hypokalemia nursing diagnosis

All rights reserved. Conditions that cause hypoaldosteronism, such as adrenal insufficiency and hyporeninemic hypoaldosteronism (a common complication of diabetic nephropathy and tubulointerstitial diseases), can lead to hyperkalemia. (1998). Gitelman Syndrome UK [gitelmansuk]. 5. Eh wala, yung 15, naging 7. Your kidneys or adrenal glands don't work well. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. This is commonly done through the administration of oral potassium supplement and high potassium diet. Inform the healthcare team about the patients level of risk of falls.Effective communication among healthcare team members encourages collaboration and teamwork, which promotes the safety and prevention of fall incidents for the patient. The effect can cause slow peristalsis which can lead to constipation. Because of their increased risk of developing hyperkalemia, patients with underlying renal dysfunction merit special attention.22, Severe hyperkalemia (more than 6.5 mEq per L [6.5 mmol per L]) can cause muscle weakness, ascending paralysis, heart palpitations, and paresthesias. Skidmore-Roth Publications. Monitor laboratory results, such as serum potassium and arterial blood gases, as indicated.Evaluate therapy needs and effectiveness. Views on topics do not generally reflect that of the entire community. Fluid loss from the body such as vomiting and diarrhea causes depletion of the electrolyte potassium partly because potassium is actually lost with gastric fluid. 4. All information expressed here are courtesies of the respective authors. Intravenous potassium should be reserved for patients with severe hypokalemia (serum potassium < 2.5 mEq per L [2.5 mmol per L]), hypokalemic ECG changes, or physical signs or symptoms of hypokalemia, or for those unable to tolerate the oral form. 11. 3. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Sample Osteoporosis Nursing Care Plans |NANDA Nursing Diagnosis |Interventions with Rationales, Clopidogrel Bisulfate (Plavix) Nursing Implications |Patient Teachings, 19 NANDA Nursing Diagnosis for Fracture |Nursing Priorities & Management, 25 NANDA Nursing Diagnosis for Breast Cancer, 5 Stages of Bone Healing Process |Fracture classification |5 Ps, 9 NANDA nursing diagnosis for Cellulitis |Management |Patho |Pt education, 20 NANDA nursing diagnosis for Chronic Kidney Disease (CKD). Nursing Care Plans The goal of nursing care is to restore and maintain normal potassium levels through monitoring and appropriate interventions. Administer prescribed potassium with precautions.Potassium can be administered IV or PO. She has more than 10 years of clinical and teaching experience and worked as a licensed Nursing Specialist in JCI-accredited hospitals in the Middle East. It gets potassium through the food you eat. 1. If the patient is on diuretics regimen, switch to potassium-sparing diuretics as prescribed. Start a strict input and output monitoring. Recommended nursing diagnosis and nursing care plan books and resources. Dialysis should be considered in patients with kidney failure or life-threatening hyperkalemia, or when other treatment strategies fail.23,37 Other modalities are not rapid enough for urgent treatment of hyperkalemia.39, Currently available cation exchange resins, typically sodium polystyrene sulfonate (Kayexalate) in the United States, are not beneficial for the acute treatment of hyperkalemia but may be effective in lowering total body potassium in the subacute setting.25,39 Because sodium polystyrene sulfonate can be constipating, many formulations include sorbitol for its laxative effects. Hypokalemia | Definition & Patient Education - Healthline The nerve impulses are created by the movement of sodium and potassium in and out the cells. Perform a fall risk assessment.In acute care and long-term settings, fall risk scales are commonly utilized. Weight should be performed every day to help assess fluid volume status. To effectively monitory the patients daily nutritional intake and progress in weight loss goals. Careful monitoring during treatment is essential because supplemental potassium is a common cause of hyperkalemia in hospitalized patients.21 The risk of rebound hyperkalemia is higher when treating redistributive hypokalemia. If you continue to use this site we will assume that you are happy with it. Explain to the patient the relation of altered potassium levels to nausea and vomiting and loss of appetite. She received her RN license in 1997. You have diarrhea. It is advised to dilute the solution no more than 1 mEq/10 mL (1 mmol/10 mL). The combination of furosemide and beta-blocker may reduce blood pressure and decrease heart rate. This must be given at a controlled slow rate as potassium solution may cause a burning sensation on the infusion site. Teach and assist the client with range-of-motion (ROM) exercises, as tolerated.Improves muscle tone and reduces muscle cramps and pain. Patients with a history of congestive heart failure or myocardial infarction should maintain a serum potassium concentration of at least 4 mEq per L (4 mmol per L). 