Hyperkalemia & Hypokalemia Nursing Care Plans - Nurseslabs You have diarrhea. Hypokalemia | NEJM - New England Journal of Medicine The normal serum potassium concentration ranges from 3.5 to 5.0 mEq/L. Prevent sudden hypotension.Changes in blood potassium levels can cause hypotension due to decreased levels of aldosterone, vasopressin, and responsiveness to the effects of angiotensin II. 3. 4. Check renal function.Excess potassium can build up in the body if damaged kidneys are unable to eliminate it. Carefully check the administration rate, with 2 nurses if needed. Monitor respiratory rate and depth. Medical conditions can also cause abnormal potassium levels; therefore, treatment also includes correcting the main cause of abnormal potassium levels. Hypokalemia. Save my name, email, and website in this browser for the next time I comment. Peripherally potassium should be administered no faster than 10 mEq per hour. Common acute manifestations are muscle weakness and ECG changes. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively sample clinical applications, prioritized action/interventions with rationales a documentation section, and much more! The majority of potassium is stored in the intracellular compartment. To provide information on hyperkalemia and its pathophysiology in the simplest way possible. Monitor for signs and symptoms of hypokalemia: Assist client in selecting foods rich in potassium as such as banana, fruit juices, melon, citrus fruits,and fresh vegetables. Dewit, S. C., Stromberg, H., & Dallred, C. (2017). Potassium is an important electrolyte for nerve and muscle cell functioning, especially for muscle cells in the heart. Relative insulin deficiency or insulin resistance, which also occurs in persons with diabetes, prevents potassium from entering cells. Neurologic signs of hypokalemia include generalized weakness and decreased deep tendon reflexes.11. The patient says: Ive been on Lasix for years now so I know what to expect, but I still think Ive been urinating more than usual. He also reports thirst and constipation, but he was careful not to drink excess water because of his heart failure. Now, my body feels very weak., Vomitus of yellowish fluid approximately 70 cc times three episodes for two days, Diarrhea; Watery stools times 4 episodes for two days, Presence of an elevated U wave on ECG result, Altered electrolyte balance related to active fluid loss secondary to vomiting and diarrhea. a nursing problem (nursing diagnosis) is based upon the symptoms the patient is having and not solely on lab data. Including the client in the plan of care elicits participation. Volume depletion from vomiting, diarrhea, increased sweating, and excessive laxative use can all lead to hypokalemia. St. Louis, MO: Elsevier. Hypokalemia results from abnormal losses, transcellular shifts, or insufficient intake (Table 1).68 Abnormal losses are most common.9 Because the kidney can significantly lower potassium excretion in response to decreased intake, insufficient intake is rarely the sole cause of hypokalemia, but it often contributes to hypokalemia in hospitalized patients.9, Diuretic use is a common cause of renally mediated hypokalemia.10 When given in the same dosage, chlorthalidone is more likely to induce hypokalemia than hydrochlorothiazide, which is more often implicated because of its widespread use.11,12 Diuretic-induced hypokalemia is dose-dependent and tends to be mild (3 to 3.5 mEq per L [3 to 3.5 mmol per L]), although it can be more severe when accompanied by other causes (e.g., gastrointestinal [GI] losses).13, GI losses are another common cause of hypokalemia, particularly among hospitalized patients.9 The mechanism by which upper GI losses induce hypokalemia is indirect and stems from the kidney's response to the associated alkalosis. Patients with chronic hyperkalemia should be counseled to reduce dietary potassium. Nurses pocket guide: Diagnoses, interventions, and rationales (15th ed.). Potassium Disorders: Hypokalemia and Hyperkalemia | AAFP Hypokalemia. Causes of potassium loss include: Alcohol use (excessive) Chronic kidney disease. Eating disorders such as bulimia nervosa and anorexia nervosa can lead to deficits in potassium. Therefore, potassium helps control the fluid inside the cell, while sodium . The rapidity and method of potassium repletion depends on the: Nursing diagnosis:- Potential for dysrrythmia r/t hyperkalemia. (1998). Nursing interventions for hyperkalemia patients aim to prevent life-threatening cardiac dysrhythmias by reducing serum potassium levels through a combination of medication administration, dietary management, and monitoring. Clinical features include muscle weakness and polyuria; cardiac hyperexcitability may occur with severe hypokalemia. 2. His temperature is 37.4 C, heart rate is 122 beats per minute, blood pressure is 142/84 mmHg, respirations are 20 breaths per minute, and oxygen saturation is 98% on room air. Potassium levels can fluctuate in the treatment of DKA. Potassium is a main intracellular electrolyte. Normal Potassium Level 3.5-5.1 ( 2.5 or less is very dangerous) Most of the body's potassium is found in the intracellular part of the cell (inside of the cell) compared to the extracellular (outside of the cell), which is where sodium is mainly found.
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