Potassium- Electrolytes Flashcards
what is the normal serum potassium level?
3.5 to 5.0
what is the action of potassium in the body?
Influences both skeletal and cardiac muscle activity
(sodium potassium pump)
what is potassium a major electrolyte in?
major electrolyte in the intracellular fluid (ICF)
where is potassium obtained, absorbed and secreted?
obtained by the diet
absorbed by the Intestines
excreted through the kidneys and bowels
why is the renal system so important for maintaining and balancing potassium?
Renal system important in keeping balanced potassium because the body does not conserve potassium
what are some things that can cause HYPOkalemia?
- think the body is trying to “DITCH” potassium
Drugs: medication
Inadequate consumption of potassium
Too much water intake
Cushing’s syndrome
Heavy Fluid Loss
what are the 7 “SLOW” signs and symptoms of HYPOkalemia?
“SLOW”
1. Weak, Irregular pulses
2. Orthostatic Hypotension
3. Depressed ST, flat or inverted T wave, prominent U wave
4. Shallow Respiration
5. Confusion, weak
6. Decreased deep tendon reflexes
7. Decreased bowel sounds
what are the 7 “LOW” signs and symptoms of HYPOkalemia?
“LOW”
1. Lethargy (confusion)
2. Low, shallow respirations
3. Lethal cardiac dysrythmias
4. Lots of urine
5. Leg cramps
6. Limp muscles
7. Low BP and HR
Renal (kidney) loss of potassium can be caused by what?
- Diuretics
- Hyperaldosteronism (too much aldosterone = Aldosterone causes sodium to be absorbed and potassium to be excreted)
- High dose of sodium PCN’s
- Large dose corticosteriods
how is the heart affected by HYPOkalemia? 4
- strength of contraction
- myocardium irritability
- ST segment depression
- digoxin toxicity
potassium less than 2.7 may cause what?
PAC’s (premature atrial contractions)
PVC’s (premature ventricular contractions)
V-fib or cardiac arrest
potassium less than 3.5 may be associated with what?
metabolic alkalosis
high ph
and a
high bicarb
what is the medical treatment for HYPOkalemia ? 5
- potassium replacement either PO or IV
- Increase on a daily basis (40-80mg/day)
- At risk patient
(50-100 mg/day) - potassium rich foods
- treat the underlying cause
how do you give potassium PO to minimize GI upset? 3
- Dilute liquid & effervescent supplement
2.Give tabs & capsules w/ 8 oz. H2O - Give K+ with food
Adverse reaction – N/V, diarrhea, GI bleed
how do you give potassium through an IV? 7
- Must be diluted
- DO NOT GIVE BY Direct IVP
- Max. dose is 60 mEq at a time
- Must use IV pump
- Monitor renal output
- CHS policy – pt on heart monitor
- Monitor IV site
what are the nursing interventions of HYPOkalemia? 7
- Identify pt at risk – esp. if on Digoxin
- Monitor ECG & BP
- Monitor serum K+
- Pt education – diuretics & laxatives
- Administer K+ supplements PO or IV
- dietary K+
- Monitor urine output
what are some causes of HYPERkalemia? 5
- Think “CARED”*
1. Cellular movement
2. Adrenal Insufficiency
w/ Addison’s disease
3. Renal Failure
4. Excessive potassium intake
5. Drugs: medications
signs and symptoms of HYPERkalemia? 6
think MURDER*
1, Muscle weakness
2. Urine production is little to none
3. Respiratory failure
4. Decreased cardiac contractility
5. Early signs of muscle twitches /cramps
6. Rhythm changes
how is the heart affected by HPERkalemia?
- slow heart rate
- ECG changes:
Tall, peaked T wave, short QT interval
Longer PR interval, widening QRS complex
** Risk for Heart Block, A-fib, or, V-fib
severely high potassium levels effect on the heart?
- Decreased heart contraction strength
- Dilated & flaccid heart
HYPERkalemia medical treatment? 5
- potassium restricted diet
- stop potassium containing medications
- monitor for digitalis toxicity
- Cation-exchange resins
Polystyrene sulfonate (Kayexalate) – PO or PR
1Gm of resin removes 1 mEq K+ - conservative methods not suffice
what is the emergency medical treatment for hyperkalemia?
- Calcium Gluconate IV: - does not lower potassium
- antagonizes potassium action on the heart
- monitor ECG - Hypertonic Glucose and insulin:
- Insulin - facilitates K+ movement into cells
- Glucose - ↑ insulin release from pancreas - Sodium Bicarbonate
- potassium shifts into the cell
Nursing interventions for HYPERkalemia: 5
- Be aware of pt at risk
- Monitor for:
Generalized weakness & dysrhythmias
Irritability & GI symptoms
Nausea & intestinal colic
ECG or lab abnormalities - Prevention of hyperkalemia
- Educate pt: medication & diet
- Do NOT draw blood above K+ infusion site
