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:
- Record fluid intake and output.
- Check blood volume and venous pressure.
- Identify ECG changes such as depressed T waves, peaking P waves.
- Observe for dehydration. Accurately record state of hydration.
- Observe for neuromuscular changes such as fatigue and muscular weakness.
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Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
