The nurse is assessing a client who is one hour post percutaneous valvuloplasty via a left groin site. Which intervention does the nurse consider the priority?

a. Serum potassium 3.1 mEq/L (3.5-5.0 mEq/L): Furosemide (a loop diuretic) can cause potassium loss (hypokalemia). A potassium level of 3.1 mEq/L is below the normal range, and administering Furosemide could further decrease potassium levels. The nurse should question giving the medication and consider potassium supplementation.

b. Patient reports abdominal pain:Abdominal pain is not directly related to Furosemide administration. While it's essential to assess the cause of pain, it doesn't specifically impact the decision to administer Furosemide.

c. Patient does not have a foley catheter: The absence of a foley catheter is not a contraindication for Furosemide administration. It's unrelated to the medication's safety or effectiveness.

d. Blood pressure 132/70: The blood pressure reading falls within a normal range. Furosemide is commonly used to manage hypertension and fluid overload in heart failure patients. This blood pressure reading does not raise concerns about administering Furosemide.

a. Urinary output 275ml over the last 8 hours: While urinary output is an important parameter to monitor, especially in post-operative patients, a urinary output of 275ml over 8 hours is within an acceptable range. It is important to ensure adequate renal perfusion and urine output, but this finding does not raise immediate concerns.

b. Hemoglobin 14g/dl (12-16 g/dl): A hemoglobin level of 14g/dl is within the normal range and does not indicate any immediate issues with oxygen-carrying capacity or blood loss. While it is important to monitor hemoglobin levels post-operatively, this finding does not require immediate action.

c. Heart rate 110 and irregular: A heart rate of 110 beats per minute (bpm) and irregular rhythm is concerning, especially in a post-operative patient who recently underwent valve replacement surgery. An irregular heart rate could indicate cardiac dysrhythmias, which may be related to the surgery or underlying cardiac issues. This finding warrants further evaluation and may require intervention, making it a priority for the nurse to report to the healthcare provider.

d. Oral temperature 99.2°F: An oral temperature of 99.2°F is slightly elevated but is not significantly outside the normal range. While fever can indicate infection, post-operative patients can have mild elevations in temperature due to the inflammatory response to surgery. Unless accompanied by other signs of infection or instability, this finding may not be a priority for immediate reporting.