- Potassium loss-
- GI losses-d/v, fistulas, NG suction
- Renal losses-diuretics, hyperaldosteronism, magnesium depletion
- Skin losses-diaphoresis
- Shift of potassium into cells -
- Increased insulin (IV dextrose load), Alkalosis
- Tissue repair, increase in epinephrine (stress)
- Lack of potassium intake-Starvation, diet low in potassium, failure to include potassium in parenteral fluids in NPO.
Fatigue, muscle weakness, leg cramps, n/v, paralytic ileus, soft flabby muscles, paresthesias, decreased reflexes, weak irregular pulse, polyuria, hyperglycemia
Bradycardia, enhance digitalis effect, ventricular dysrhythmias.
- Nursing implementation:
- give potassium chloride-must always be diluted, NEVER give in IV push or in concentrated amounts, NEVER add to hanging IV bag to prevent giving bolus dose. Invert several times to ensure even distribution. Preferred max concentration is 40mEq/L. Rate of IV administration should not exceed 10-20mEq/L per hour and should be administered via infusion pump to ensure administration rate.
- Central IV lines shoud used when rapid correction of hypokalemia is necessary.