Potassium also maintains normal neuromuscular contraction by participation in the sodium-potassium pump. A blood test is performed to check the levels of electrolytes in the blood including potassium. Potassium helps carry electrical signals to cells in your body. A detailed medication list is vital as abnormal potassium levels can be caused by certain medications. Symptoms usually develop at higher levels, 6.5 mEq/L to 7 mEq/L, but the rate of change is more important . Severe hyponatremia (<115 mEq/L) can cause confusion, seizures, coma, and death. Hypokalemia can be life-threatening. Patients receiving digitalis should be monitored closely for signs of digitalis toxicity because hypokalemia potentiates the action of digitalis. Bananas, spinach, broccoli, and some fish are high in potassium. It should ideally be done at the same time and same method (standing, bed weight, etc.) Also, large amounts of potassium found in the intestinal fluids are excreted during episodes of diarrhea. The nerve impulses are created by the movement of sodium and potassium in and out the cells. Encourage deep breathing and coughing exercise. Muscular cramps or twitching hyperkalemia or high potassium levels in the blood can cause alteration in the voltage of the nerve cells causing unregulated muscle contractions. By using any content on this website, you agree never to hold us legally liable for damages, harm, loss, or misinformation. Here are some nursing interventions for patients with hyperkalemia: 1. 9. Potential health risks are avoidable as long as the potassium levels are kept at a normal level. 3. How to Diagnose Fluid Volume Deficit: Signs and Care Plan - PrepScholar Administer medications as ordered.Aldosterone receptor antagonists (such as spironolactone or eplerenone) can be used to treat mild hypokalemia. The IV potassium can be given in a solution with normal saline . Apply visible fall prevention signage.Informing the patient and the caregiver about fall prevention measures will promote participation and lower the risk for falls. If administering IV, infuse secondarily to a compatible IV solution such as 0.9% normal saline to minimize burning at the IV site. Buy on Amazon, Silvestri, L. A. Volume depletion from vomiting, diarrhea, increased sweating, and excessive laxative use can all lead to hypokalemia. Nursing Diagnoses Handbook: An Evidence-based Guide to Planning Care (12th ed.). There are different types of test and diagnosis for hypokalemia disease, those are given in the below: S. Electrolytes / Potassium, Magnesium, Calcium, Phosphorous, TSH, Aldosterone, ECG, . 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. This may lead to serious heart problems, heart attack or death. Furosemide is a potassium wasting diuretic but diuretics such as Spironolactone (Aldactone) or Amiloride (Midamor) are potassium-sparing diuretics. High potassium occurs due to lack of insulin. Diuretics. Figure 3 is an algorithm for the management of hyperkalemia, and Table 322,30,36 summarizes medications used in the treatment of the condition. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. (1998). Here are two nursing diagnosis for hyperkalemia and hypokalemia nursing care plans: Hyperkalemia: Risk for Electrolyte Imbalance Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2006). Evaluation begins with a search for warning signs or symptoms warranting urgent treatment (Figure 1).7,14 These include weakness or palpitations, changes on electrocardiography (ECG), severe hypokalemia (less than 2.5 mEq per L [2.5 mmol per L]), rapid-onset hypokalemia, or underlying heart disease or cirrhosis.7,15 Most cases of hypokalemia-induced rhythm disturbances occur in individuals with underlying heart disease.10 Early identification of transcellular shifts is important because management may differ. The patient is tachycardic and PVCs are noted on ECG. Potassium pills are quite large if the patient has a difficult time swallowing, consider potassium powder or IV administration. (fatigue) NURSING DIAGNOSIS Hypokalemia RATIONALE Potassium is essential for many body functions. Evaluation of hypokalemia - Differential diagnosis of symptoms | BMJ Nursing care plans: Diagnoses, interventions, & outcomes. Potassium is mainly excreted in the kidneys. Treatment-related side effects such as cytotoxic drugs. A risk for diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred and nursing interventions are aimed at prevention. Surgical intervention is required only with certain etiologies, such as the following: Renal artery stenosis Adrenal adenoma. The most common cause is excess loss from the kidneys or gastrointestinal tract. Obtain daily blood sample from the patient. 