hypokalemia nursing diagnosis

In general, hypokalemia is associated with diagnoses of cardiac disease, renal failure, malnutrition, and shock. Patients receiving digitalis should be monitored closely for signs of digitalis toxicity because hypokalemia potentiates the action of digitalis. 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. Insulin causes potassium to shift inside the cell which can lower potassium levels. Clinicians should review patients' medications to identify those known to cause hyperkalemia, and ask patients about the use of salt substitutes that contain potassium. It may have a role as adjuvant therapy, particularly among patients with concurrent metabolic acidosis.24,39,40, Potassium can be removed via the GI tract or the kidneys, or directly from the blood with dialysis. 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. Hypokalemia is often caused by an excessive loss of potassium in your digestive tract due to vomiting, diarrhea or laxative use. 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. Typically, the first ECG manifestation of hypokalemia is decreased T-wave amplitude. Furosemide Nursing Considerations - NurseStudy.Net Priority nursing diagnoses allnurses. If after five minutes, follow-up ECG continues to show signs of hyperkalemia, the dose should be repeated.37 Clinicians should be aware that intravenous calcium has a short duration, ranging from 30 to 60 minutes. Hyperkalemia affects this process therefore causing inadequate nerve impulses to signal the heart muscles to contract properly causing arrhythmia and palpitations. Administer medications as ordered.Aldosterone receptor antagonists (such as spironolactone or eplerenone) can be used to treat mild hypokalemia. 2. 3. Potassium is an important electrolyte for nerve and muscle cell functioning, especially for muscle cells in the heart. To give the patient enough information on hypernatremia and its effects to the body. Nursing Care Plans Nursing Diagnosis & Intervention (10th Edition)Includes over two hundred care plans that reflect the most recent evidence-based guidelines. Risk for falls associated with potassium imbalance is caused by a disruption in the electric signals in muscles resulting in muscle weakness, cramping, hyporeflexia, and paralysis. Position the patient therapeutically.Elevate the legs when hypotension occurs in hyperkalemia. Medication use is a common cause of hyperkalemia, particularly in patients with baseline renal dysfunction or hypoaldosteronism.27 Medication-induced hyperkalemia is most often a result of the medication interfering with potassium excretion. Too much or too little potassium in diet. Hypokalemia is serum potassium concentration < 3.5 mEq/L (< 3.5 mmol/L) caused by a deficit in total body potassium stores or abnormal movement of potassium into cells. For both disorders, it is important to consider potential causes of transcellular shifts because patients are at increased risk of rebound potassium disturbances. IV fluids with added potassium would be appropriate for dehydrated and hypokalemic patients, or if the patient required ongoing diuretic administration despite low potassium. Concomitant hypomagnesemia should be treated concurrently. There are subsets of patients that are susceptible to the development of hypokalemia. The most common cause is excess loss from the kidneys or gastrointestinal tract. Nursing Diagnosis: Risk for Hypernatremia Potentially Related To Dehydration Severe diarrhea Fever Vomiting Poorly controlled diabetes Certain medications Kidney disease Diabetes insipidus Extensive burns Evidenced By Extreme thirst Fatigue Headache Nausea Lethargy Confusion Muscle twitching or spasms Seizures Coma Desired Outcomes An ECG is performed to check heart rhythm. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. High alcohol intake. Hypokalemia (serum potassium level less than 3.6 mEq per L [3.6 mmol per L]) occurs in up to 21% of hospitalized patients and 2% to 3% of outpatients.13 Hyperkalemia (serum potassium level more than 5 mEq per L [5 mmol per L] in adults, more than 5.5 mEq per L [5.5 mmol per L] in children, and more than 6 mEq per L [6 mmol per L] in neonates) occurs in up to 10% of hospitalized patients and approximately 1% of outpatients.4,5 The body's plasma potassium concentration is closely regulated by a variety of mechanisms. Copyright 2015 by the American Academy of Family Physicians. Avoid using medical jargons and explain in laymans terms. Medical conditions can also cause abnormal potassium levels; therefore, treatment also includes correcting the main cause of abnormal potassium levels. 6. Monitor pulse rate and blood pressure.Hyperkalemia can cause irregular pulse rates and reduces blood artery wall tension which lowers blood pressure. and, i didn't A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Other laboratory tests include serum glucose and magnesium levels, urine electrolyte and creatinine levels, and acid-base balance. 