Constipation low potassium levels (hypokalemia) can affect the intestinal muscles. Organ system dysfunction, such as life-threatening dysrhythmias, can occur when potassium is not balanced. Please follow your facilities guidelines and policies and procedures. Inhaled Beta Agonists. Administered when potassium levels need to be replenished, as well as, in patients with ongoing potassium loss when it must be maintained. There are subsets of patients that are susceptible to the development of hypokalemia. Low potassium (hypokalemia) refers to a lower than normal potassium level in your bloodstream. Hypokalemia Treatment & Management - Medscape You have diarrhea. Monitor urine output.In kidney failure, potassium is retained because of improper excretion. Nursing Care Plans The goal of nursing care is to restore and maintain normal potassium levels through monitoring and appropriate interventions. You vomit a lot. Treatment-related side effects such as cytotoxic drugs. The normal serum potassium level is between 3.5 to 5.2 mmoL/L. Eating disorders such as bulimia nervosa and anorexia nervosa can lead to deficits in potassium. Low Potassium Level Causes (Hypokalemia) - Cleveland Clinic This content is owned by the AAFP. How to Diagnose Fluid Volume Deficit: Signs and Care Plan - PrepScholar PO potassium can cause stomach upset so its best to administer with food or after meals. Surgical intervention is required only with certain etiologies, such as the following: Renal artery stenosis Adrenal adenoma. Saunders comprehensive review for the NCLEX-RN examination. 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. All the contents on this site are for entertainment, informational, educational, and example purposes ONLY. The infusion should be discontinued immediately if this occurs. Hypokalemia. Potential health risks are avoidable as long as the potassium levels are kept at a normal level. Symptoms usually develop at higher levels, 6.5 mEq/L to 7 mEq/L, but the rate of change is more important . 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. A blood test is performed to check the levels of electrolytes in the blood including potassium. 3. Review the patients current medications.Imbalanced potassium levels can be caused by drugs including diuretics, beta-blockers, and aminoglycosides. For example, a decline in serum potassium from 3.8 to 2.9 mEq per L (3.8 to 2.9 mmol per L) roughly corresponds to a 300-mEq (300-mmol) reduction in total body potassium. Buy on Amazon. Hypokalaemia ECG Changes. Educate the patient about the symptoms of hypokalemia. Encourage deep breathing and coughing exercise. Short-term goal: By the end of the shift the patient will experience a resolution of heart palpitations and shortness of breath, with no further PVCs seen on ECG.Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-leader-2','ezslot_8',642,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-leader-2-0'); Long-term goal: The patient will maintain a normal potassium level, monitoring for recurrent signs and symptoms of hypokalemia. Nursing care plans: Diagnoses, interventions, & outcomes. Strategies to prevent chronic hyperkalemia include instructing patients to eat a low-potassium diet, discontinuing or adjusting medications, avoiding nonsteroidal anti-inflammatory drugs, and adding a diuretic if the patient has sufficient renal function. Treatment of hyperkalemia. Her nursing career has brought her through a variety of specializations, including medical-surgical, emergency, outpatient, oncology, and long-term care. Patients with a serum glucose level of more than 250 mg per dL (13.9 mmol per L) typically do not require coadministration of glucose. 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. A 12-lead ECG is performed and shows sinus tachycardia with PVCs. 4. Herdman, T., Kamitsuru, S. & Lopes, C. (2021). Potassium is a main intracellular electrolyte. Used in the treatment of potassium deficiency when oral replacement is not feasible. Hypokalemia occurs when potassium falls below 3.6mmol/L and hyperkalemia occurs when potassium level in the blood is greater than 5.2mmol/L. Inform the healthcare team about the patients level of risk of falls.Effective communication among healthcare team members encourages collaboration and teamwork, which promotes the safety and prevention of fall incidents for the patient. Magnesium helps the movement potassium in and out the cells. Assess the patients readiness to learn, misconceptions, and blocks to learning (e.g. Although sodium bicarbonate is often used to treat hyperkalemia, the evidence to support this use is equivocal, showing minimal to no benefit.39 Therefore, sodium bicarbonate should not be used as monotherapy. Typically, 10 units of insulin are administered, followed by 25 g of glucose to prevent hypoglycemia.37 Because hypoglycemia is a common adverse effect even with the provision of glucose, serum glucose levels should be monitored regularly. Further replenishment can proceed