Hypokalemia is when the serum potassium level is below ____ mEq/L
3.5
When _____ is present, a temporary shift of serum potassium into the cells occurs
alkalosis (high blood pH)
Potassium-losing diuretics, such as the ____ and ______, can induce hypokalemia
thiazides and loop diuretics
Other medications that can lead to hypokalemia include: (3)
corticosteroids
sodium penicillin
amphotericin B
______ and _______ frequently lead to hypokalemia, because potassium is lost when gastric fluid is lost and because potassium is lost through the kidneys in response to metabolic alkalosis
Vomiting and gastric suction
Alterations in acid–base balance have a significant effect on potassium
distribution due to shifts of _____ and _____ ions between the cells and
the ECF.
hydrogen and potassium
T or F: Patients who are not able to eat a normal diet for a prolonged period are at risk for hypokalemia
T
This may occur in debilitated older adults and in patients with _____ or ______.
alcoholism or anorexia nervosa
Severe hypokalemia can cause death through _____ or ______ arrest.
cardiac or respiratory arrest
If prolonged, hypokalemia can lead to:
an inability of the kidneys to concentrate urine, causing dilute urine (resulting in polyuria, nocturia) and excessive thirst
Potassium depletion suppresses the release of ____ and results in glucose intolerance
insulin
Signs/Symptoms of hypokalemia
Fatigue
anorexia
nausea and vomiting
muscle weakness
polyuria
decreased bowel motility
ventricular asystole or fibrillation
paresthesias
leg cramps
↓ Blood pressure
ileus
abdominal distention
hypoactive reflexes.
ECG: flattened T waves, prominent U waves, ST depression, prolonged PR interval
Contributing factors of hypokalemia
Diarrhea
vomiting
gastric suction
corticosteroid administration
hyperaldosteronism
carbenicillin
amphotericin B
bulimia
osmotic diuresis
alkalosis
starvation
diuretics
digoxin toxicity
An elevated _ wave is specific to hypokalemia.
U
T or F: Metabolic acidosis is commonly associated with hypokalemia
F: Metabolic alkalosis is commonly associated with hypokalemia
If hypokalemia cannot be prevented by conventional measures such as
increased intake in the daily diet or by oral potassium supplements for
deficiencies, then it is treated cautiously with ___________.
IV replacement therapy
Medical Management:
Potassium loss must be corrected daily; administration of __ to __mEq/day of potassium is adequate in the adult if there are no abnormal losses of potassium.
40 to 60 mEq/day
Foods high in potassium include most: (6)
fruits and vegetables, legumes, whole grains, milk, and meat
Medical Management:
Although potassium chloride (KCl) is usually used to correct potassium deficits, ______ or ______ may be prescribed
potassium acetate or potassium phosphate
Nursing Management:
What are signals that warrant assessing the serum potassium concentration? (6)
Fatigue,
anorexia,
muscle weakness,
decreased bowel motility,
paresthesias,
and arrhythmias
Patients receiving digitalis who are at risk for potassium deficiency should be monitored closely for signs of ______.
digitalis toxicity
The nurse helps prevent hypokalemia by encouraging patients at risk to:
☁ eat foods rich in potassium (when the diet allows)
☁ patient education
☁ Careful monitoring of fluid I&O
☁ The ECG is monitored for changes,
☁ arterial blood gas (ABG) values are checked for elevated bicarbonate and pH levels.
Correcting Hypokalemia:
The ___ route is ideal to treat mild to moderate hypokalemia because ___
potassium supplements are well absorbed.
oral, oral
Potassium may be retained more readily in ____ than in ____ people
older than in younger people
Administering Intravenous Potassium:
Potassium should be given only after adequate _____ has been established.
urine output
Potassium is primarily excreted by the kidneys; when ____ occurs,
potassium administration can cause the serum potassium concentration to rise to dangerous levels
oliguria
ADDITIONAL INFO:
Potassium is never given by IV push or intramuscularly to avoid
replacing potassium too quickly. Potassium is extremely irritating to
tissues. IV potassium must be given using an infusion pump.
ADDITIONAL INFO
Renal function should be monitored through ___ and ________
levels and ______ if the patient is receiving potassium replacement.
