracture, especially if a cast or splint is applied too tightly. Some of the signs and symptoms of compartment syndrome are severe pain, paresthesia, pallor, and pulselessness.
2. Two actions the nurse should take to address compartment syndrome are:
   • Elevate the extremity above the level of the heart to reduce swelling and improve venous return.
   • Remove the cast or loosen the dressing to relieve the pressure and restore blood flow. This may require notifying the physician or obtaining an order for bivalving or cutting the cast.
3. Two parameters the nurse should monitor to assess the client’s condition are:
   • Capillary refill of the affected fingers, which should be less than 3 seconds. A prolonged capillary refill indicates poor perfusion and tissue ischemia.
   • Blood pressure of the client, which should be maintained within normal limits. Hypotension can worsen the perfusion deficit and lead to tissue necrosis.