Electrolyte imbalance potassium

Electrolyte imbalances that may be seen during therapy with a diuretic include hyponatremia (low blood sodium) and hypokalemia (low blood potassium), although other imbalances may also be seen. See Chapter 58 and Display 58-2 for the signs and symptoms of electrolyte imbalances. The primary care provider is notified if any signs or symptoms of an electrolyte imbalance occur. 

Older adults are particularly prone to fluid volume deficit and electrolyte imbalances (see Display 46-1) while taking a diuretic. The older adult is carefully monitored for hypokalemia (when taking the loop or thiazide diuretic and hyperkalemia (with the potassium-sparing diuretics... 

The nurse must closely observe patients receiving a potassium-sparing diuretic for signs of hyperkalemia (see Display 46-1), a serious and potentially fatal electrolyte imbalance The patient is closely monitored for hypokalemia during loop or thiazide diuretic therapy. A supplemental potassium supplement may be prescribed to prevent hypokalemia. The primary health care provider may also encourage the patient to include... 

In men, administration of an androgen may result in breast enlargement (gynecomastia), testicular atrophy, inhibition of testicular function, impotence, enlargement of the penis, nausea, jaundice, headache, anxiety, male pattern baldness, acne, and depression. Fluid and electrolyte imbalances, which include sodium, water, chloride, potassium, calcium, and phosphate retention, may also be seen. 

Adverse reactions associated with loop diuretics include nausea vomiting diarrhea gastric irritation headache fatigue dizziness thrombocytopenia rash orthostatic hypotension hyperuricemia hyperglycemia electrolyte imbalance (decreased chloride, potassium and sodium) dehydration. 

The value of pharmacological interventions is not as firmly established as is desirable. Control of pre-cipitants notably gastrointestinal haemorrhage, systemic infection, constipation and electrolyte, particularly potassium imbalance is important. Despite lack of consistent evidence, use of synthetic sugars by mouth and oral antibiotics (neomycin or metronidazole) remains standard. Oral neomycin, though poorly absorbed, can still cause eighth cranial nerve damage. 

Most patients with BN can be effectively treated as outpatients. Medical hospitalizations result from consequences of purging activities, such as frequent vomiting and abuse of laxatives and diuretics, which can create electrolyte imbalances and dehydration. These patients are at risk for developing cardiac arrhythmias due to hypokalemia. If the patient s serum potassium falls below 2.5 mEq/T, the patient should be hospitalized. Other medical emergencies are gastric dilatation and esophageal tears (both are rare). Cardiac failure caused by cardiomyopathy from ipecac intoxication is a medical emergency. 

When salt intake is reduced, a series of "dry look" nemesis arise. Salt contains sodium, and to a lesser degree potassium in the form of potassium iodide. When salt/sodium is reduced or eliminated from the diet the result is increased Aldosterone release. This makes the body excrete more potassium and hold more sodium/water. The resulting water retention gives the athlete a puffy wet look. This is due to electrolyte imbalances. 

The most serious side effects of diuretics are fluid depletion and electrolyte imbalance.13,88 By the very nature of their action, diuretics decrease extracellular fluid volume as well as produce sodium depletion (hyponatremia) and potassium depletion (hypokalemia). Hypokalemia is a particular problem with the thiazide and loop diuretics, but occurs less frequently when the potassium-sparing agents are used. Hypokalemia and other disturbances in fluid and electrolyte balance can produce serious metabolic and cardiac problems and may even prove fatal in some individuals. Consequently, patients must be monitored closely, and the drug dosage should be maintained at the lowest effective dose. Also, potassium supplements are used in some patients to prevent hypokalemia. 

Diabetic ketoacidosis may either result from or be aggravated by infection, surgery, trauma, shock, emotional stress, or failure to take sufficient amounts of insulin. Treatment is focused on reversing the hypokalemia by administering potassium chloride and on offsetting the acidosis by providing bicarbonate. The dehydration and electrolyte imbalance are treated with appropriate measures and crystalline zinc insulin is administered to counter the hyperglycemia. 

ELECTROLYTE IMBALANCE Improper proportions of acids, bases, salts, and fluids in the body. Electrolytes include the salts sodium, potassium, magnesium, chloride chlorine. They can conduct electricity, and therefore are essential in nerve, muscle, and heart function. 

