A patient on loop diuretics has muscle weakness and flattened T waves on ECG. What is the priority intervention?

• A. Increase fluid intake to dilute potassium.
• B. Administer potassium replacement per protocol and monitor potassium and ECG.
• C. Stop loop diuretics permanently.
• D. Administer sodium bicarbonate.

Answer: (B)

Hypokalemia from loop diuretics presents with muscle weakness and ECG changes such as flattened T waves. The priority is to restore potassium to safe levels and watch the response to prevent dangerous arrhythmias. Administer potassium replacement per protocol and monitor potassium levels and the ECG closely to ensure the patient is repleted safely and to catch any signs of overcorrection. This directly addresses the deficit causing symptoms and rhythm changes. Increasing fluids won’t correct the electrolyte problem and could worsen balance; stopping the diuretic permanently isn’t appropriate without a plan to manage the underlying volume status and potassium loss; giving sodium bicarbonate isn’t indicated for hypokalemia and could cause unnecessary shifts.