A nurse prepares to interpret the ABG values of a client diagnosed with an acid-base imbalance. Which values are most important for the nurse to consider? (Select 4 options that apply.)

Rationale:
A. Cool, moist skin is typically seen in conditions like shock or anxiety, not dehydration. Dehydrated clients often have dry, warm skin.
B. Urine output of 20 mL/hr is below the normal minimum (about 30 mL/hr) and is a common sign of dehydration as the body conserves fluid.
C. Sodium of 142 mEq/L is within the normal range (135–145 mEq/L) and does not indicate dehydration by itself.
D. Bradycardia (low heart rate) is not typical in dehydration. Instead, the body usually responds with tachycardia to compensate for low fluid volume.

Rationale:

A. Mix with a dextrose solution only: Potassium can be mixed in various compatible solutions (such as 0.9% NS or D5½NS). There is no requirement that potassium chloride must be mixed only with dextrose-containing fluids.

B. Administer as a rapid IV push: This is dangerous and contraindicated. IV potassium must never be given as a rapid IV push or bolus, as it can cause fatal cardiac arrhythmias. It must be diluted and administered slowly.

C. Monitor for signs of hypernatremia: While electrolyte monitoring is important, hypernatremia is not the main concern when administering potassium. The nurse should focus on monitoring potassium levels and cardiac status.

D. Ensure the infusion is diluted and given via an IV pump: IV potassium chloride must always be diluted in an appropriate IV fluid and administered via an infusion pump to control the rate and avoid complications such as arrhythmias and vein irritation. Also, the infusion rate should typically not exceed 10 mEq/hr through a peripheral vein.