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Normal value for Potassium (K):
3.5 - 5.1 mEq/L
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Common food sources for Potassium (K):
- Avocado
- Bananas
- Cantaloupe
- Carrots
- Fish
- Mushrooms
- Oranges
- Potatoes
- Pork, beef, veal
- Raisins
- Spinach
- Strawberries
- Tomatoes
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Hypokalemia
Description:
Serum potassium level below 3.5 mEq/L
-most common electrolyte imbalance and is potentially life threatening
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Hypokalemia
Conditional causes:
- -Diarrhea
- -Vomitting
- -Alkalosis
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Hypokalemia
Pathological causes:
- -Cushing's syndrome
- -Renal disease
- -Uncontrolled diabetes
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Hypokalemia
Pharmacological causes:
- -Use of non-potassium sparing diuretics
- -Total parenteral nutrition
- -Chronic use of corticosteroids
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Hypokalemia
Procedural causes:
- -Excessive gastric suction
- -Excessive fistula drainage
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Hypokalemia
Monitoring interventions:
- -vital signs
- -neuromuscular activity
- -I&O
- -cardiac changes during administration of potassium
- -electrolyte values
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Hypokalemia
Instruct client to not use:
-salt substitutes containing potassium unless prescribed by the physician
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Before administering potassium check:
-renal function
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A ______ is needed before administering potassium supplements (orally or monitor by IV)
-prescription from physician
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Oral potassium preparation can cause 1._____ and should not be taken 2.______
- 1.: GI irritation
- 2.: on an empty stomach
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A client receiving more than 10 mEq/hr should be placed on 1._____; the infusion needs to be controlled by 2._____
- 1.: a cardiac monitor
- 2.: infusion device
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Oral potassium may need to be discontinued if client is complaining or presenting the following signs or symptoms:
- abdominal pain, distention
- nausea
- vomiting
- diarrhea
- GI bleeding
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Hyperkalemia
Description:
A serum potassium level exceeding 5.1 mEq/L
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Hyperkalemia
Conditional causes:
- renal failure
- intestinal obstruction
- cell damage
- metabolic acidosis
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Hyperkalemia
Pharmacological causes:
- excessive use of potassium based salt substitutes
- excessive oral or parenteral administration of potassium
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Hyperkalemia
Pathological causes:
Addison's disease
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Hyperkalemia
Procedural causes:
Transfusion of stored blood (breakdown of older RBC release potassium)
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Hyperkalemia
Monitoring interventions:
- vital signs
- cardiac changes
- I&O
- lab values
- renal function
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Emergency treatment for Hyperkalemia includes rapid IV administration of 1._____ with 2._____ in order to 3._____
- 1.: dextrose
- 2.: regular insulin
- 3.: move excess potassium into the cells
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In hyperkalemic clients, administer 1._____ orally or by enema as prescribed; it releases sodium ions in exchange for primarily potassium ions and absorbs the potassium into the GI tract for excretion.
During this treatment, the nurse needs to monitor for 2._____ and 3._____ loss.
- 1.: sodium polystyrene sulfonate (Kayexalate)
- 2.: calcium
- 3.: magnesium
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In hyperkalemic clients, the physician may prescribe 1._____ or 2._____ procedure to be done.
- 1.: peritoneal dialysis
- 2.: hemodialysis
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When blood transfusions are prescribed for a client with a potassium imbalance, the client should receive_____, if possible.
fresh blood
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Hyperkalemia
Patient instructions:
- avoid foods high in potassium
- avoid the use of salt substitutes or other potassium-containing substances
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Hypokalemia
Signs and symptoms:
- leg and abdominal cramps
- lethargy and weakness
- shallow respirations and thready pulse
- confusion
- decreased or absent reflexes
- hypoactive bowel sounds and ileus
- postural hypotension
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Hyperkalemia
Signs and symptoms:
- muscle weakness
- paresthesias
- hypotension
- diarrhea
- hyperactive bowel sounds
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In clients with Hypokalemia, their P waves are 1.__, T waves are 2.__, ST segment and U waves are 3.__
- 1.: peaked
- 2.: flat
- 3.: depressed
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In clients with Hyperkalemia, their P waves are 1.__, QRS complex are 2.__, PR interval are 3.__, ST segments are 4.__, T waves are 5.__ and 6.__
- 1.: flat
- 2.: widened
- 3.: prolonged
- 4.: depressed
- 5.: narrow
- 6.: peaked
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