Hypokalemia Flashcards
What is hypokalemia?
Serum potassium level lower than 3.5 mEq/L
Why is potassium deficit potentially life-threatening?
Every body system is affected.
What are the basic causes of hypokalemia? (4)
- Actual total body potassium loss
- Inadequate potassium intake
- Movement of potassium from the extracellular fluid to the intracellular fluid
- Dilution of serum potassium
What can cause actual total body potassium loss? (7)
Excessive use of medications such as diuretics or corticosteriods.
Increased secretion of aldosterone, such as in Cushing’s syndrome.
Vomiting, diarrhea
Wound drainage, particularly gastrointestinal
Prolonged nasogastric suction
Excessive diaphoresis
Kidney disease impairing reabsorption of potassium
What are causes of inadequate potassium intake? (2)
Fasting, NPO status
What can cause movement of potassium from the extracellular fluid to the intracellular fluid? (2)
Alkalosis
Hyperinsulinism
What can cause dilution of serum potassium? (2)
Water intoxication
IV therapy with potassium-deficient solutions
What are the cardiovascular signs and symptoms of hypokalemia? (3)
Thready, weak, irregular pulse
Weak peripheral pulses
Orthostatic hypotension
What are the respiratory signs and symptoms of hypokalemia? (2)
Shallow, ineffective respirations that result from profound weakness of the skeletal muscles of respiration.
Diminished breath sounds.
What are the neuromuscular signs and symptoms of hypokalemia? (5)
Anxiety, lethargy, confusion, coma Skeletal muscle weakness, leg cramps Loss of tactile discrimination Paresthesias (pins and needle sensation) Deep tendon hyporeflexia
What are the gastrointestinal signs and symptoms of hypokalemia?(3)
Decreased motility, hypoactive to absent bowel sounds
Nausea, vomiting, constipation, abdominal distention
Paralytic ileus
What are the laboratory findings that indicate hypokalemia? (2)
Serum potassium levels lower than 3.5 mEq/L
Electrocardiogram changes
What are the electocardiogram changes that indicate hypokalemia?
ST depression; shallow, flat or inverted T wave; prominent U wave
What interventions should be implemented by the nurse in a patient with hypokalemia?
Monitor cardio, resp, neuromuscular, GI, and renal status.
Place the client on a cardiac monitor.
Monitor electrolyte values.
Administer potassium supplements orally or IV as prescribed.
Institute safety measures for the patient experiencing muscle weakness.
If the client is taking a potassium-depleting diuretic, it may be discontinued; a potassium-retaining diuretic may be prescribed.
Instruct the client about foods that are high in potassium.
What are the side effects and precautions when taking oral potassium?
May cause nausea and vomiting. Should not be taken on an empty stomach.
If the patient complains of abdominal pain, distention, nausea, vomiting, diarrhea, or GI bleeding, it may beed to be discontinued.
Liquid potassium tastes unpleasant and should be taken with juice.
