A client with ESRD is scheduled for hemodialysis in one hour. The nurse should notify the physician if the client has which potassium level?

• A. 3.5
• B. 5.0
• C. 5.5
• D. 6.8

Answer: (D)

Potassium balance is critical in clients with end-stage renal disease because the kidneys can’t excrete excess potassium effectively. When hemodialysis is planned soon, a very high potassium level poses a real risk of dangerous heart rhythm problems during the procedure or beforehand. A potassium level of 6.8 mEq/L indicates severe hyperkalemia that requires urgent physician notification and likely immediate action, such as adjusting the dialysis plan or initiating pre-dialysis treatments to lower potassium. The other values are less urgent in this context: 3.5 is low but not acutely dangerous, and 5.0 or 5.5 are elevated yet typically managed with the upcoming dialysis or standard care rather than immediate intervention.