Which client should the nurse assess first based on her condition?

• A. A client with chronic kidney disease who has a sodium level of 130 mEq/L.
• B. A client with hyperparathyroidism who has a calcium level of 11.0 mg/dL.
• C. A client with dehydration who has a potassium level of 6.0 mEq/L.
• D. A client with alcoholism who has a magnesium level of 1.6 mEq/L.

Answer: (C)

The rationale for prioritizing the client with dehydration and a potassium level of 6.0 mEq/L lies in the potential severity of hyperkalemia, which is defined as a potassium level greater than 5.0 mEq/L. In this case, the client’s potassium level is critically elevated at 6.0 mEq/L, which poses a serious risk for life-threatening cardiac dysrhythmias and other complications. It is imperative to assess this client first to monitor their cardiac status and potentially initiate treatment to lower their potassium levels, as this can have immediate and significant implications for their health.

In contrast, while the other patients have concerning lab values, they do not present the same immediate threat. The client with chronic kidney disease and a sodium level of 130 mEq/L is experiencing hyponatremia, which should be addressed, but it typically does not pose as urgent a risk as hyperkalemia. The client with hyperparathyroidism and a calcium level of 11.0 mg/dL is slightly elevated but may not require immediate intervention depending on their symptoms. Lastly, the client with alcoholism and a magnesium level of 1.6 mEq/L is also low, but, in the context of acute conditions,