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Front
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Back
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Hypokalemia Causes
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Use of non-potassium spearing diuretics - Diarrhea
- Vomiting
- Inadequate intake of potassium
- Excessive gastric suction
- Excessive fistula drainage
- Cushing's syndrome
- Chronic use of corticosteroids
- Renal disease
- Parenteral nutrition
- Uncontrolled diabetes
- Alkalosis
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- Renal Failure
- Intestinal Obstruction
- Cell Damage
- Excessive oral or parenteral administration of potassium
- Metabolic Acidosis
- Addison's Disease
- Excessive use of Potassium based salt substitutes
- Transfusion of stored blood (the breakdown of older red blood cells releases potassium)
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- Leg and Abdominal Cramps
- Lethargy and Weakness
- Shallow Respirations and thready pulse
- confusion
- Decreased or absent Reflexes
- Hypoactive bowel sounds and ileus
- Postural Hypotension
- Peaked P waves, Flat T Waves, Depressed ST Segment and U Waves
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- Muscle Weakness
- Paresthesis
- Hypotension
- Diarrhea
- Hyperactive Bowel Sounds
- Wide Flat P waves; Widened QRS Complex; Prolonged PR Interval; depressed ST Segment; and narrow, peaked T Waves
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Potassium Common Food Sources
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- Avocados
- Bananas
- Cantaloupes
- Carrots
- Fish
- Mushrooms
- Oranges
- Potatoes
- Pork, Beef, and Veal
- Raisins
- Spinach
- Strawberries
- Tomatoes
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Interventions for Hypokalemia
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- Monitor vital signs
- Monitor neuromuscular activity
- Monitor I&O
- Check Renal Function before administering Potassium
- Administer Potassium supplements as prescribed (orally or monitor by IV)
- Oral Potassium chloride has an unpleasant taste and should be taken with juice or other desired liquid.
- Oral Potassium preparations can cause GI Irritation and should not be taken on an empty Stomach
- If the client complains of abdominal Pain, distention, nausea, vomiting, diarrhea, or GI bleeding, the oral potassium may need to be discontinued.
- When potassium is added to an IV Solution shake the bag, and invert it to ensure that the potassium is evenly distributed.
- An IV bolus injection of concentrated potassium is never administered; it is always diluted.
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Interventions for Hyperkalemia
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- Monitor Vital Signs
- Monitor for Cardiac Changes
- Decrease Potassium Intake
- Administer Potassium-excreting diuretics as prescribed
- Monitor I&O
- Monitor Laboratory Values
- Emergency Treatment includes the rapid IV Administration of dextrose with regular Insulin to move excess potassium into the cells
- Administer Sodium polystyrene sulfonate (Kayexalate) orally or by enema as prescribed, which releases sodium ions in exchange for primarily potassium ions and absorbs the potassium into the GI tract for excretion.
- Monitor for Calcium and Magnesium loss when using Kayexalate
- Monitor Renal Function
- Prepare for peritoneal dialysis or hemodialysis as prescribed.
- When blood transfusions are prescribed for a client with a potassium imbalance the client should receive fresh blood, If possible; transfusions of stored blood may elevate the potassium level, because the breakdown of older blood cells release potassium.
- Instruct the client to avoid foods high in potassium
- Instruct the client to avoid the use of salt substitutes or other potassium-containing substances.
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- Fluid Intake or retention exceeds the bodys fluid needs
- Also called over hydration or fluid overload
- The goals of treatment are to restore fluid balance; to correct electrolyte imbalances, if present; and to eliminate or control the underlying cause of the overload
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Fluid Volume Excess: Data Collection
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- Cough & Dyspnea
- Lung Crackles
- Increased Respirations & HR
- Increased BP and bounding pulse
- Pitting Edema
- Weight Gain
- Neck and Hand Vein Distention
- Decreased Hematocrit Level
- Confusion
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Fluid Volume Excess: Interventions
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- Monitor Vital SIgns
- Position Client in Semi-Fowlers position
- Check fro Edema
- Monitor I&O
- Monitor Weight
- Administer Diuretics as prescribed
- Monitor hematocrit and electrolyte Levels
- Restrict fluids as prescribed
- Provide a low-sodium diet as prescribed
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- Dehydration in which the body fluid's intake is not sufficient to meet the body's fluid needs
- The goal of treatment is to restore fluid volume, replace electrolytes as needed, and eliminate the cause of the fluid volume deficit.
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Fluid Volume Deficit Causes
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- Vomiting and/or diarrhea
- Continuous GI irrigation
- GI suctioning
- Ileostomy or colostomy drainage
- Draining wounds, burns, or fistulas
- Increased urine output from the use of diuretics
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Fluid Volume Deficit: Data Collection
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- Thirst
- Poor SKin Turgor and dry mucous membranes
- INcreased HR, thread pulse, and postural hypotension
- Rappid Weight Loss
- Flat NEck or hanf VEins
- Dizziness or Weakness
- Decrease in urine volume and dark concentrated URine
- Increased specific Gravity of the Urine
- Confusion
- Increased Hematocrit Level
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Fluid Volume Deficit: Interventions
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- The cause of the fluid volume deficit is treated, and fluids are replaced (lactated Ringers Solution, 0.9% Normal Saline) as prescribed.
- Monitor Vital Signs
- Check mucous membranes and skin turgor
- Monitor weight daily
- Monitor I&O
- Test Urine for specific gravity
- Monitor hematocrit and electrolyte levels
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