What should a nurse do if a patient has high potassium?
B. Dysrhythmias. Because thiazide diuretics may lower the serum potassium level, patients taking digoxin are at increased risk for fatal dysrhythmias from the digoxin if the potassium level falls. The serum potassium level needs to be monitored and maintained above 3.5 mEq/L. When teaching a patient about the effects of a diuretic, the nurse ...
What is the potassium level of a patient on a medical unit?
· … 6/9 QUESTION 20 The patient's potassium is 5.9 meq/L, what treatment below should the nurse prepare to administer? Medication to promote the movement of potassium into the intracellular space An aldosterone antagonist to alter renal excretion of potassium 3.33 points Saved Click Save and Submit to save and submit. Click Save All Answers to ...
Which indicates that the patient is aware of foods that contain potassium?
A patient who has a potassium level of 5.9 mEq/L will be given oral polystyrene sulfonate (Kayexalate). What nursing actions are necessary? Select all that apply. 1. Monitor for onset of action of this drug in an hour. 2. Administer sorbitol concurrently. 3. Repeat the dose in 4 hours if needed. 4. Mix the dose with a high sugar liquid. 5.
How do I administer potassium to a client with potassium deficiency?
A patient being treated for adrenal insufficiency has a serum potassium level of 5.9 mEq/L. What should the nurse expect to be prescribed for this patient? 1) Kayexalate 2) Hydrocortisone 3) Dexamethasone 4) Dextrose 5% and 0.45% normal saline ____
What do you administer for high potassium?
Patients with hyperkalemia and characteristic ECG changes should be given intravenous calcium gluconate. Acutely lower potassium by giving intravenous insulin with glucose, a beta2 agonist by nebulizer, or both. Total body potassium should usually be lowered with sodium polystyrene sulfonate (Kayexalate).
What is the first line treatment for hyperkalemia?
Calcium gluconate should be used as a first-line agent in patients with EKG changes or severe hyperkalemia to protect cardiomyocytes. Insulin and glucose combination is the fastest acting drug that shifts potassium into the cells.
What drug do we administer when potassium is low?
In order to correct the blood potassium level, and bring it into the "normal" range, you must often take magnesium as well. These medications may be taken in a pill form, or in an intravenous (IV) form, if you are severely deficient in these electrolytes.
Which treatments are usually ordered for hyperkalemia?
The Importance of Hyperkalemia TreatmentWater pills (diuretics), which rid the body of extra fluids and remove potassium through urine.Sodium bicarbonate, which temporarily shifts potassium into body cells.Albuterol, which raises blood insulin levels and shifts potassium into body cells.More items...
When do you treat hyperkalemia?
If the hyperkalemia is severe (potassium >7.0 mEq/L) or if the patient is symptomatic, begin treatment before diagnostic investigation of the underlying cause. Individualize treatment in accordance with the patient's presentation, potassium level, and electrocardiographic findings.
How does IV insulin lower potassium?
Insulin shifts potassium into cells by stimulating the activity of Na+-H+ antiporter on cell membrane, promoting the entry of sodium into cells, which leads to activation of the Na+-K+ ATPase, causing an electrogenic influx of potassium. IV insulin leads to a dose-dependent decline in serum potassium levels [16].
What is the nurse's role in administration of potassium?
potassium administration is necessary to prevent toxic effects from hyperkalemia. Evaluate his response to treatment by checking serum potassium levels and assessing him for signs and symptoms of toxicity, such as muscle weakness and paralysis.
Should potassium of 3.3 Be treated?
Patients who have mild or moderate hypokalemia (potassium level of 2.5-3.5 mEq/L) are usually asymptomatic; if these patients have only minor symptoms, they may need only oral potassium replacement therapy. If cardiac arrhythmias or significant symptoms are present, then more aggressive therapy is warranted.
How do you correct hypokalemia?
Hypokalemia is treated with oral or intravenous potassium. To prevent cardiac conduction disturbances, intravenous calcium is administered to patients with hyperkalemic electrocardiography changes.
What is the serum potassium level of a thiazide diuretic?
