Potassium Imbalances Flashcards
What are the normal lab values for potassium?
K+ = 3.5-5
What is Hyperkalemia?
Too much potassium, K+
What is hypokalemia?
Too little potassium, K+
Causes for hyperkalemia
-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
Causes for hypokalemia
-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
Manifestations of hyperkalemia
EKG changes--can be life threatening Fatigue, irritability, muscle weakness Loss of muscle tone Paresthesia Confusion
Manifestations of hypokalemia
EKG changes–can be life threatening
Fatigue, muscle weakness, cramps
Paresthesia
Nursing care for hyperkalemia
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 monitoringNursing care for hypokalemia
-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
High potassium fruits
dried fruits, raisins, and prunes cantaloupe and honey dew melon oranges and grapefruit apricots banana avocado
High potassium vegetables
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
Other high potassium foods
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
