hypokalemia nursing diagnosis

NurseTogether.com does not provide medical advice, diagnosis, or treatment. Psychiatric Nursing . Encourage intake of carbohydrates and fats and low potassium food such as pineapple, plums, strawberries, carrots, cauliflower, corn, and whole grains.Reduces exogenous sources of potassium and prevents metabolic tissue breakdown with the release of cellular potassium. Hypokalemia nursing diagnosis Tips and Tricks From Doctors. 1. Cardiac enzymes are normal but his potassium level is 2.8 mmol/L. The patient is experiencing weakness, heart palpitations, and shortness of breath. Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-large-mobile-banner-2','ezslot_6',662,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-large-mobile-banner-2-0');Risk for decreased cardiac tissue perfusion related to severe potassium deficiency as evidenced by heart palpitations, tachycardia, and presence of PVCs. Ackley and Ladwigs Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning CareWe love this book because of its evidence-based approach to nursing interventions. Her nursing career has brought her through a variety of specializations, including medical-surgical, emergency, outpatient, oncology, and long-term care. Hyponatremia (decreased sodium in blood) OR hypernatremia (increased sodium in the blood) could be present depending on the types of fluid lost. Hypokalemia refers to a condition in which the concentration of Potassium in the blood is low. Various mechanisms promote the exit of potassium from cells or impede its entrance, thereby raising the plasma potassium concentration (redistributive hyperkalemia). A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented. Bounding pulses. 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. Hypokalemia is a side effect of diuretic administration and the patient is showing signs of dehydration. Administered when potassium levels need to be replenished, as well as, in patients with ongoing potassium loss when it must be maintained. ANTHONY J. VIERA, MD, MPH, AND NOAH WOUK, MD. 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. INTRODUCTION. Activity intolerance related to insufficient potassium to support regular body functions as evidenced by weakness, palpitations, and shortness of breath. The nerve impulses are created by the movement of sodium and potassium in and out the cells. Herdman, T., Kamitsuru, S. & Lopes, C. (2021). As a portion of daily potassium is excreted in the colon, lower GI losses in the form of persistent diarrhea can also result in hypokalemia and may be accompanied by hyperchloremic acidosis.6, Hypokalemia is often asymptomatic. This is commonly done through the administration of oral potassium supplement and high potassium diet. Prepare for and assist with dialysis.May be required when more conservative methods fail or are contraindicated such as severe heart failure. Lewiss medical-surgical nursing 2-Volume set: Assessment and management of clinical problems (11th ed., pp. 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). Your body needs potassium to function correctly. Intravenous calcium should be administered if hyperkalemic ECG changes are present. Hypokalemia is defined as a serum potassium level below 3.5 mEq/L. Inadequate or too much intake of potassium-rich food can alter the blood levels of potassium. Conditions such as alcoholism, eating disorders, and renal disorders can cause a severe case of hypokalemia. About 98% of the bodys potassium is found inside the cells and the rest is found extracellularly. For hypokalemia associated with diuretic use, stopping the diuretic or reducing its dosage may be effective.15 Another strategy, if otherwise indicated to treat a comorbid condition, is use of an angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB), beta blocker, or potassium-sparing diuretic because each of these drugs is associated with an elevation in serum potassium. Surgical intervention is required only with certain etiologies, such as the following: Renal artery stenosis Adrenal adenoma. Nonurgent hypokalemia is treated with 40 to 100 mmol of oral potassium per day over days to weeks. Diabetic ketoacidosis. Assess the patients neuromuscular status.Potassium is utilized by muscles to transmit electrical signals to the brain leading to muscle contraction. nursing diagnosis provided by NANDA nursing care plans for various nursing mental health and psychiatric nursing. Inhaled Beta Agonists. Administer a slow intravenous potassium solution as prescribed. Potassium helps in utilizing carbohydrates and protein to produce energy. Polyuria -potassium is mainly excreted through the kidneys. Please read our disclaimer. Instruct the client in the use of potassium-containing salts or salt substitutes, and taking potassium supplements safely.Prevention of hyperkalemia can be managed with diet, supplements, and other medications. 