Which lab result would prompt a nurse to hold spironolactone for a client with left-sided heart failure?

• A. Potassium (K) 5.0 mEq/L
• B. Potassium (K) 6.2 mEq/L
• C. Potassium (K) 4.0 mEq/L
• D. Potassium (K) 3.5 mEq/L

Answer: (B)

Spironolactone is a potassium-sparing diuretic commonly prescribed for patients with left-sided heart failure to help reduce fluid overload while preserving potassium levels. However, one significant risk associated with this medication is hyperkalemia, which is an elevated level of potassium in the blood.

A potassium level of 6.2 mEq/L is indicative of hyperkalemia and is a critical threshold that requires immediate attention. High potassium levels can lead to severe cardiac complications, such as arrhythmias, which make it unsafe to administer spironolactone or any other medication that could further elevate potassium levels. Therefore, if a nurse identifies a potassium level of 6.2 mEq/L, it is essential to hold spironolactone and evaluate the patient's condition to prevent potential adverse effects.

In contrast, levels like 5.0 mEq/L, 4.0 mEq/L, and 3.5 mEq/L indicate potassium levels that are either within a normal range or slightly elevated without posing an immediate risk. While the normal upper limit can vary slightly among different guidelines, a potassium level above 5.0 mEq/L generally warrants caution but does not always necessitate withholding spironolactone unless it reaches