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electrolytes
potassium
Question | Answer |
---|---|
The normal range for potassium is | 3.5 to 5 mEq/L |
List potential causes of hypokalemia | inadeuqate dietary intake, GI fluid loss (gastric suctioning, lavage, prolonged vomiting) Diarrhea, laxative abuse, metabolic alkalosis, diuretics and some other drugs, low serum magnesium |
List potential causes of hyperkalemia | metabolic acidosis, cell injury, increased dietary intake, use of salt substitutes, use of potassium suplliments (oral or IV), transfusion of blood nearing expiration date, certain meds, kidney disease, burns, insulin deficiency |
Would a patient who has sustained a crushing injury be more at risk for hyper or hypokalemia? | hyperkalcemia |
List signs and symptoms of hypokalemia | skeletal muscle weakness, parethesia, leg cramps, paralysis, respiratory failure, paralytic ileus, cardiac problems - may lead to cardiac arrest |
List signs and symptoms of hyperkalemia | skeletal muscle weakness (especially lower extremitites) leading to flaccid paralysis, hyperactive GI tract (nausea, vomiting and diarrhea), restlessness, tingling in the lips and fingers, decrease cardiac output and cardiac arrest |
The menomic SUCTION may be used for hypokalemia (remember that hypokalemia can be caused by a loss of stomach contents from gastric suctioning) What do the letters stand for? | S = skeletal muscle weaknessU = U wave changesC = constipation due to paralytic ileu T = toxic effects of digoxinI = irregular and weak pulseO = orthostatic hypotensionN = numbness |
If your patient has dereased strength, muscle cramps, and decreased deep tendon reflexes you should suspect ___________ | hypokalemia |
The patient has a decreased heart rate, irregular pulse, hypotension, and changes in the ECG including a tall, tented T wave. You should suspect ___________ | hyperkalemia |
In acidosis the patient would have ________kalemia | hyperkalemia |
In alkalosis the patient would have _________kalemia | hypokalemia |
What would you teach patients about taking an oral potassium suppliment? | Take with at least 4 ounces of fluid or with food |
Can slow released potassium tablets be crushed? | No |
Treatment for hypokalemia | oral or IV potassium suppliments |
treatment for hyperkalemia | loop diuretics, restriction of dietary potassium, hemodialysis, Kayexalate, severe-calcium gluconate IV, sodium bicarbonate IV, insulin IV with glucose |
Nursing intervention hypokalemia: monitor vital signs, especially pulse and blood pressure. Rationale is: | assoicated with orthostatic hypotension, caridac arrythmias |
Nursing intervention hypokalemia:monitor respirations | hypokalemia can weaken or paralyse respiratory muscles |
Nursing intervention hypokalemia: closely monitor patients on digoxin | increased risk of digoxin toxicity |
Nursing intervention hyperkalemia: monitor intake and output | report output of less than 30 ml/hr: inability to excrete potassium adequately may lead to dangerously high potassium levels |