In order to function properly, the body requires several electrolytes, one of which is potassium. The majority of potassium is stored in the intracellular compartment. While some can be found in the bones, liver, and red blood cells, 98% is found in the muscle cells. Potassium regulates fluid and facilitates muscular contraction and nerve activity. It is also responsible for keeping the heartbeat regular and promotes the movement of nutrients into and waste out of the cells. Show
The normal blood potassium level is 3.5 – 5.0 mEq/L. Imbalances in blood potassium levels are referred to as hypokalemia and hyperkalemia.
Possible causes of hypokalemia include the following:
Possible causes of hyperkalemia include the following:
Signs and symptoms of potassium imbalance include:
The Nursing ProcessTo ensure proper functioning and homeostasis the body must maintain a dynamic equilibrium of fluids and electrolytes. Organ system dysfunction, such as life-threatening dysrhythmias, can occur when potassium is not balanced. Nurses must closely monitor patients’ lab results and correct imbalances to prevent complications. Nursing Care Plans Related to Hyperkalemia and HypokalemiaElectrolyte Imbalance Care PlanElectrolyte imbalance associated with potassium imbalance (hypokalemia/hyperkalemia) can be caused by conditions affecting the regulation, intake and excretion, and movement of potassium in the cellular space. Nursing Diagnosis: Electrolyte Imbalance Related to:
As evidenced by:
Expected outcomes:
Electrolyte Imbalance Assessment1. Monitor blood potassium levels. 2. Check renal function. 3. Review the patient’s current medications. 4. Review the patient’s diet. Electrolyte Imbalance Interventions1. Include or limit potassium in the diet. 2. Administer
prescribed potassium with precautions. 3. Monitor strict intake and output. 4. Treat underlying
conditions. Risk for Decreased Cardiac Output Care PlanRisk for decreased cardiac output associated with potassium imbalance is caused by a disruption in the electric signals in the myocardium resulting in dysrhythmias. Nursing Diagnosis: Risk for Decreased Cardiac Output Related to:
As evidenced by:A risk for diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred and nursing interventions are aimed at prevention. Expected outcomes:
Risk for Decreased Cardiac Output Assessment1. Determine cardiovascular status. 2. Monitor pulse rate and blood pressure. 3. Obtain ECG and observe signs of dysrhythmias. Risk for Decreased Cardiac Output Interventions1. Administer medications as ordered. 2.
Dilute potassium when given IV. 3. Implement safety measures when administering IV potassium. 4. Prevent sudden hypotension. Risk for Falls Care PlanRisk 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. Nursing Diagnosis: Risk for Falls Related to:
As evidenced by:A risk for diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred and nursing interventions are aimed at prevention. Expected outcomes:
Risk for Falls Assessment1. Perform a fall risk assessment. 2. Assess the patient’s neuromuscular status. 3. Determine the patient’s independence in
performing activities. 4. Check for safety hazards in the patient’s environment.
5. Review the patient’s current medications. Risk for Falls Interventions1. Institute fall and safety measures. 2. Apply visible fall prevention signage. 3. Inform the healthcare team about the patient’s level of risk of falls. 4. Encourage physical therapy. 5. Position the patient therapeutically. References and Sources
What are the clinical symptoms of hyperkalemia?If hyperkalemia comes on suddenly and you have very high levels of potassium, you may feel heart palpitations, shortness of breath, chest pain, nausea, or vomiting. Sudden or severe hyperkalemia is a life-threatening condition. It requires immediate medical care.
What are the signs and symptoms of hypokalemia?More severe cases of low potassium may cause signs and symptoms such as:. Muscle twitches.. Muscle cramps.. Severe muscle weakness, leading to paralysis.. Low blood pressure (hypotension).. Lightheadedness or faintness.. Abnormal heart rhythms (arrhythmias).. Excessive urination (polyuria).. Excessive thirst (polydipsia).. What does nurse do for hyperkalemia?Calcium therapy will stabilize the cardiac response to hyperkalemia and should be initiated first in the setting of cardiac toxicity. Calcium does not alter the serum concentration of potassium but is a first-line therapy in hyperkalemia-related arrhythmias and ECG changes.
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