Because they affect sodium, potassium, and chloride levels in the body, diuretics can trigger electrolyte imbalances. An electrolyte imbalance can cause a variety of neurological symptoms, including confusion, fainting, dizziness, and headache. 

Theoretically, any of the protective interventions mentioned in the previous section may be applicable to a clinical setting, but few have actually been studied, in some instances, because there are practical limitations to their use. For example, the duration of protection conferred by furosemide is brief, being confined to the time furosemide is present in the renal tubule. Furosemide would exacerbate electrolyte imbalance by causing sodium and potassium depletion, which, if not adequately monitored and replaced, would be expected to potentiate AmB-induced nephrotoxicity. Furthermore, none of the advocated drug interventions are itmocuous. Of all the alternatives, manipulation of sodium status or of the method of administration offer simple interventions that can be readily and usually... 

The sodium or potassium content of i.v. formulations can contribute to electrolyte imbalances associated with congestive heart failure and renal function impairment. Care should be taken when using these formulations in neonates. 

Diarrhea can cause dehydration and electrolyte imbalance because intestinal fluids are rich in water, sodium, potassium, and bicarbonate. To rehydrate and restore electrolyte imbalance, patients are administered Gatorade, Pedialyte, Ricelyte, and electrolytes given IV. Antidiarrheal medication decreases the hypermotility (increased peristalsis) that stimulates frequent bowel movements and should be administered for less than 2 days and not if the patient experiences a fever. There are four classifications of antidiarrheal medication. These are ... 

Diarrhea can cause dehydration and electrolyte imbalance because intestinal fluids are rich in water, sodium, potassium, and bicarbonate. To rehydrate and restore electrolyte imbalance, patients are administered Gatorade, Pedialyte, Ricelyte, and electrolytes given IV. 

Electrolytes are important minerals that are required for normal functioning of the body. They are found in the bloodstream, as well as in other bodily fluids such as sweat. It is necessary to maintain normal levels of electrolytes such as sodium, potassium, and bicarbonate in order to sustain muscle functioning, nerve impulses, and normal fluid levels in the body. When laxatives and diuretics are used, water and electrolytes are removed from the body, causing an electrolyte imbalance and accompanying health problems. 

The need for fluid replacement is obvious. Oral rehydration is preferred over intravenous administration of fluids and electrolytes since it is noninvasive. In many third world countries, it is the only therapy available in remote areas. The rehydration formula includes 50-80 g/L rice (or other starch), 3.5 g/L sodium chloride, 2.5 g/L sodium bicarbonate, and 1.5 g/L potassium chloride. Oral rehydration takes advantage of the cotransport of Na and glucose across the cells lining the intestine. Thus, the channel protein brings glucose into the cells, and Na+ is carried along. Movement of these materials into the cells will help alleviate the osmotic imbalance, reduce the diarrhea, and correct the fluid and electrolyte imbalance. 

Side effects and adverse reactions include flushing, fever, chills, nausea, vomiting, hypotension, paresthesias, and thrombophlebitis. It is highly toxic, causes nephrotoxicity and electrolyte imbalance, especially hypokalemia (low potassium) and hypomagnesemia (low serum magnesium). Urinary output, BUN, and serum creatinine levels should be closely monitored. 

Osmotic laxatives contain three types of electrolyte salts sodium salts (sodium phosphate or phospho-soda, sodium biphosphate), magnesium salts (magnesium hydroxide (milk of magnesia), magnesium citrate, magnesium sulfate (Epsom salts), and potassium salts (potassium bitartrate, potassium phosphate). Serum electrolytes should be monitored to avoid electrolyte imbalance. Good renal function is needed to excrete any excess salts. 

Results occur in 6 to 12 hours. Stimulant laxatives such as bisacodyl are used to empty the bowel before diagnostic tests (for example, barium enema) because they are minimally absorbed from the G1 tract. Most are excreted in feces. However, a small amount of bisacodyl absorption excreted in the urine changes the color to reddish-brown. With excessive use, fluid and electrolyte imbalances can occur (especially potassium and calcium). Mild cramping and diarrhea are side effects. 

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