hypokalemia nursing diagnosis

The signs and symptoms of hypokalemia and hyperkalemia depend on how critical the potassium level is and how rapid the rise and fall in potassium levels happens: Hypokalemia and hyperkalemia typically happen as a result of another problem. 2. 4. Clinical manifestations of hypokalemia are typically seen only if the serum potassium is <3.0 mEq/L. Explain to the patient the relation of altered potassium levels to nausea and vomiting and loss of appetite. Potassium movement from extracellular to intracellular fluid due to: IV therapy with potassium-deficient solutions, Rapid infusion of potassium-containing IV solutions, Adrenal insufficiency (such as in Addisons disease), Potassium movement from intracellular to the extracellular fluid, Muscle weakness, leg cramps, deep tendon hyporeflexia, and paresthesias, ECG changes: ST depression, inverted T waves, and prominent U waves, Increased motility, hyperactive bowel sounds, and diarrhea, Ascending flaccid paralysis until the respiratory muscles become affected as a toxic level of serum potassium is reached, ECG changes: Tall peaked T waves, widened QRS complexes, and prolonged PR intervals, Conditions that affect the movement of potassium in the cellular space, Alterations in the electrical conductivity of the heart, Patient will demonstrate serum potassium levels within normal limits, Patient will verbalize the absence of muscle pain or cramping, Disruption in the electric functioning of the heart, Patient will display pulse and blood pressure within acceptable limits, Patient will verbalize the absence of angina or palpitations, Patient will demonstrate ECG results of normal sinus rhythm, Patient will be able to verbalize understanding of decreased cardiac output in relation to hypo/hyperkalemia, Patient will participate in physical therapy sessions, Patient will be able to maintain or regain muscle strength. The patient thought apples were high in potassium. Some blood pressure medications such as angiotensin-converting enzymes inhibitors, beta blockers, and angiotensin-receptor blocker are known to cause hyperkalemia. Studies suggest that some antibiotics can cause high potassium levels. Intravenous calcium, which helps prevent life-threatening conduction disturbances by stabilizing the cardiac muscle cell membrane, should be administered if ECG changes are present.24,25,35 Intravenous calcium has no effect on plasma potassium concentration. Common acute manifestations are muscle weakness and ECG changes. Educate the patient about hyperkalemia. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. A more practical approach is calculation of the urine potassium-to-creatinine ratio from a spot urine specimen; a ratio greater than 1.5 mEq per mmol (13 mEq per g) is indicative of renal potassium wasting.18 If no cause is identified with the initial workup, assessment of thyroid and adrenal function should be considered. Careful monitoring during treatment is essential because supplemental potassium is a common cause of hyperkalemia in hospitalized patients.21 The risk of rebound hyperkalemia is higher when treating redistributive hypokalemia. Significant leukocytosis (> 75,000 cells per mm, Acute kidney injury/chronic kidney disease, Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, Calcium chloride, 10 mL of 10% solution IV over 5 to 10 minutes, or calcium gluconate, 30 mL of 10% solution IV over 5 to 10 minutes, Stabilizes cardiac muscle cell membrane; no effect on serum potassium or total body potassium, May potentiate digoxin toxicity; calcium chloride can cause phlebitis and tissue necrosis, Regular insulin, 10 units IV followed immediately by 50 mL of 50% glucose (25 g) IV, Shifts potassium into cells; no effect on total body potassium, May cause hypoglycemia; glucose is unnecessary if serum glucose level is > 250 mg per dL (13.9 mmol per L); additive effect when combined with albuterol, Can cause tachycardia and thus should be used with caution in patients with underlying heart disease; potassium-lowering effect not reliable in all patients; additive effect when combined with insulin, Sodium polystyrene sulfonate (Kayexalate), Binds potassium in exchange for sodium; lowers total body potassium, Association with gastrointestinal complications, particularly when combined with sorbitol; should be avoided in patients at risk of abnormal bowel function. 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 is an essential mineral that is responsible for fluid balance, regulating nerve signals, and muscle contraction. The physical examination should focus on identifying cardiac arrhythmias and neurologic manifestations, which range from generalized weakness to ascending paralysis. 1 - 3 Hyperkalemia (serum potassium level. Potassium is an electrolyte needed primarily for muscle and nerve tissue function. A slow intravenous potassium solution is given to raise the potassium level in the blood stream. Hypokalemia refers to a condition in which the concentration of Potassium in the blood is low. Determine cardiovascular status.Heart dysrhythmias can result from an excess or deficit of potassium that disrupts the normal electric transmission of signals responsible for heart (myocardium) contraction. Encourage physical therapy.Encourage participation in physical and occupational therapy sessions as ordered to regain strength and adapt to changes. 5. Potassium disorders are common. Boiling potatoes and cutting vegetable sin small pieces are also recommended. Hypokalemia | Definition & Patient Education - Healthline This includes the heart muscle wherein when the potassium level is depleted abnormal heart waves are formed. There are subsets of patients that are susceptible to the development of hypokalemia. List of NANDA Approved Nursing Diagnoses Nurse Hussein. 3. A low serum potassium concentration is perhaps the most common electrolyte abnormality encountered in clinical practice. Assess the patients readiness to learn, misconceptions, and blocks to learning (e.g. Too much or too little potassium in diet. A blood test is performed to check the levels of electrolytes in the blood including potassium. Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal, usually greater than 5.0 mEq/L to 5.5 mEq/L. The oral potassium should be used in the dose 20-40 mEq three to four times a day (the lower dose is for patients receiving IV potassium, and the higher doses for patients receiving just the oral). Clinical features include muscle weakness and polyuria; cardiac hyperexcitability may occur with severe hypokalemia. When intravenous potassium is used, standard administration is 20 to 40 mmol of potassium in 1 L of normal saline. Potassium levels can fluctuate in the treatment of DKA. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. Administered when potassium levels need to be replenished, as well as, in patients with ongoing potassium loss when it must be maintained. Intravenous potassium should be reserved for patients with severe hypokalemia (serum potassium < 2.5 mEq per L [2.5 mmol per L]), hypokalemic ECG changes, or physical signs or symptoms of hypokalemia, or for those unable to tolerate the oral form. Neurologic signs of hypokalemia include generalized weakness and decreased deep tendon reflexes.11. F A Davis Company. Potassium also maintains normal neuromuscular contraction by participation in the sodium-potassium pump. Hyperkalemia - SlideShare Please read our disclaimer. Careful monitoring of fluid intake and output is necessary because 40 mEq of potassium is lost for every liter of urine. An ECG is performed to check heart rhythm. Saunders comprehensive review for the NCLEX-RN examination (9th ed.). Buy on Amazon, Silvestri, L. A. Anna Curran. Check for safety hazards in the patients environment.Assess the following environmental factors: 5. Review the patients current medications.Imbalanced potassium and the use of cardiac medications (used to treat dysrhythmias) greatly increase the risk for muscle weakness and potential falls. Searches of PubMed, the Cochrane Database of Systematic Reviews, and the National Guideline Clearinghouse were completed using the key terms hypokalemia and hyperkalemia. Magnesium helps the movement potassium in and out the cells. Silvestri, L. A., Silvestri, A. E., & Grimm, J. Indications for urgent treatment include severe or symptomatic hypokalemia or hyperkalemia; abrupt changes in potassium levels; electrocardiography changes; or the presence of certain comorbid conditions.

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