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HYPOKALEMIA: Risk Factors
Excessive diaphoresis |
Adverse effects of medications |
Body fluid loss |
Kidney disease |
Corticosteroids |
Vomiting |
Dietary deficiency |
Diuretics |
Diarrhea |
Alkalosis |
Digitalis |
Wound drainage |
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Laxatives (abuse of) |
Nasogastric suction |
HYPOKALEMIA: Manifestations
Muscle weakness, cramping |
Fatigue |
Nausea, vomiting |
Irritability, confusion |
Decreased bowel motility |
Paresthesia |
Dysrhythmias |
Flat and/or inverted T waves (ECG) |
HYPOKALEMIA: Nursing Interventions
Monitor respiratory status |
Initiate fall precautions |
Initiate and monitor potassium replacement (oral, IV) |
Monitor ECG |
Monitor I&O |
Monitor arterial HCO3 and pH |
Reinforce client teaching: dietary sources, medications |
HYPOKALEMIA: Notes
NEVER give K+ IV bolus. MUST dilute. |
"No P = No K." If the client is not urinating, do NOT administer potassium. |
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HYPERKALEMIA: Risk Factors
Renal failure |
Adrenal insufficiency |
Acidosis |
Excessive potassium intake |
Medications: potassium-sparing diuretics, ACE inhibitors |
HYPERKALEMIA: Manifestations
Peaked T-waves (ECG) |
Ventricular dysrhythmias |
Muscle twitching and paresthesia (early) |
Increased bowel motility |
Ascending muscle weakness (late) |
HYPERKALEMIA: Nursing Interventions
Administer medications |
Monitor ECG |
Kayexalate (monitor bowel sounds) |
Monitor bowel sounds |
50% glucose with insulin |
Initiate dialysis |
Calcium gluconate |
Dietary restriction and teaching |
Bicarbonate |
Loop diuretics |
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