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. Because potassium can only be administered slowly and in small doses via a peripheral IV, a central line is recommended to correct hypokalemia more quickly. Your kidneys or adrenal glands don't work well. For more information, check out our privacy policy. Albuterol, a beta2 agonist, is an underutilized adjuvant for shifting potassium intracellularly.24,37 All forms of administration (i.e., inhaled, nebulized, and intravenous where available) are effective. Further evaluation may include measurement of serum glucose to evaluate for hyperglycemia, and measurement of serum renin, aldosterone, and cortisol to further investigate kidney and adrenal function. Medical-surgical nursing: Concepts & practice (3rd ed.). Therefore, potassium helps control the fluid inside the cell, while sodium . Include or limit potassium in the diet.Educate the patient on their prescribed diet depending on the condition. Gastric fluid contains little amount of potassium. Severe or symptomatic hypokalemia can be treated promptly with oral and IV potassium. Obtain ECG and observe signs of dysrhythmias.A potassium imbalance may result in alterations in ECG findings since potassium is essential for both depolarization (contraction) and repolarization (relaxation) of the heart. Position the patient therapeutically.Elevate the legs when hypotension occurs in hyperkalemia. 2. [Twitter moment] Retrieved from. Teach and assist the client with range-of-motion (ROM) exercises, as tolerated.Improves muscle tone and reduces muscle cramps and pain. Ignatavicius, MS, RN, CNE, ANEF, D. D., Workman, PhD, RN, FAAN, M. L., Rebar, PhD, MBA, RN, COI, C. R., & Heimgartner, MSN, RN, COI, N. M. (2018). These contents are not intended to be used as a substitute for professional medical advice or practice guidelines. Repeat measurement of serum potassium can help identify pseudohyperkalemia, which is common and typically results from potassium moving out of cells during or after sample collection.31 Other laboratory studies include measurement of serum blood urea nitrogen and creatinine, measurement of urine electrolytes and creatinine, and assessment of acid-base status. Hypokalemia is a serum potassium level less than 3.5 mEq/L or 3.5 mmol/L. By using any content on this website, you agree never to hold us legally liable for damages, harm, loss, or misinformation. It gets potassium through the food you eat. Potassium (K) is a major cation in intracellular fluid (ICF). The patient has a past medical history of heart failure and takes furosemide (Lasix) daily. Nurses Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. 5. Intravenous Calcium. Hyperkalemia secondary to decreased distal delivery of sodium and water occurs with congestive heart failure, cirrhosis, acute kidney injury, and advanced chronic kidney disease. These assessments allow the nurse to determine patients at the highest risk for falls to implement precautions. Electrocardiogram (ECG). Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are common causes of hyperkalemia. Some types of diuretics increase potassium excretion through the kidneys. Sodium polystyrene sulfonate (Kayexalate) may be effective in lowering total body potassium in the subacute setting. Renally mediated hyperkalemia results from derangement of one or more of the following processes: rate of flow in the distal nephron, aldosterone secretion and its effects, and functioning potassium secretory pathways. Hypokalemia can cause muscle weakness, paralysis, breathing and swallowing problems (because of muscle paralysis), and irregular heart rate in serious conditions. Blood test. Nursing Care Plans Nursing Diagnosis & Intervention (10th Edition)Includes over two hundred care plans that reflect the most recent evidence-based guidelines. 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. Inform the patient of the need to undergo dialysis, if indicated by the physician. 4. Increased plasma osmolality, such as with uncontrolled diabetes mellitus, establishes a concentration gradient wherein potassium follows water out of cells. Severe hyponatremia (<115 mEq/L) can cause confusion, seizures, coma, and death. