Fluid and Electrolyte Imbalance: Hypokalemia

Hypokalemia

• Potassium plays an important role in nerve conduction, muscle function, acid-base balance and osmotic pressure.
• Potassium levels are obtained through venous blood extraction.
• It is a metabolic disorder wherein the level of potassium in the blood is lower than normal (< 3.5 mEq/L).
• It is associated with shifting of K+ into cells, K+ loss from GI and biliary tracts, renal K+ excretion and reduced K+ intake.
• It is a result of one of the following:
  • Diarrhea, sweating, vomiting
  • Starvation, malabsorption
  • Bartter’s syndrome
  • Draining wounds
  • Cystic fibrosis
  • Severe burns
  • Primary aldosteronism
  • Chronic alcoholism
  • Osmotic hyperglycemia
  • Respiratory alkalosis
  • Renal tubular acidosis
  • Diuretics, antibiotics and mineralocorticoid administration
  • Barium chloride poisoning

Symptoms:

• Arryrthmias, especially for persons with cardiovascular disease
• Breakdown of muscle fibers
• Constipation
• Fatigue
• Muscle weakness or spasms, paralysis

Treatment:

• Correct underlying disorder associated with hypokalemia.
• Give potassium tablets.
• Have a diet rich in potassium such as bananas, apples, oranges, milk and tomatoes.

Nursing Considerations:

1. Record fluid intake and output.
2. Check blood volume and venous pressure.
3. Identify ECG changes such as depressed T waves, peaking P waves.
4. Observe for dehydration. Accurately record state of hydration.
5. Observe for neuromuscular changes such as fatigue and muscular weakness.

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