3. Our website services and content are for informational purposes only. Nursing interventions for hyperkalemia patients aim to prevent life-threatening cardiac dysrhythmias by reducing serum potassium levels through a combination of medication administration, dietary management, and monitoring. Provide fresh blood or washed red blood cells (RBCs), if transfusion is indicated.Fresh blood has less potassium than banked blood because the breakdown of older RBCs releases potassium. Boiling potatoes and cutting vegetable sin small pieces are also recommended. Distended neck and peripheral veins. Muscular weakness can affect respiratory muscles and lead to respiratory complications. Identify the client at risk or the cause of the hyperkalemia such as excessive intake of potassium or decreased excretion.Early identification and intervention can avoid complications. Nursing assessment for hyperkalemia patients focuses on monitoring for signs and symptoms of life-threatening cardiac dysrhythmias, as well as identifying and addressing the underlying cause of hyperkalemia. 10 Electrolyte Imbalance Nursing Diagnosis & Care Plans The combination of furosemide and beta-blocker may reduce blood pressure and decrease heart rate. A more recent article on potassium disorders is available. Certain antibiotics. Insulin and Glucose. Potassium is important in regulating the osmolarity of ECF by exchanging it with sodium. Studies suggest that some antibiotics can cause high potassium levels. Excessive alcohol intake is known to reduce potassium levels. Insulin and glucose . There is an additive effect when albuterol is combined with insulin.38 Albuterol's potassium-lowering effect is mitigated in some patients, particularly those with end-stage kidney disease; therefore, albuterol should not be used as monotherapy.30, Sodium Bicarbonate. 5. If you continue to use this site we will assume that you are happy with it. Hypokalemia | Definition & Patient Education - Healthline Sodium polystyrene sulfonate (Kayexalate) may be effective in lowering total body potassium in the subacute setting. Hyperaldosteronism Nursing Diagnosis and Nursing Care Plan 2. Urine test. We use cookies to ensure that we give you the best experience on our website. Create a daily weight chart and a food and fluid chart. (fatigue) NURSING DIAGNOSIS Hypokalemia RATIONALE Potassium is essential for many body functions. 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. Hyperkalemia - SlideShare After 1 hour of health teaching, the client will be able to: Identify measures to prevent hypokalemia. 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). 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. Assess the patients neuromuscular status.Potassium is utilized by muscles to transmit electrical signals to the brain leading to muscle contraction. Diuretics. Hypokalemia is treated with oral or intravenous potassium. Nursing Diagnoses Handbook: An Evidence-based Guide to Planning Care (12th ed.). The diagnosis should be confirmed with a repeat serum potassium measurement. This indicates depletion in the normal potassium levels in the body, a potential life-threatening emergency and can be fatal. A history of paralysis, hyperthyroidism, or use of insulin or beta agonists suggests possible transcellular shifts leading to redistributive hypokalemia. Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed., pp. It is advised to dilute the solution no more than 1 mEq/10 mL (1 mmol/10 mL). 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. If able to eat and drink, administer PO potassium. Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client CareIdentify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Therefore, potassium helps control the fluid inside the cell, while sodium . Hyperkalemia (Nursing) - StatPearls - NCBI Bookshelf Her nursing career has brought her through a variety of specializations, including medical-surgical, emergency, outpatient, oncology, and long-term care. 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. Hypokalemia Treatment & Management - Medscape Potassium levels should be closely monitored during repletion, making sure the level is rising but does not exceed 4.0 mmol/L. Activity intolerance related to insufficient potassium to support regular body functions as evidenced by weakness, palpitations, and shortness of breath. Learn how your comment data is processed. Nanda Nursing Diagnosis List Mental Health Hyperkalemia - forums.usc.edu Be aware that cardiac arrest can occur.Potassium excess depresses myocardial conduction. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Disclosure: Included below are affiliate links from Amazon at no additional cost from you. Deficient knowledge related to diuretic side-effects and hypokalemia as evidenced by the patient thinking apples were high in potassium. 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. 