4. Inform him/her the target range for serum potassium levels. While mild hyperkalemia is usually asymptomatic, high potassium levels may cause life-threatening cardiac arrhythmias, muscle weakness, or paralysis. Volume depletion is typically accompanied by increased potassium excretion in the kidneys. if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[468,60],'nurseship_com-large-mobile-banner-1','ezslot_4',646,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-large-mobile-banner-1-0'); The patient is admitted to the hospital for Hypokalemia. Saunders comprehensive review for the NCLEX-RN examination (9th ed.). Hypokalemia Article - StatPearls Other recommended site resources for this nursing care plan: Other nursing care plans related to endocrine system and metabolism disorders: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Matt Vera, a registered nurse since 2009, leverages his experiences as a former student struggling with complex nursing topics to help aspiring nurses as a full-time writer and editor for Nurseslabs, simplifying the learning process, breaking down complicated subjects, and finding innovative ways to assist students in reaching their full potential as future healthcare providers. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are common causes of hyperkalemia. Wolters Kluwer India Pvt. Nursing Diagnosis: Acute Confusion Related to: Dehydration Electrolyte imbalance Impaired metabolism Urinary retention As evidenced by: Cognitive dysfunction The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. She has more than 10 years of clinical and teaching experience and worked as a licensed Nursing Specialist in JCI-accredited hospitals in the Middle East. Potassium is an electrolyte needed primarily for muscle and nerve tissue function. Please read our disclaimer. Medical-surgical nursing: Concepts for interprofessional collaborative care. 2697-2729). Hyperkalemia can result from taking potassium chloride or salt substitutes. 4. Hypokalemia Disease with Causes, Symptom and Nursing Intervention Interprofessional patient problems focus familiarizes you with how to speak to patients. 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. Implement safety measures when administering IV potassium.Because IV potassium infusion can cause phlebitis as a complication, the nurse should regularly check the IV site for indications of phlebitis or infiltration. Here we will formulate sample Hypokalemia nursing care plans based on a hypothetical case scenario. Cardiac enzymes are normal but his potassium level is 2.8 mmol/L. Administer the following drugs, as prescribed: Also, potassium-rich foods in the diet help maintain potassium balance. Hyperkalemia-induced ventricular fibrillation is treated with calcium. 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. Common acute manifestations are muscle weakness and ECG changes. It is also needed in the formation of muscles in the body. We use cookies to ensure that we give you the best experience on our website. Hypokalemia and Hyperkalemia are conditions that refer to abnormal levels of potassium in the blood. 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. Hypokalemia means low blood potassium levels. Stress the importance of the clients notifying future caregivers when a chronic condition potentiates the development of hyperkalemia, such as oliguric renal failure.May help prevent hyperkalemia recurrences. However, we aim to publish precise and current information. 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. 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! Hypokalemia is a side effect of diuretic administration and the patient is showing signs of dehydration. Monitor urine output.In kidney failure, potassium is retained because of improper excretion. Clinicians should review patients' medications to identify those known to cause hyperkalemia, and ask patients about the use of salt substitutes that contain potassium. To treat the kidney disease if this is the underlying cause of hyperkalemia. Potassium levels should be closely monitored during repletion, making sure the level is rising but does not exceed 4.0 mmol/L. Potassium levels can fluctuate in the treatment of DKA. Nursing Care Plans The goal of nursing care is to restore and maintain normal potassium levels through monitoring and appropriate interventions. Causes of potassium loss include: Alcohol use (excessive) Chronic kidney disease. Too much potassium supplementation can cause hyperkalemia. 5. Centrally potassium can be administered more quickly and in larger doses via this route. Medication intake. Monitor pulse rate and blood pressure.Hyperkalemia can cause irregular pulse rates and reduces blood artery wall tension which lowers blood pressure. Treat underlying conditions.Potassium imbalances can be caused by kidney disease, diabetes, alcoholism, Addisons disease, and more. Inadequate or too much intake of potassium-rich food can alter the blood levels of potassium. 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. 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. P. otassium functions to maintain fluid balance, to regulate nerve signals, and to help with muscle contractions. Diuretics (water retention relievers) Excessive laxative use. Monitor heart rate and rhythm. Elsevier. 6. Common concentrations are 20 mEq/100 ml over 1 hour or 40 mEq/100 ml over 2 hours. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Hyperaldosteronism Nursing Diagnosis and Nursing Care Plan Assess the level of consciousness and neuromuscular function, including sensation, strength, and movement.The client is usually conscious and alert; however, muscular paresthesia, weakness, and flaccid paralysis may occur.
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