6. Copyright 2023 American Academy of Family Physicians. Possible causes of hypokalemia include the following: Possible causes of hyperkalemia include the following: Signs and symptoms of potassium imbalance include: To ensure proper functioning and homeostasis the body must maintain a dynamic equilibrium of fluids and electrolytes. His temperature is 37.4 C, heart rate is 122 beats per minute, blood pressure is 142/84 mmHg, respirations are 20 breaths per minute, and oxygen saturation is 98% on room air. Encourage frequent rest periods; assist with daily activities, as indicated.General muscle weakness decreases activity tolerance. Elsevier. Polyuria -potassium is mainly excreted through the kidneys. The patient complains of weakness, nausea, heart palpitations, and shortness of breath. Inhibits renal potassium excretion, can ameliorate some of the hypokalemia that thiazide and loop diuretics can cause. Hypothermia and increased blood cell production (for example, leukemia) are additional risk factors for developing hypokalemia. Comer, S. and Sagel, B. Inhaled Beta Agonists. Nonurgent hypokalemia is treated with 40 to 100 mmol of oral potassium per day over days to weeks. Administer medications as ordered.Aldosterone receptor antagonists (such as spironolactone or eplerenone) can be used to treat mild hypokalemia. Nursing Diagnosis: Electrolyte Imbalance Related to: Changes in the regulation of potassium Changes in the intake of potassium Difficulty excreting potassium Conditions that affect the movement of potassium in the cellular space As evidenced by: Alterations in the electrical conductivity of the heart Ineffective respirations Short-term goal: By the end of the shift the patient will experience a resolution of heart palpitations and shortness of breath, with no further PVCs seen on ECG.Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-leader-2','ezslot_8',642,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-leader-2-0'); Long-term goal: The patient will maintain a normal potassium level, monitoring for recurrent signs and symptoms of hypokalemia. All Rights Reserved. This includes the heart muscle wherein when the potassium level is depleted abnormal heart waves are formed. There are subsets of patients that are susceptible to the development of hypokalemia. Bananas, oranges, apricots, cooked spinach, potatoes, and mushrooms are all high in potassium. Risk for falls associated with potassium imbalance is caused by a disruption in the electric signals in muscles resulting in muscle weakness, cramping, hyporeflexia, and paralysis. An ECG is performed to check heart rhythm. 1. NCP (Hypokalemia) | PDF - Scribd Low magnesium levels. Common acute manifestations are muscle weakness and ECG changes. Correction typically should not exceed 20 mmol per hour, although higher rates using central venous catheters have been successful in emergency situations.22 Continuous cardiac monitoring is indicated if the rate exceeds 10 mmol per hour. The most common cause of excessive loss of Potassium is often associated with heavy fluid losses that flush Potassium out of . ANTHONY J. VIERA, MD, MPH, AND NOAH WOUK, MD. Prepare for and assist with dialysis.May be required when more conservative methods fail or are contraindicated such as severe heart failure. To help the patient understand why nausea and vomiting associated with loss of appetite are signs of hypokalemia. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. The infusion should be discontinued immediately if this occurs. 1. Urinalysis can also show the presence of potassium in the urine. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented. Administer a slow intravenous potassium solution as prescribed. Implement safety measures when administering IV potassium.Because IV potassium infusion can cause phlebitis as a complication, the nurse should regularly check the IV site for indications of phlebitis or infiltration. The most accurate method for evaluating urinary potassium excretion is a 24-hour timed urine potassium collection; normal kidneys excrete no more than 15 to 30 mEq per L (15 to 30 mmol per L) of potassium per day in response to hypokalemia. Hypokalemia occurs when potassium falls below 3.6mmol/L and hyperkalemia occurs when potassium level in the blood is greater than 5.2mmol/L. 3. About 98% of the bodys potassium is found inside the cells and the rest is found extracellularly. While others spare potassium from being excreted through the kidneys. Mosby. (2022). New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance. High alcohol intake. Interprofessional patient problems focus familiarizes you with how to speak to patients. Potassium helps carry electrical signals to cells in your body. Encourage physical therapy.Encourage participation in physical and occupational therapy sessions as ordered to regain strength and adapt to changes. Hypokalemia is defined as a serum potassium level below 3.5 mEq/L. Saunders comprehensive review for the NCLEX-RN examination. Learn about the essential nursing care plans and nursing diagnosis for the nursing management of potassium (K) imbalances: hypokalemia and hyperkalemia. Wound Care & Infection Nursing Diagnosis & Care Plan, Parkinsons Disease Nursing Diagnosis & Care Plan, Hypokalemia serum potassium level < 3.5 mEq/L (3.5 mmol/L), Hyperkalemia serum potassium level > 5.0 mEq/L (5.0 mmol/L), Excessive use of potassium-wasting diuretics, Increased production of aldosterone (water and salt regulating hormone) (such as in Cushings syndrome), Kidney disease impairing the reabsorption of potassium, Poor potassium intake such as through eating disorders. Anna Curran. Hypokalemia is a serum potassium level less than 3.5 mEq/L or 3.5 mmol/L. Brunner and Suddarths textbook of medical-surgical nursing (13th ed.). 1. Monitor potassium every 6 hours or as needed. High potassium occurs due to lack of insulin. Nursing Diagnosis (hypokalemia)-help? - allnurses Although sodium bicarbonate is often used to treat hyperkalemia, the evidence to support this use is equivocal, showing minimal to no benefit.39 Therefore, sodium bicarbonate should not be used as monotherapy. The rapidity and method of potassium repletion depends on the: A 57-year old male presents to the ED with complaints of nausea, weakness, heart palpitations, and mild shortness of breath. Imbalanced Nutrition Less than Body requirements, BPH Nursing Diagnosis and Nursing Care Plan, Legionnaires Disease Nursing Diagnosis and Nursing Care Plan. Intravenous calcium, which helps prevent life-threatening conduction disturbances by stabilizing the cardiac muscle cell membrane, should be administered if ECG changes are present.24,25,35 Intravenous calcium has no effect on plasma potassium concentration. Symptoms usually develop at higher levels, 6.5 mEq/L to 7 mEq/L, but the rate of change is more important . Include or limit potassium in the diet.Educate the patient on their prescribed diet depending on the condition. Determine cardiovascular status.Heart dysrhythmias can result from an excess or deficit of potassium that disrupts the normal electric transmission of signals responsible for heart (myocardium) contraction. Hypokalemia (Low Potassium): Symptoms, Causes, Diagnosis, Treatment - WebMD Wolters Kluwer India Pvt. Nursing Diagnosis Excess Fluid Volume May be related to Excess fluid or sodium intake. Treatment-related side effects, such as certain medications or chemotherapy, can also contribute to hyperkalemia by altering potassium levels in the body, leading to a risk for electrolyte imbalance. Obtain ECG and observe signs of dysrhythmias.A potassium imbalance may result in alterations in ECG findings since potassium is essential for both depolarization (contraction) and repolarization (relaxation) of the heart. Significant leukocytosis (> 75,000 cells per mm, Acute kidney injury/chronic kidney disease, Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, Calcium chloride, 10 mL of 10% solution IV over 5 to 10 minutes, or calcium gluconate, 30 mL of 10% solution IV over 5 to 10 minutes, Stabilizes cardiac muscle cell membrane; no effect on serum potassium or total body potassium, May potentiate digoxin toxicity; calcium chloride can cause phlebitis and tissue necrosis, Regular insulin, 10 units IV followed immediately by 50 mL of 50% glucose (25 g) IV, Shifts potassium into cells; no effect on total body potassium, May cause hypoglycemia; glucose is unnecessary if serum glucose level is > 250 mg per dL (13.9 mmol per L); additive effect when combined with albuterol, Can cause tachycardia and thus should be used with caution in patients with underlying heart disease; potassium-lowering effect not reliable in all patients; additive effect when combined with insulin, Sodium polystyrene sulfonate (Kayexalate), Binds potassium in exchange for sodium; lowers total body potassium, Association with gastrointestinal complications, particularly when combined with sorbitol; should be avoided in patients at risk of abnormal bowel function. