# A client with kidney failure has a potassium level of 6.4 mEq/L. Which finding requires immediate action?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=394118&lang=en  
> language: en  
> subject: Illness Management  
> category: PA

## Question

A client with kidney failure has a potassium level of 6.4 mEq/L. Which finding requires immediate action?

## Option

1. Tall peaked T waves on the cardiac monitor **✔ Correct answer**
2. Warm dry skin and normal bowel sounds
3. Mild thirst after breakfast
4. A healed scar on the forearm

**Correct answer: 1**

## Explanation

Hyperkalemia can cause life-threatening dysrhythmias, and tall peaked T waves are a concerning ECG change. Immediate provider notification and treatment are needed. The other findings are not priority indicators of dangerous hyperkalemia.

## In-depth explanation

Clinical Judgment
High potassium becomes urgent when the heart shows electrical instability.

Memory Tip
Hyperkalemia peaks the T wave.

## Clinical scenario

Clinical Practice Guide
Hyperkalemia care includes cardiac monitoring, repeat labs when appropriate, medication review, and rapid treatment for ECG changes.

Caution
Do not wait for symptoms when ECG changes are present.

## Key concepts

- **Hyperkalemia** — A high serum potassium level that can cause dangerous dysrhythmias.
- **Peaked T Wave** — A tall narrow T wave that can occur with hyperkalemia.
- **Dysrhythmia** — An abnormal heart rhythm.

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