more slowly, and attention can turn to the diagnosis and management of the underlying disorder.15 Patients with a history of congestive heart failure or myocardial infarction should maintain a serum potassium concentration of at least 4 mEq per L (4 mmol per L), based on expert opinion.15. Nursing Diagnoses Handbook: An Evidence-based Guide to Planning Care (12th ed.). About 98% of the bodys potassium is found inside the cells and the rest is found extracellularly. All Rights Reserved. Some medications can cause abnormal blood potassium levels. Other causes include certain medications and some adrenal and genetic conditions. Clinical features include muscle weakness and polyuria; cardiac hyperexcitability may occur with severe hypokalemia. Silvestri, L. A., Silvestri, A. E., & Grimm, J. Nursing Diagnosis: Risk for Decreased Cardiac Output. Potassium also maintains normal neuromuscular contraction by participation in the sodium-potassium pump. Diabetic ketoacidosis. Avoid using medical jargons and explain in laymans terms. 1. Treating these conditions involves monitoring and preventing hypo/hyperkalemia. Potassium regulates fluid and facilitates muscular contraction and nerve activity. Encourage physical therapy.Encourage participation in physical and occupational therapy sessions as ordered to regain strength and adapt to changes. When severe, potassium disorders can lead to life-threatening cardiac conduction disturbances and neuromuscular dysfunction. In response to acidosis, extracellular hydrogen is exchanged for intracellular potassium, although the net result is highly variable and depends in part on the type of acidosis; metabolic acidosis produces the greatest effect.26 Because 98% of total body potassium is intracellular, any process that increases cell turnover, such as rhabdomyolysis, tumor lysis syndrome, or red blood cell transfusions, can result in hyperkalemia. Hinkle, J. L., & Cheever, K. H. (2018). Dewit, S. C., Stromberg, H., & Dallred, C. (2017). Monitor respiratory rate and depth. Searches of PubMed, the Cochrane Database of Systematic Reviews, and the National Guideline Clearinghouse were completed using the key terms hypokalemia and hyperkalemia. 2697-2729). Wolters Kluwer India Pvt. List of NANDA Approved Nursing Diagnoses Nurse Hussein. Common concentrations are 20 mEq/100 ml over 1 hour or 40 mEq/100 ml over 2 hours. Hypokalemia nursing diagnosis Tips and Tricks From Doctors. Medication intake. Pills should not be crushed but can be dissolved in 3.8 ounces of cold water or juice. Hypokalemia means low blood potassium levels. You take medication that makes you pee ( water pills or diuretics) It's possible, but rare, to get . Chronic kidney disease, diabetes, heart failure, and liver disease all increase the risk of hyperkalemia. (2022). Place the patient on high potassium diet as per the physicians order. 4. As an Amazon Associate I earn from qualifying purchases. Studies suggest that some antibiotics can cause high potassium levels. Bananas, oranges, apricots, cooked spinach, potatoes, and mushrooms are all high in potassium. Also, large amounts of potassium found in the intestinal fluids are excreted during episodes of diarrhea. https://twitter.com/gitelmansuk/status/668416488211136512, Urinary Tract Infection Nursing Care Plan, Impaired concentrating ability Dizziness and fainting, Increased ammonia production Increased frequency in urination, Increased bicarbonate reabsorption extreme thirst, Altered sodium reabsorption seizure and coma, Hypokalemic nephropathy Unable to hold urine, Serum potassium levels less than 3.5 mEq/L, ECG changes- flat/inverted T waves, depressed ST segment, elevated U wave, Urinary potassium excretion test exceeding 20 mEq/day. Educate the patient about the role of potassium in the body. 4. If you continue to use this site we will assume that you are happy with it. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). To conclude, here we have formulated a scenario-based nursing care plan for Hypokalemia. Polyuria -potassium is mainly excreted through the kidneys. Nurses must closely monitor patients lab results and correct imbalances to prevent complications. Explain what hyperkalemia is, and how it affects the vital organs such as the kidneys and heart. Prepare for and assist with dialysis.May be required when more conservative methods fail or are contraindicated such as severe heart failure. Typically, the first ECG manifestation of hypokalemia is decreased T-wave amplitude. St. Louis, MO: Elsevier. Encourage the patient to stand up and reposition slowly to prevent faintness and falls. Here we will formulate sample Hypokalemia nursing care plans based on a hypothetical case scenario. Too much potassium supplementation can cause hyperkalemia. 4. Review the patients diet.Potassium levels can be influenced by the amount of potassium that is being consumed. a nursing problem (nursing diagnosis) is based upon the symptoms the patient is having and not solely on lab data.