As the nurse is assessing a patient who is taking a thiazide diuretic, the lab calls to report that the patient's serum potassium level is 5.9 mEq/L. Which diagnostic test should be scheduled in response to this finding?
What should a patient do if postural hypotension occurs?
D. If postural hypotension occurs, the patient should reduce his or her activity level.
What does hyperkalemia mean on an ECG?
A. Electrocardiogram (ECG) Hyperkalemia causes alterations in the ECG and cardiac rhythm and may lead to cardiac dysrhythmias or even cardiac arrest if the serum potassium level reaches 8 to 9 mEq/L.
What are the signs of hyperkalemia?
Confusion, anxiety, weakness, and numbness or tingling of the hands and feet are possible signs of hyperkalemia. Intestinal dilation, ileus, and paralysis of skeletal muscle are signs of possible hypokalemia.
Is furosemide a diuretic?
Furosemide, a high-ceiling (loop) di uretic, is useful in patients with severe renal impairment because it can promote diuresis in the presence of reduced glomerular filtration rate. Thiazides are not effective if renal impairment is present, and potassium-sparing diuretics have limited diuretic effects.
Can digoxin cause dysrhythmias?
B. Dysrhythmias. Because thiazide diuretics may lower the serum potassium level, patients taking digoxin are at increased risk for fatal dysrhythmias from the digoxin if the potas sium level falls. The serum potassium level needs to be monitored and maintained above 3.5 mEq/L.
Can spironolactone be used with thiazide?
Potassium-sparing diuretics such as spironolactone are frequently combined with thiazide and loop diuretics to promote diuresis and to help counteract the potassium loss that may occur with thiazides/loop diuretics. Because of the risk for hyperkalemia, spironolactone must never be combined with potassium supplements.
What does the physician order for a patient in critical care who has cerebral edema?
The physician orders a hypertonic crystalloid solution for the patient in critical care who has cerebral edema. The nurse hangs a bag of a hypotonic solution. What will the priority assessment by the nurse include?
Which electrolytes are the most important?
4. "The most important electrolytes are sodium, potassium, and magnesium."
What organs keep electrolytes in narrow balance?
1. "The kidneys and GI tract keep electrolytes in narrow balance, where they must be."
What is a nurse practitioner?
The nurse practitioner conducts education for home-health nurses who care for geriatric patients. Many of the patients abuse laxatives, so the nurse practitioner focuses the education on problems that can be caused by chronic laxative use. The nurse practitioner evaluates that learning has occurred when the nurses make which statements?
Does insulin lower potassium levels?
1. "Insulin will cause his extra potassium to go into his cells and lower the blood level."
Does insulin help kidneys?
4. "Insulin will help his kidneys excrete the extra potassium."
Why is potassium important?
2) It is used in the body to synthesize ingested protein. 3) It is vital in regulating muscle contraction and relaxation. 4) It is needed to maintain skeletal, cardiac, and neuromuscular activity. Potassium is the major cation in intracellular fluids, with only a small amount found in plasma and interstitial fluid.
What is the average urine output for a 70 kg patient?
Expected urine output for an adult patient is 0.5 mL/kg/hr. The patient currently weighs 70 kg; therefore, adequate urine output would be at least 35 mL/hr.
What unit does a nurse receive shift report on?
The nurse receives shift report on a pediatric medical-surgical unit. The nurse has been assigned four patients for the shift. Which child does the nurse plan to assess first based on the increased risk for dehydration?
What is hypotonic dehydration?
Hypotonic dehydration occurs when fluid loss is characterized by a proportionately greater loss of sodium than water, causing serum sodium to fall below normal levels.
What is the drink of choice for replenishing fluids that are lost during exercise?
2) "Water is the drink of choice to replenish fluids that are lost during exercise."
What is a phosphorus level of 2.0?
A phosphorus level of 2.0 is low , and the client will need additional dietary phosphorus. Providing phosphorus-rich foods such as milk and yogurt is a good way to provide that additional phosphorus.
Which age group has the greatest risk of dehydration?
The pediatric patient with the greatest risk for dehydration is the child who is under 2 years of age experiencing tachypnea which increases insensible fluid loss.
