Fluid and electrolytes (NUR 453, Role Transition, exam 1)
Questions With Complete Solutions
Causes and Effects of Hypokalemia
Hypokalemia Sign and Symptoms
}Cardiovascular
◦Thready, weak, irregular pulse
◦Peripheral pulse weak
◦Cardiac Arrhythmias
◦EKG changes: ST depression, flat or inverted T wave, and
prominent U wave
}Respiratory
◦Shallow, ineffective respirations that result from profound
weakness of the skeletal muscles of respiration
}Neuromuscular
,◦Anxiety, lethargy, confusion, coma
}Gastrointestinal
◦Nausea, vomiting
◦Abdominal distention
◦ileus
Hypokalemia Nursing Interventions
}Monitor for arrhythmias (telemetry)
}Monitor electrolyte Imbalance
}Administer potassium supplements orally or intravenously as
prescribed
}Instruct client about foods that are high in potassium content
}Strict I & O
you can NOTTT replace potassium more than 10 mEqs without
cardiac telemetry
on cardiac telemetry you can do it at 20 mEqs per hour
never replace potassium faster than 20 mEqs per hour
- needs to be diluted
Potassium IV
}NEVER given IV push or by IM or SQ route
}After adding potassium to an IV solution, shake the bag and
invert it to ensure that the potassium is distributed evenly
throughout the IV solution
, }The maximum recommended infusion rate is 5 to 10 mEq/hr,
never to exceed 20 mEq/hr under any circumstances
}A client receiving more than 10 mEq/hr should be place in
telemetry monitoring
}Monitor for Phlebitis; if occur, STOP infusion
}Nurse should assess renal function before infusion and monitor
I&O
potassium is very irritating to the veins, very common for pt to
get redness and irritation
Potassium Common Food Sources
}Avocado
}Bananas
}Cantaloupe
}Carrots
}Fish
}Mushrooms
}Oranges
}Potatoes
}Pork, beef, veal
}Raisins
}Spinach
}Strawberries
}Tomatoes
Causes and Effects of Hyperkalemia
Questions With Complete Solutions
Causes and Effects of Hypokalemia
Hypokalemia Sign and Symptoms
}Cardiovascular
◦Thready, weak, irregular pulse
◦Peripheral pulse weak
◦Cardiac Arrhythmias
◦EKG changes: ST depression, flat or inverted T wave, and
prominent U wave
}Respiratory
◦Shallow, ineffective respirations that result from profound
weakness of the skeletal muscles of respiration
}Neuromuscular
,◦Anxiety, lethargy, confusion, coma
}Gastrointestinal
◦Nausea, vomiting
◦Abdominal distention
◦ileus
Hypokalemia Nursing Interventions
}Monitor for arrhythmias (telemetry)
}Monitor electrolyte Imbalance
}Administer potassium supplements orally or intravenously as
prescribed
}Instruct client about foods that are high in potassium content
}Strict I & O
you can NOTTT replace potassium more than 10 mEqs without
cardiac telemetry
on cardiac telemetry you can do it at 20 mEqs per hour
never replace potassium faster than 20 mEqs per hour
- needs to be diluted
Potassium IV
}NEVER given IV push or by IM or SQ route
}After adding potassium to an IV solution, shake the bag and
invert it to ensure that the potassium is distributed evenly
throughout the IV solution
, }The maximum recommended infusion rate is 5 to 10 mEq/hr,
never to exceed 20 mEq/hr under any circumstances
}A client receiving more than 10 mEq/hr should be place in
telemetry monitoring
}Monitor for Phlebitis; if occur, STOP infusion
}Nurse should assess renal function before infusion and monitor
I&O
potassium is very irritating to the veins, very common for pt to
get redness and irritation
Potassium Common Food Sources
}Avocado
}Bananas
}Cantaloupe
}Carrots
}Fish
}Mushrooms
}Oranges
}Potatoes
}Pork, beef, veal
}Raisins
}Spinach
}Strawberries
}Tomatoes
Causes and Effects of Hyperkalemia
