In reviewing prescriptions for a newly admitted client, which finding would be a priority to flow up with the physician?

• A. Flow up with the physician immediately when a client has a potassium level of 4.0 and Kayexalate prescribed
• B. Ignore the prescription since Kayexalate is not needed for a potassium level of 4.0
• C. Flow up only if the potassium rises above 6.0
• D. Document that Kayexalate was prescribed and proceed with routine care

Answer: (A)

This item tests prioritizing patient safety when a medication order doesn’t align with current lab data. Kayexalate is used to lower elevated potassium. A potassium level of 4.0 mEq/L is within the normal range, so issuing Kayexalate at that level isn’t indicated and could cause unnecessary side effects or an unwanted drop in potassium. The correct action is to immediately contact the physician to verify the order and reconcile the discrepancy before giving the medication.

Ignoring the order, waiting to see if potassium climbs higher, or simply documenting and proceeding with routine care would miss a potential medication error that could harm the patient. Safety steps like clarifying mismatched orders help prevent adverse events and ensure the treatment plan matches the patient’s current condition.