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HYPOKALEMIA: Risk FactorsExcessive diaphoresis | Adverse effects of medications | Body fluid loss | Kidney disease | Corticosteroids | Vomiting | Dietary deficiency | Diuretics | Diarrhea | Alkalosis | Digitalis | Wound drainage | | | Laxatives (abuse of) | Nasogastric suction |
HYPOKALEMIA: ManifestationsMuscle weakness, cramping | Fatigue | Nausea, vomiting | Irritability, confusion | Decreased bowel motility | Paresthesia | Dysrhythmias | Flat and/or inverted T waves (ECG) |
HYPOKALEMIA: Nursing InterventionsMonitor 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: NotesNEVER give K+ IV bolus. MUST dilute. | "No P = No K." If the client is not urinating, do NOT administer potassium. |
| | HYPERKALEMIA: Risk FactorsRenal failure | Adrenal insufficiency | Acidosis | Excessive potassium intake | Medications: potassium-sparing diuretics, ACE inhibitors |
HYPERKALEMIA: ManifestationsPeaked T-waves (ECG) | Ventricular dysrhythmias | Muscle twitching and paresthesia (early) | Increased bowel motility | Ascending muscle weakness (late) |
HYPERKALEMIA: Nursing InterventionsAdminister 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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