Potassium imbalances

The most common imbalances are a loss of potassium and water. Other electrolytes, namely magnesium, sodium, and chlorides, are also lost. When too much potassium is lost, hypokalemia (low blood potassium) occurs (see Home Care Checklist Preventing Potassium Imbalances). In certain patients, such as those also receiving a digitalis glycoside or those who currently have a cardiac arrhythmia, hypokalemia has the potential to create a mo re serious arrhythmia Hypokalemia is... 

Potassium imbalance Disopyramide may be ineffective in f7ypokalemia and its toxic effects may be enhanced in /lyperkalemia. Correct any potassium deficit before instituting therapy. 

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. 

Several children who were treated with mercurous chloride for constipation, worms, or teething discomfort had swollen red gums, excessive salivation, anorexia, diarrhea, and/or abdominal pain (Warkany and Hubbard 1953). They also experienced muscle twitching or cramping in the legs and/or arms, but these muscular effects were probably secondary to changes in electrolyte balance (i.e., potassium imbalance due to fluid loss or renal wasting). 

Whilst 6 g kg DM of dietary potassium seemed to be a more suitable level to ensure against potassium imbalance at high temperatures, 10 g kg appeared to be an excessive level (Deetz and Ringrose 1976). 

Potassium-sparing diuretics enhance sodium and water excretion while retaining potassium. These agents are marketed in combination with potassium-wasting diuretics in order to minimize potassium imbalances. 

Which of the following statements is accurate about the patient at risk for a potassium imbalance ... 

Sodium imbalances can lead to other electrolyte imbalances, and if not corrected quickly, potassium imbalance can be fatal because imbalances can lead to nerve and cardiac dysfunction. 

Overtreatment of sodium imbalance could result in the opposite, sodium imbalance, as well as fluid and electrolyte (potassium) imbalances, if care is not exercised. 

Identify patients at high risk for potassium imbalance. 

Distinguish symptoms of excess and deficient potassium imbalances. Identify diagnostic values associated with potassium imbalances. 

Determine the nursing implications related to treatments for potassium imbalances. 

The level of potassium in the cells and in the extracellular fluid will influence cell depolarization—the movement of the resting potential closer to the threshold at which an action potential can occur, causing more cell excitability and hyperpolarization—decreased resting membrane potential to a point far away from the threshold at which an action potential can occur, causing less cell excitability. Potassium imbalance thus can affect nerve and muscle cells by causing hyperexcitability or depressed excitability. 

Mr. Lawrence Key, age 62, was admitted 5 days ago after a car accident with massive injuries to his extremities and trunk. Vital signs are blood pressure (BP) 100/60 mm Hg, pulse (P) 118 beats/minute, and respiration (R) 32 breaths/minute. He is lethargic, his skin is cool to the touch, and his mucous membranes are dry. His laboratory a results today revealed Na" 137 mEq/L, K+ 4.9 mEq/L, CO 20 mEq/L, blood urea nitrogen (BUN) 40 mg/dL, and creatinine 2.7 mg/dL. His urine output has been 20 mL/h except when a diuretic (Lasix) was administered. The nurse considers the following when analyzing Mr. Key s risk for potassium imbalance ... 

A 55-year-told patient was admitted after a car accident with crush injury to the chest and extremities. The nurse is concerned that the patient is demonstrating a potassium imbalance. The nurse would anticipate which of the following treatments to address the potassium imbalance for which the patient is at the highest risk ... 

Bailey McIntosh has had 300 00 mL of urine each hour over the past 26 hours. The nurse would watch closely for which of the following signs of a likely potassium imbalance ... 

Hypernatremia andhypercalcemiacanresultindecreasedmagnesium reabsorption. Magnesium may contribute to hypokalemia and associated symptoms. Symptoms of magnesium imbalance occasionally will be mixed with symptoms of calcium or potassium imbalance. 

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