Before adding potassium chloride to the maintenance IV fluids of a hospitalized child, which condition must be confirmed?

• A Serum potassium below 3.5 mEq/L on two samples
• B Adequate urine output or confirmed normal renal function ✓
• C Completion of the first 48 hours of admission
• D Serum sodium restored to the normal range

Explanation

Potassium must not be added to IV fluids until urine output is established or renal function is known to be normal, because impaired potassium excretion produces life-threatening hyperkalemia and cardiac arrhythmia. Serum potassium alone does not predict how the kidney will handle an added load, so option A is insufficient. Timing of admission and the sodium level have no bearing on this safety rule.

Reference: Nelson Textbook of Pediatrics, 22nd ed.

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Written and medically reviewed by the StethoPrep medical team.