Which client is at highest risk for the development of a potassium value at the following level?
A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one clients laboratory report.
A. The client with colitis B. The client with Cushing s syndrome C. The client who has been overusing laxatives D. The client who has sustained a traumatic burn
Rationale: A serum potassium level higher than 5.1 mEq/L indicates hyperkalemia. Clients who experience cellular shifting of potassium in the early stages of massive cell destruction, such as with trauma, burns, sepsis, or metabolic or respiratory acidosis, are at risk for hyperkalemia. The client with Cushings syndrome or colitis and the client who has been overusing laxatives are at risk for hypokalemia.
Test-Taking Strategy: Use the process of elimination. Eliminate option A and C first because they are similar or alike, with both reflecting a gastrointestinal loss. From the remaining options, recalling that cell destruction causes potassium shifts will assist in directing you to the correct option. Remember that Cushings syndrome presents a risk for hypokalemia and that Addisons disease presents a risk for hyperkalemia. If you had difficulty with this question, review the risk factors associated with hyperkalemia.