WordPress.com
Electrolyte: POTASSIUM (K+)Major Electrolyte (Cation) in ICF (Normal: 3.5 – 5.0 mEq/L)LOWCOMPARE & CONTRASTHIGHHYPOKALEMIATermsHYPERKALEMIASerum K+ level < 3.5 mEq/LResult of ↑ loss of K+ from body or movement of K+ into cells.DefinitionSerum K+ level > 5.0 mEq/LResult of ↑ intake of K+, movement of K+ out of cells, or inadequate renal excretion. Decreased total body potassiumAbnormal GI losses: vomiting, NG suctioning, diarrhea, inappropriate laxative useRenal losses: excessive use of diuretics (Lasix), large dose corticosteroids, hyperaldosteronism, high does Na+ PCNsSkin losses: diaphoresis, wound losses, traumaUncontrolled diabetesMeds: diuretics, laxatives, insulinInsufficient potassiumInadequate dietary intake (rare)TPN or IVF without K+ replacement (ex: D5W) CausesIncreased total body potassiumIV K+ administration Salt substitute High K+ intakeExtracellular shift ↓ insulin, acidosis (ex: diabetic ketoacidosis), tissue catabolism (sepsis, trauma, surgery, fever, MI), release of K+ from damaged cellsHypertonic statesUncontrolled diabetesDecreased excretionRenal failure (#1 cause), severe dehydration, potassium-sparing diuretics, ACE I, NSAIDs, adrenal insufficiencyAddison’s Disease, MedicationsFatigue, anorexia, N/V, ↓ bowel motility, muscle weakness & leg cramps, impaired glucose tolerance, paresthesias, impaired renal concentrating ability, diminished deep tendon reflexes, flaccid paralysis (late sign), ↑ sensitivity to digitalis, dysrhythmias, severe hypokalemia Cardiac: ↓ strength of contraction; myocardium irritability; ST segment depression; K+ < 2.7 mEq/L may result in PACs, PVCs, V-fib or cardiac arrest; K+ < 3.5 assoc. with met. alkalosis, high pH & high HCO3; Digoxin toxicity Signs & SymptomsCardiacRespiratoryNeurologicalGeneralMainly affects cardiac function, muscle weakness & paralysis, ventricular conduction slowed, paresthesia & irritability (resp. & speech muscles), flaccid muscular paralysis (legs-trunk-arms-including resp.), GI hyperactivity (N/V/D, colic)Cardiac:Slows heart rate, ECG changes (tall, peaked T wave, short QT interval; longer PR interval, widening QRS complex; risk for heart block, A-fib, or V-fib), Severe ↑K+ → decreased heart contraction strength, dilated & flaccid heart, bradycardia K+ deficit < 3.5 mEq/LK+ < 3.5 mEq/L often assoc. with metabolic alkalosis, high pH, & high HCO3K+ < 2.7 → dangerous dysrhythmias↑ pH & HCO3Lab & Diagnostic TestsSerum K+ > 5.0 mEq/LECG abnormalitiesABGs – low pH indicating metabolic acidosis K+ replacement (PO or IV)Increase on a daily basis – 40-80 mEq/dayAt risk pt. – 50-100 mEq/dayK+ rich foodsTreat underlying causeOral K+ Supplements Minimize GI irritation: dilute liquid & effervescent supplement, give tabs & capsules w/ 8 oz. water, give K+ with foodAdverse reaction – N/V, diarrhea, GI bleedAvoid overdose (hyperkal…)↓ K+ dose if using K+ salt substituteNot used w/ K+ sparing diureticsIntravenous K+ SupplementMust be dilutedDo NOT give by direct IVPMax. dose: 60 mEq at a timeMust use IV pumpMonitor renal outputCHS policy – pt. on heart monitorMonitor IV siteLR, NS (watch for S/S of fluid overload or pulmonary edema)*Serum Na+ must not be increased > 12 mEq/L in 24 hoursWater gain:Restrict H2O safer than giving Na (800ml/24hr)Hypertonic solution 3%-5% NaCLEdema only – restrict Na+Edema & Na+ – restrict both Loop diureticsTreatmentK+ restricted dietStop K+ containing medsMonitor for “Digitalis toxicity”Cation-exchange resins: Kayexalate PO or PR, 1 gm of resin removes 1 mEq K+ Dialysis – if conservative methods not sufficient Emergency Medical TreatmentCa++ Gluconate IV – does not ↓ K+ (keeps heart from getting flaccid), antagonizes K+ action on heart, monitor ECGHypertonic glucose & insulin – insulin facilitates K+ into cells; glucose ↑ insulin release from pancreas NaHCO3 (Sodium Bicarb) → K+ shifts into cells very quickly (reverses acidosis)Identify pt. at risk – esp. if on DigoxinMonitor ECG & BPMonitor serum K+Pt. education – diuretics & laxativesAdminister K+ supplements PO or IV↑ dietary K+Monitor urine output Nursing InterventionsBe aware at risk pt. (elderly)Monitor for: generalized weakness & dysrhythmias, irritability & GI symptoms, nausea & intestinal colic, ECG or lab abnormalitiesPrevention of hyperkalemiaEducate pt. – meds & dietDo NOT draw blood above K+ infusion sitePotassium Rich FoodsBananasApricotsOrangesCantaloupeBroccoliPotatoesCarrotsAvocadosDried fruitLegumesMeatsWhole grain breadDairy products Coffee/tea/cocoaHYPOKALEMIAS – skeletal muscle weaknessU – u-waveC – constipation or ileus T – toxicity of DigoxinI – irregular or weak pulse O – orthostatic hypotensionN – numbness or paresthesia 409448014605KEY POINTS:Potassium plays a vital role in cell metabolism, transmission of nerve impulses, functioning of cardiac, lung, and muscle tissues, and acid-base balancePotassium has a reciprocal action with sodiumMinor variations in potassium levels are significantImbalancesRenal system important in keeping balanced potassiumBody does not conserve potassium ................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
Related searches
- wordpress passing data between pages
- wordpress business templates
- wordpress rss feed not working
- wordpress jquery is not defined
- create wordpress blog
- wordpress roles editor
- wordpress full rss feed
- wordpress rss feed settings
- wordpress rss feed plugin
- wordpress display rss feed
- wordpress rss feed link
- wordpress rss feed to post