Hypokalemia is level below 3.5
it can be life threatening because every body system is affected
what are the respiratory changes with HYPOkalemia
mucles become weak-> results in shallow respirations
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THUS RESPIRATORY STATUS SHOULD BE ASSESSED FIRST IN ANY PATIENT WHO MIGHT HAVE HYPOKALEMIA
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What is the priority assessment with HYPOkalemia
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RESPIRATORY STATUS SHOULD BE ASSESSED FIRST IN ANY PATIENT WHO MIGHT HAVE HYPOKALEMIA
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Neurologic changes seen with HYPOkalemia
Th patient may have short term irritability & anxiety, followed by lethargy that progresses to acute confusion and coma as hypokalemia worsens
what intestinal changes might take place with hypokalemia?
severe hypokalemia can cause the absence of peristalsis (paralytic ileus)
what are the priorities for nursing care of the patient with HYPOkalemia?
ensuring adequate oxygenation, patient safety for falls prevention and prevention of injury from potassium administration and monitoring the patient's response to therapy
What should you know about administration route for potassium?
It is NEVER given by IM or SQ injections!!!! potassium is a severe tissue irritant
for a pt recieving IV potassium you need to do what assessment
you need to asses the IV site every 2 hrs and ask whether he/she feels burning or pain at the site
What do you do if a pt receiving IV potassium reports feelings of burning and pain at IV site?
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Stop the IV solution immediately if infiltration occurs, remove the venous access, and notify the health care provider or rapid response team
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for administrating potassium what should you do/know
check and re-check the concentration of the drug in the vial with another RN, pharmacist or doctor. and carefully calculate the required dilution before adding it to the IV solution.
-the maximum infusion rate is 5-10mEq/hr; this is to never exceed 20 mEq
For hypokalemia what would be foods good to eat (high in potassium)?
*meats, esp organ or preserved meat
*dairy products
*dried fruit
*fruit high is potassium= bananas, cantaloupe, kiwi, oranges
*Vegetables high in patassium= avocados, broccoli, dried beans/peas, lima beans, mushrooms, potatoes, seaweed, soybeams, spinach
What are common causes of hypokalemia?
* excessive use of drugs (diuretics, digitalis, corticosteroids)
*increased secretion of aldosterone
*cushing's
*Diarrhea, vomiting, diaphoresis
*wound drainage (esp GI)
*prolonged NG suctioning
*NPO
*renal disease
What is potassium needed for?
depolarization and generation of action potentials, as well as regulating protein synthesis and glucose use and storage
What is the most serious complication of hyperkalemia?
altered cardiac function
What are common causes of hyperkalemia?
*over-ingestion of potassium-containing foods (salt substitutes, potassium chloride, bolus IV injection,rapid infusion)
*transfusions of whole blood or packed cells
*adrenal insufficiency (addison's or adrenalectomy)
*renal failure
*potassium-sparing diur
What foods are good for you to eat for hyperkalemia (low in potassium)
*eggs
*breads
*butter
*cereals
*sugar
*fruits low in potassium= apples apricots, berries, cherries, grapefruit, peaches, pineapple, cranberries
*Vegetables low in potassium=alfalfa sprouts,cabbage, carrots, cauliflower, celery, eggplant, green beans, lett
What are the neuromuscular changes and intestinal changes with hyperkalemia?
neuromuscular- starts as twitching, then goes onto tingling and burning around hands/feet/mouth-->as worsens then changes to weakness followed by flaccid paralysis
intestinal- hyperactive bowel sounds and increased motility-->diarrhea,frequent/watery
What are the priorities interventions for nursing care of the pt with hyperkalemia
monitoring to prevent cardiac complications, pt safety for falls prevention, monitoring the pt's response to therapy, & health teaching
what drugs should you give for hyperkalemia?
potassium excreting diuretics- furosimide
for renal problem pts give Kayexalate
maybe glucose and insulin
what is the key to prevention of hyperkalemia and the early detection of complications?
health teaching