A client with Congestive heart failure is about to take a dose of furosemide (Lasix). Which of following potassium levels, if noted in client’s record, should be reported before giving due medication?

Correct Answer: D. 3.3 mEq/L.

The normal potassium level is 3.5 to 5.5 mEq/L. Low potassium levels can be dangerous, especially for people with CHF. Low potassium can cause fatal heart arrhythmias. An abnormal serum K+ level is associated with an increased risk of ventricular arrhythmia and sudden cardiac death (SCD) and these patients are generally prescribed furosemide and potassium chloride (KCl).

• Option A: Furosemide, a short-acting diuretic is commonly recommended as an essential drug in patients with heart failure and fluid retention. A recent study has shown that furosemide administration increases mortality in heart failure rat models. The commonly used drugs, furosemide, and KCl in the treatment of various diseases render the differential expression of proteins in the LV tissue, which is involved in the cardiac conductivity.
• Option B: The risk of hypokalemia increases with the use of a high dose of furosemide, decreased oral intake of potassium in patients with hyperaldosteronism states (liver abnormalities or licorice ingestion), or concomitant use of corticosteroid, ACTH, and laxatives.
• Option C: Careful monitoring of the patient’s clinical condition, daily weight, fluids intake, and urine output, electrolytes, i.e., potassium and magnesium, kidney function monitoring with serum creatinine and serum blood urea nitrogen level is vital to monitor the response to furosemide. If indicated as diuresis with furosemide, replete electrolytes lead to electrolyte depletion and adjust the dose or even hold off on furosemide if laboratory work shows signs of kidney dysfunction.