A nurse is caring for a female client at risk for renal failure and has reviewed the latest lab results. Which assessment finding warrants further action?

A nurse is caring for a female client at risk for renal failure and has reviewed the latest lab results. Which assessment finding warrants further action?

• A. Hemoglobin 12 g/dL (120 g/L)
• B. Hematocrit 38% (0.38)
• C. Potassium levels of 5.2 mEq/L (5.2 mmol/L)
• D. BUN of 15 mg/dL (5.35 mmol/L)

Answer: (C)

Potassium balance is tightly linked to kidney function. When the kidneys aren’t working well, potassium isn’t excreted efficiently, so levels can rise and affect the heart’s electrical activity. A potassium level of 5.2 mEq/L is above the normal upper limit (about 3.5–5.0), and in a patient at risk for renal failure this elevation flags a potential issue that requires action to prevent arrhythmias or further deterioration.

This finding should prompt closer assessment: repeat the electrolyte test to confirm, obtain an ECG to look for early signs of hyperkalemia such as tall, peaked T waves or broader changes in conduction, and review medications that can raise potassium (like ACE inhibitors, ARBs, potassium-sparing diuretics, and certain NSAIDs). It’s also prudent to evaluate acid-base status and renal function, and consider dietary potassium restrictions or specific treatments if potassium remains elevated or rises further (for example, measures to lower potassium or adjust therapies).

The other values listed—hemoglobin 12 g/dL and hematocrit 38%—are within or near typical ranges for many adults, and the BUN 15 mg/dL is normal, so they do not indicate an immediate need for intervention in this context.