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Neurologic signs of hypokalemia include generalized weakness and decreased deep tendon reflexes.11. Hyperkalemia can result from taking potassium chloride or salt substitutes. If administering IV, infuse secondarily to a compatible IV solution such as 0.9% normal saline to minimize burning at the IV site. Non-steroidal anti-inflammatory medications (NSAIDs). Eating disorders such as bulimia nervosa and anorexia nervosa can lead to deficits in potassium. Swearingen, P. (2016). Hypokalaemia ECG Changes. Please read our disclaimer. It is critical to the proper functioning of nerve and muscles cells, particularly heart muscle cells. Changes in the level of consciousness (lethargy, disorientation, confusion to coma). Potassium disorders are common. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. Here are some nursing interventions for patients with hyperkalemia: 1. Articles submitted here are original but are checked for minor typographical errors, and are formatted for site compatibility.This is a site that continuously improves and broadcasts healthcare information relevant to today's ever-changing world. Bounding pulses. Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client CareIdentify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Hypokalemia can be life-threatening. Treat underlying conditions.Potassium imbalances can be caused by kidney disease, diabetes, alcoholism, Addisons disease, and more. Dewit, S. C., Stromberg, H., & Dallred, C. (2017). 2023 nurseship.com. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. The patients lung sounds are clear. Nursing Diagnosis: Electrolyte Imbalance related to hypokalemia as evidenced , serum potassium level of 2.9 mmol/L, polyuria, increased thirst, weakness, tachycardia, and fatigue Desired Outcome: Patient will be able to re-establish a normal electrolyte and fluid balance. Conditions such as alcoholism, eating disorders, and renal disorders can cause a severe case of hypokalemia. Hyponatremia (decreased sodium in blood) OR hypernatremia (increased sodium in the blood) could be present depending on the types of fluid lost. Ackley and Ladwigs Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning CareWe love this book because of its evidence-based approach to nursing interventions. Long-term goal: The patient will eat a broad variety of fruits and vegetables, with knowledge of a few high-potassium foods to eat in case of suspected hypokalemia. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are common causes of hyperkalemia. A potassium deficiency can result in shortness of breath, and in severe cases, can stop the lungs from working completely. Potassium can be obtained as a dietary supplement but is naturally available in many foods. Hinkle, J. L., & Cheever, K. H. (2018). Furosemide Nursing Considerations - NurseStudy.Net The patient says: Ive been on Lasix for years now so I know what to expect, but I still think Ive been urinating more than usual. He also reports thirst and constipation, but he was careful not to drink excess water because of his heart failure. 4. Although hypokalemia can be transiently induced by the entry of potassium into the cells, most cases result from unreplenished gastrointestinal or urinary losses due, for example, to vomiting, diarrhea, or diuretic therapy []. Hypokalemia refers to a condition in which the concentration of Potassium in the blood is low. Hypokalemia Disease with Causes, Symptom and Nursing Intervention Further progression can lead to ST-interval depression, T-wave inversions, PR-interval prolongation, and U waves. It is also responsible for keeping the heartbeat regular and promotes the movement of nutrients into and waste out of the cells. Centrally potassium can be administered more quickly and in larger doses via this route. Hyperkalemia & Hypokalemia Nursing Care Plans - Nurseslabs Nursing diagnoses handbook: An evidence-based guide to planning