The nurse practitioner determines that a patient is experiencing serious complications from high potassium levels—what should be the first action taken?

When faced with serious complications from high potassium levels, such as hyperkalemia, the immediate priority is to stabilize the cardiac function. High potassium can cause life-threatening conditions like cardiac arrhythmias, and calcium gluconate acts to protect the myocardium by reducing the excitability of the heart muscle and stabilizing its electrical activity. Administering calcium gluconate is an essential step to minimize the risk of potential cardiac arrest resulting from elevated potassium levels.

In this scenario, while informing the physician is important and may occur simultaneously, the critical nature of hyperkalemia necessitates immediate intervention to protect the patient’s heart. Starting CPR would only be warranted if the patient were in cardiac arrest, which is a more advanced step following stabilization efforts. Communicating with the family, while essential for overall care and transparency, does not address the immediate life-threatening nature of the hyperkalemic crisis. Thus, calcium gluconate is the first line of action to afford the patient the best chance of avoiding severe complications.