Potassium Imbalances

Question 1

What are the normal lab values for potassium?

Answer 1

K+ = 3.5-5

Question 2

What is Hyperkalemia?

Answer 2

Too much potassium, K+

Question 3

What is hypokalemia?

Answer 3

Too little potassium, K+

Question 4

Causes for hyperkalemia

Answer 4

-Excess potassium intake
-Excess parenteral administration
-Shift of potassium out of cells
-Acidosis (low pH)
-Tissue catabolism
-Intense exercise
Failure to eliminate potassium
-Renal disease (oliguria- low urine output)
-Adrenal insufficiency

Question 5

Causes for hypokalemia

Answer 5

-Excess potassium loss:
-GI, kidney, skin (diaphoresis),
dialysis, loop & thiazide diuretics
-Shift of potassium into cells
-Increased insulin release (e.g., IV dextrose load)
-Insulin therapy (e.g., w/ DKA)
-Alkalosis
-Lack of potassium intake
-Starvation or low potassium diet
-No K+ in IVF if NPO

Question 6

Manifestations of hyperkalemia

Answer 6

EKG changes–can be life threatening
Fatigue, irritability, muscle weakness
Loss of muscle tone
Paresthesia
Confusion

Question 7

Manifestations of hypokalemia

Answer 7

EKG changes–can be life threatening
Fatigue, muscle weakness, cramps
Paresthesia

Question 8

Nursing care for hyperkalemia

Answer 8

Stop intake
Increase K+ excretion:
-Loop/thiazide diuretics
-Dialysis
-Patiromer (Veltessa) or sodium polystyrene sulfonate
(Kayexalate) – takes hours to days to work
Force K+ back into cell:
-Insulin & dextrose
-If acidotic give them sodium bicarb
Continuous EKG monitoring

Question 9

Nursing care for hypokalemia

Answer 9

-Increase med intake (oral or IV)
-Increase PO intake (foods)
-IV KCL – Safety Alert:
-Always dilute; never IV push
-Should not exceed 10 mEq/hour unless in ICU
setting & has CVAD
-Infiltration can cause necrosis
-Note: Hypokalemia precipitates digitoxicity

Question 10

High potassium fruits

Answer 10

dried fruits, raisins, and prunes
cantaloupe and honey dew melon
oranges and grapefruit
apricots
banana
avocado

Question 11

High potassium vegetables

Answer 11

Baked, refried & black beans
Butternut squash
Broccoli, cooked
Carrots, raw
Greens, except kale
Mushrooms, canned
Potatoes, white and sweet
Spinach, cooked
Tomatoes or tomato products
Vegetable juices

Question 12

Other high potassium foods

Answer 12

Bran or bran products
Chocolate (1.5–2 oz)
Granola
Milk, all types (1 cup)
Nutritional supplements
Nuts and seeds (1 oz)
Peanut butter (2 Tbsp)
Salt substitutes, Lite Salt
Salt-free broth
Yogurt