care. Potassium supplementation is the main treatment for hypokalemia. Too much or too little potassium in diet. Low potassium (hypokalemia) - Mayo Clinic Medical-surgical nursing: Concepts for interprofessional collaborative care. Abnormal potassium levels commonly occur due to the following: Abnormal potassium levels can easily become a medical emergency as it can cause life-threatening cardiac arrhythmias. Searches of PubMed, the Cochrane Database of Systematic Reviews, and the National Guideline Clearinghouse were completed using the key terms hypokalemia and hyperkalemia. Treatment-related side effects such as cytotoxic drugs. Abnormal heart rhythm and palpitation- the brain sends nerve signals to the heart muscles to make them contract and beat. In children, dosing is 0.5 to 1.0 mmol per L per kg over one hour (maximum of 40 mmol).23 Potassium should not be given in dextrose-containing solutions because dextrose-stimulated insulin secretion can exacerbate hypokalemia. Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). In general, hypokalemia is associated with diagnoses of cardiac disease, renal failure, malnutrition, and shock. The patient should be able to monitor for hypokalemia, which is common with diuretic administration. Insulin and Glucose. Because serum potassium concentration drops approximately 0.3 mEq per L (0.3 mmol per L) for every 100-mEq (100-mmol) reduction in total body potassium, the approximate potassium deficit can be estimated in patients with abnormal losses and decreased intake. Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed., pp. Potassium levels should be closely monitored during repletion, making sure the level is rising but does not exceed 4.0 mmol/L. Volume depletion. It also maintains the transmembrane electrical potential that exists between the ICF and ECF. nursing diagnosis provided by NANDA nursing care plans for various nursing mental health and psychiatric nursing. See permissionsforcopyrightquestions and/or permission requests. Nursing Diagnosis: Risk for Hypernatremia Potentially Related To Dehydration Severe diarrhea Fever Vomiting Poorly controlled diabetes Certain medications Kidney disease Diabetes insipidus Extensive burns Evidenced By Extreme thirst Fatigue Headache Nausea Lethargy Confusion Muscle twitching or spasms Seizures Coma Desired Outcomes Hypokalemia and Hyperkalemia Nursing Care Plan 2 Check for safety hazards in the patients environment.Assess the following environmental factors: 5. Review the patients current medications.Imbalanced potassium and the use of cardiac medications (used to treat dysrhythmias) greatly increase the risk for muscle weakness and potential falls. Cardiac enzymes are normal but his potassium level is 2.8 mmol/L. Muscular weakness can affect respiratory muscles and lead to respiratory complications. Please follow your facilities guidelines and policies and procedures. Patients with heart failure may experience hyperkalemia due to their medications (ACE inhibitors and beta blockers). If after five minutes, follow-up ECG continues to show signs of hyperkalemia, the dose should be repeated.37 Clinicians should be aware that intravenous calcium has a short duration, ranging from 30 to 60 minutes. What is the NANDA nursing diagnosis for pneumonia . For both disorders, it is important to consider potential causes of transcellular shifts because patients are at increased risk of rebound potassium disturbances. Hyperkalemia & Hypokalemia Nursing Diagnosis and Nursing Care Plan Potential health risks are avoidable as long as the potassium levels are kept at a normal level. However, potassium will need to be given intravenously in the following conditions: Treating of underlying disease. Severe or symptomatic hypokalemia can be treated promptly with oral and IV potassium. To prevent cardiac conduction disturbances, intravenous calcium is administered to patients with hyperkalemic electrocardiography changes. Potassium helps in utilizing carbohydrates and protein to produce energy. Bananas, spinach, broccoli, and some fish are high in potassium. 2. Potassium supplement. Potassium Disorders: Hypokalemia and Hyperkalemia | AAFP Hypokalemia and Hyperkalemia are conditions that refer to abnormal levels of potassium in the blood. 9. The patient thought his potassium might be low, so he ate 2 apples with no improvement noted. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside.

Darnell Rodgers Dr Phil, Pda Hibernian Coaches, Avengers Fanfiction Loki Sexually Abused, Articles H