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Carefully check the administration rate, with 2 nurses if needed. The normal blood potassium level is 3.5 5.0 mEq/L. F A Davis Company. Administer medications as ordered.Aldosterone receptor antagonists (such as spironolactone or eplerenone) can be used to treat mild hypokalemia. When severe, potassium disorders can lead to life-threatening cardiac conduction disturbances and neuromuscular dysfunction. Articles submitted here are original but are checked for minor typographical errors, and are formatted for site compatibility.This is a site that continuously improves and broadcasts healthcare information relevant to today's ever-changing world. It is also responsible for keeping the heartbeat regular and promotes the movement of nutrients into and waste out of the cells. Nursing care plans: Diagnoses, interventions, & outcomes. Continuous telemetry should be implemented when administering medications that affect cardiac status. Fluid loss from the body such as vomiting and diarrhea causes depletion of the electrolyte potassium partly because potassium is actually lost with gastric fluid. Comer, S. and Sagel, B. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. Inhibits renal potassium excretion, can ameliorate some of the hypokalemia that thiazide and loop diuretics can cause. Encourage frequent rest periods; assist with daily activities, as indicated.General muscle weakness decreases activity tolerance. The IV potassium can be given in a solution with normal saline . Other diagnostic tests that may be performed are as follows: Potassium replacement. The most common cause is excess loss from the kidneys or gastrointestinal tract. The infusion should be discontinued immediately if this occurs. Urinalysis can also show the presence of potassium in the urine. Furosemide is a potassium wasting diuretic but diuretics such as Spironolactone (Aldactone) or Amiloride (Midamor) are potassium-sparing diuretics. Here are two nursing diagnosis for hyperkalemia and hypokalemia nursing care plans: Hyperkalemia, an elevated level of potassium in the blood, can occur in patients with renal disease due to the kidneys reduced ability to excrete potassium, and in patients who have received massive blood transfusions due to the release of potassium from stored blood cells. 3. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. (See "Causes of hypokalemia in adults".). Too much or too little potassium in diet. Monitor urine output.In kidney failure, potassium is retained because of improper excretion. Apply visible fall prevention signage.Informing the patient and the caregiver about fall prevention measures will promote participation and lower the risk for falls. Possible causes of hypokalemia include the following: Possible causes of hyperkalemia include the following: Signs and symptoms of potassium imbalance include: To ensure proper functioning and homeostasis the body must maintain a dynamic equilibrium of fluids and electrolytes. During the treatment, however, low potassium may result due to the administration of insulin. Nursing Diagnosis: Electrolyte Imbalance related to hypokalemia as evidenced , serum potassium level of 2.9 mmol/L, polyuria, increased thirst, weakness, tachycardia, and fatigue Desired Outcome: Patient will be able to re-establish a normal electrolyte and fluid balance. With a critically low potassium level, the patient is at risk for ventricular arrhythmias. A potassium deficiency can result in shortness of breath, and in severe cases, can stop the lungs from working completely. Nursing Diagnosis: Deficient Knowledge related to new diagnosis of hyperkalemia as evidenced by patients verbalization of I want to know more about my new diagnosis and care. Views on topics do not generally reflect that of the entire community. Correction typically should not exceed 20 mmol per hour, although higher rates using central venous catheters have been successful in emergency situations.22 Continuous cardiac monitoring is indicated if the rate exceeds 10 mmol per hour. 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). Urine test. Because serum potassium concentration drops approximately 0.3 mEq per L (0.3 mmol per L) for every 100-mEq (100-mmol) reduction in total body potassium, the approximate potassium deficit can be estimated in patients with abnormal losses and decreased intake. Blood pressure medications. Volume depletion from vomiting, diarrhea, increased sweating, and excessive laxative use can all lead to hypokalemia. Nurses pocket guide: Diagnoses, interventions, and rationales (15th ed.). 1. Closely monitoring intake and output can help assess the patients current fluid status and will guide treatment. To replace potassium lost by the body. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. High potassium occurs due to lack of insulin. Nursing Care Plans The goal of nursing care is to restore and maintain normal potassium levels through monitoring and appropriate interventions. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Aphasia, muscle twitching, tremors, seizures. Low potassium diet include eating apples, berries, pineapple, breads, and cereals. Elsevier.

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