electrolytes imbalance

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  1. what is hypokalemia
    when potassium level is lower than 3.5

    normal range 3.5-5.0
  2. physical assessment / clinical manifestations of hypokalemia
    musculoskeletal and respiratory
    Musculoskeletal - skeletal muscle weakness, hyporeflexia of deep tendon reflexes and flaccid paralysis (feel tired and weak)

    Respiratory - Shallow, ineffective respirations accompanied by diminished breath sounds (because respiratory muscles are weak too)
  3. physical assessment and clinical manifestations
    • Variable pulse rate and rhythm (often rapid) with weak thread pulse
    • pulse poor palpability
    • ECG changes
  4. Physical assessment and Clinical manifestations
    of hypokalemia
    Neuro, gastro, and renal
    Lethargy to coma with LOC changes

    Constipation from decreased motility, absent bowel sounds, N/V, abdominal distention, paralytic ileus

    Polyuria, decreased specific gravity, inability to concentrate urine
  5. what route is potassium given and why
    potassium can only be given IV infusion or PO because it is a tissue irritant
  6. what is maximum recommended infusion rate for K (potassium)
    • 5 to 10 mEq/hr
    • never to exceed 20mEq/hr under any circumstances

    must always use a machine pump to make sure dose is accurate, and check levels often to make sure pt does not get too much
  7. Never give potassium to a pt
    • in renal failure without questioning the order.
    • Renal patients are usually hyperkalemic
  8. should you ever infuse K+ through an IV in a small hand vein?
    No, should have a good IV in a good vein because K+ can damage the tissue

    Always check the IV site closely every 2 hours while infusing, DC at first signs of infiltration or Phelbitis
  9. what are some potassium sparing diuretics?
    • aldactone/spironolactone
    • triamterene/dyrenium
    • amiloride/midamor
  10. interventions for hypokalemia
    administer K+ supplements orally of IV Drip

    Administer K+ sparring diuretics

    Avoid K+ wasting or loop diuretics

    encourage salt substitute (it is made of potassium)

    Safety measures to decrease fall risk (pt with hypokalemia will have weakness and muscle flaccidity)
  11. Interventions for constipation
    • Laxatives (bulk or fiber)
    • increase fiber and bulk if not on fluid restricted diet
    • pt privacy
    • encourage ambulation or frequent position change if on bedrest
  12. potential for respiratory insufficiency
    • Monitor respiratory rate and depth
    • Assess respiratory muscle effectiveness
    • Assess face and nail beds for pallor or cyanosis
    • Evaluate arterial blood gas values or pulse oximetry for hypoxemia
  13. hyperkalemia
    what is it
    when potassium level is above 5.0

    It alters the function of all excitable cell membranes to some degree, the heart is very sensitive to serum potassium increases

    the most serious complication of hyperkalemia is altered cardiac function
  14. hyperkalemia is uncommon to people with
    normal kidney function

    if present it is likely associated with excessive IV or dietary intake, acidosis, tissue trauma or burns, K= SPARING DIURETICS
  15. Hyperkalemia
    dysrhythmias and peaked T-Waves

    increased GI motility may occur
  16. Nursing Interventions for hyperkalemia
    • eliminating extra potassium in diet and drug therapy
    • increase potassium excretion (use of sodium polystyrene sulfonate which causes diarrhea, administer loop diuretic or dialysis for renal failure patients
    • Continuous cardiac monitoring
Card Set:
electrolytes imbalance
2014-02-16 16:10:55
114 electolytes imbalance

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