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. 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. Volume depletion. Hypokalemia can be life-threatening. The patients lung sounds are clear. 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. Intravenous Calcium. Comer, S. and Sagel, B. Hyponatremia (decreased sodium in blood) OR hypernatremia (increased sodium in the blood) could be present depending on the types of fluid lost. Potassium is mainly excreted in the kidneys. It is also needed in the formation of muscles in the body. Monitor strict intake and output.Monitor urine output as well as bowel movements. If the patient is on diuretics regimen, switch to potassium-sparing diuretics as prescribed. Hypokalemia is generally defined as a serum potassium level of less than 3.5 mEq/L (3.5 mmol/L). 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. 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. Nurses must closely monitor patients lab results and correct imbalances to prevent complications. Rapid correction is possible with oral potassium; the fastest results are likely best achieved by combining oral (e.g., 20 to 40 mmol) and intravenous administration.22. 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. Also, the administration of potassium to treat or prevent hypokalemia can inadvertently cause hyperkalemia.19, ACE inhibitors contributed to one-half of all cases of drug-induced hyperkalemia in one sample, and approximately 10% of outpatients who start an ACE inhibitor or an ARB will develop hyperkalemia within one year.23,28 The incidence of hyperkalemia associated with use of potassium-sparing diuretics has risen since adding spironolactone to standard therapy was shown to reduce morbidity and mortality in patients with congestive heart failure.29 Dual treatment with an ACE inhibitor and an ARB increases the risk of harmful adverse effects, including hyperkalemia, and should be avoided.11 Other commonly used medications known to cause hyperkalemia include trimethoprim, heparin, beta blockers, digoxin, and nonsteroidal anti-inflammatory drugs.3, As with hypokalemia, the immediate danger of hyperkalemia is its effect on cardiac conduction and muscle strength, and initial efforts should focus on determining the need for urgent intervention (Figure 2).14,30 The absence of symptoms does not exclude severe hyperkalemia, because hyperkalemia is often asymptomatic. Figure 3 is an algorithm for the management of hyperkalemia, and Table 322,30,36 summarizes medications used in the treatment of the condition. ECG should be considered if the potassium level is greater than 6 mEq per L; if there are symptoms of hyperkalemia; if there is suspicion of rapid-onset hyperkalemia; or among patients with underlying kidney disease, heart disease, or cirrhosis who have a new case of hyperkalemia. Desired Outcome: The patient will be able to achieve a weight within his/her normal BMI range, demonstrating healthy eating patterns and choices. 2. For more information, check out our privacy policy. Hypokalemia means low blood potassium levels. To provide a more specialized care for the patient in terms of nutrition and diet in relation to the electrolyte imbalance. About 98% of the bodys potassium is found inside the cells and the rest is found extracellularly. nursing diagnosis provided by NANDA nursing care plans for various nursing mental health and psychiatric nursing. Hemolysis or breakdown of red blood cells, Rhabdomyolysis or the breakdown of muscle tissues, Burns, trauma, and other tissue injuries can also cause the release of potassium from the cells. Some of the potassium ions are lost when vomiting occurs. Hypokalemia is a side effect of diuretic administration and the patient is showing signs of dehydration. Bananas, oranges, apricots, cooked spinach, potatoes, and mushrooms are all high in potassium. (1998). Hyperkalemia & Hypokalemia (Potassium Imbalances) Nursing Care Plans, Hyperkalemia: Risk for Electrolyte Imbalance, Hypokalemia: Risk for Electrolyte Imbalance, All-in-One Nursing Care Planning Resource E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health, Nursing Care Plans (NCP): Ultimate Guide and Database, Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing, Fluid Balance: Hypervolemia & Hypovolemia, Potassium (K) Imbalances: Hyperkalemia and Hypokalemia, Sodium (Na) Imbalances: Hypernatremia and Hyponatremia, Magnesium (Mg) Imbalances: Hypermagnesemia and Hypomagnesemia, Calcium (Ca) Imbalances: Hypercalcemia and Hypocalcemia, Hypervolemia & Hypovolemia (Fluid Imbalances) Nursing Care Plans, Hypermagnesemia & Hypomagnesemia (Magnesium Imbalances) Nursing Care Plans. Occasionally, low potassium is caused by not getting enough potassium in your diet.

Metv Spring 2021 Schedule, Multifamily Construction Costs 2021, Dempsey Funeral Notices Kilrea, Static Using Voicemeeter, Leicester City Council Timesheet, Articles H