Continuous telemetry should be implemented when administering medications that affect cardiac status. The recommended dietary replacement for potassium is 40 to 60 mEq/L/day. Here are two nursing diagnosis for hyperkalemia and hypokalemia nursing care plans: Hyperkalemia, an elevated level of potassium in the blood, can occur in patients with renal disease due to the kidneys reduced ability to excrete potassium, and in patients who have received massive blood transfusions due to the release of potassium from stored blood cells. 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. Ackley, B., Ladwig, G., Makic, M., Martinez-Kratz, M., & Zanotti, M. (2020). Medical conditions can also cause abnormal potassium levels; therefore, treatment also includes correcting the main cause of abnormal potassium levels. Muscular weakness can affect respiratory muscles and lead to respiratory complications. A history of paralysis, hyperthyroidism, or use of insulin or beta agonists suggests possible transcellular shifts leading to redistributive hypokalemia. Some blood pressure medications such as angiotensin-converting enzymes inhibitors, beta blockers, and angiotensin-receptor blocker are known to cause hyperkalemia. IV fluids with added potassium would be appropriate for dehydrated and hypokalemic patients, or if the patient required ongoing diuretic administration despite low potassium. Further evaluation may include measurement of serum glucose to evaluate for hyperglycemia, and measurement of serum renin, aldosterone, and cortisol to further investigate kidney and adrenal function. Potassium helps in utilizing carbohydrates and protein to produce energy. It will include three Hypokalemia nursing care plans with NANDA nursing diagnoses, nursing assessment, expected outcome, and nursing interventions with rationales. However, case reports linking the concomitant use of sodium polystyrene sulfonate and sorbitol to GI injury prompted a U.S. Food and Drug Administration boxed warning.41,42 More recent reports implicate sodium polystyrene sulfonate alone.43 Therefore, use of the drug with or without sorbitol should be avoided in patients with or at risk of abnormal bowel function, such as postoperative patients and those with constipation or inflammatory bowel disease.42, There is no evidence supporting the use of diuretics for the acute treatment of hyperkalemia. 1. Additional potassium will be required if losses are ongoing. She has worked in Medical-Surgical, Telemetry, ICU and the ER. Including the client in the plan of care elicits participation. This is commonly done through the administration of oral potassium supplement and high potassium diet. Saunders comprehensive review for the NCLEX-RN examination (9th ed.). Careful assessment for its early presence is needed especially for high-risk patients. Intravenous Calcium. When defined as a value of less than 3.6 mmol of potassium per . IV potassium can cause serious extravasation and vein irritation. CRITICAL CARE NURSING CARE PLANS. Bananas, oranges, apricots, cooked spinach, potatoes, and mushrooms are all high in potassium. Hypokalemia is defined as a serum potassium level below 3.5 mEq/L. Hyperkalemia-induced ventricular fibrillation is treated with calcium. Hemolysis or breakdown of red blood cells, Rhabdomyolysis or the breakdown of muscle tissues, Burns, trauma, and other tissue injuries can also cause the release of potassium from the cells. For both disorders, it is important to consider potential causes of transcellular shifts because patients are at increased risk of rebound potassium disturbances. Repeat measurement of serum potassium can help identify pseudohyperkalemia, which is common and typically results from potassium moving out of cells during or after sample collection.31 Other laboratory studies include measurement of serum blood urea nitrogen and creatinine, measurement of urine electrolytes and creatinine, and assessment of acid-base status. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This is a community of professional nurses gifted with literary skills who share theoretical and clinical knowledge, nursing tidbits, facts, statistics, healthcare information, news, disease data, care plans, drugs and anything under the umbrella of nursing. Hypokalemia occurs when potassium falls below 3.6mmol/L and hyperkalemia occurs when potassium level in the blood is greater than 5.2mmol/L. Thieme. This must be given at a controlled slow rate as potassium solution may cause a burning sensation on the infusion site. A 12-lead ECG is performed and shows sinus tachycardia with PVCs. Potassium Disorders: Hypokalemia and Hyperkalemia | AAFP The patient thought his potassium might be low, so he ate 2 apples with no improvement noted. Include or limit potassium in the diet.Educate the patient on their prescribed diet depending on the condition.
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