What is the serum potassium level of a client with acute kidney injury?
A client with acute kidney injury has a serum potassium level of 7.0 mEq/L. The nurse should plan which actions as a priority? Select all that apply.
What is the treatment for polycystic kidney disease?
Treatment options include hemodialysis or kidney transplant.
How to assess patency of fistula?
The nurse assess the patency of the fistula by palpating for the presence of a thrill or auscultating for a bruit. The presence of a thrill and bruit indicate patency of the fistula. Enlarged visible blood vessels at the fistula site are a normal observation but are not indicative of fistula patency. Although the presence of a radial pulse in the left wrist and capillary refill in the nail beds on the left hand indicate adequate circulation to the hand, it does not assess fistula patency.
What to do if a client experiences an air embolus during hemodialysis?
If the client experiences an air embolus during hemodialysis, the nurse should terminate dialysis immediately, position the client so the air embolus is in the right side of the heart, notify HCP and Rapid Response Team, and administer oxygen as needed.
What is the effect of decreased force in the stream of urine?
The stream later becomes weak and dribbling. The client then may develop hematuria, frequency, urgency, urge incontinence and nocturia. If untreated , complete obstruction and urinary retention can occur. Constipation or scrotal edema is not associated with BPH.
What is the most specific test to determine renal function?
The creatinine level is the most specific laboratory test to determine renal function. The creatinine level increases when at least 50% of renal function is lost. A decreased hemoglobin level and red blood cell count are associated with anemia or blood loos and not specifically with decreased renal function.
What does blood at the urinary meatus mean?
The presence of blood at the urinary meatus may indicate urethral trauma or disruption. The nurse notifies the HCP, knowing that the client should not be catheterized until the cause of the bleeding is determined by diagnostic testing. The other options include performing the catheterization procedure and therefore are incorrect.
What stage is a dehydrated patient in?
A dehydrated patient is in the Injury stage of the RIFLE staging of AKI . What would the nurse first anticipate in the treatment of this patient?
How much fluid is needed for AKI?
b. During the oliguric phase of AKI, daily fluid intake is limited to 1000 mL plus the prior day's fluid loss.
How is prerenal oliguria reversed?
It can be reversed by correcting the precipitating factor, such as fluid replacement for hypovolemia. Prerenal oliguria is characterized by urine with a high specific gravity and a low sodium concentration, whereas oliguria of intrarenal failure is characterized by urine with a low specific gravity and a high sodium concentration. Malignant hypertension causes damage to renal tissue and intrarenal oliguria.
What causes acute kidney injury?
Intrarenal causes of acute kidney injury (AKI) include conditions that cause direct damage to the kidney tissue, including nephrotoxic drugs, acute glomerulonephritis, and tubular obstruction by myoglobin, or prolonged ischemia. Anaphylaxis and other prerenal problems are frequently the initial cause of AKI. Renal stones and bladder cancer are ...
Which phase of AKI is metabolic acidosis?
Metabolic acidosis occurs in the oliguric phase of AKI as a result of impairment of
What is the recovery phase of AKI?
The recovery phase begins when the glomerular filtration returns to a rate at which BUN and creatinine stabilize and then decrease.
Why is it important to measure daily weights with the same scale at the same time each day?
Measuring daily weights with the same scale at the same time each day allows for the evaluation and detection of excessive body fluid gains or losses. Infection is the leading cause of death in AKI, so meticulous aseptic technique is critical. The fluid limitation in the oliguric phase is 600 mL plus the prior day's measured fluid loss. Dietary sodium and potassium intake are managed according to the plasma levels.
Renal Factors in Potassium Homeostasis
- Sodium reabsorption through epithelial sodium channels (ENaC) located on the apical membrane of cortical collecting tubule cells is driven by aldosterone and generates a negative electrical potential in the tubular lumen, driving the secretion of potassium at this site through the renal outer medullary potassium (ROMK) channels. Aldosterone also regulates sodium transport in th…
Potassium Distribution and Serum Potassium Levels
- Potassium is predominantly an intracellular cation; thus, serum potassium levels do not always accurately reflect total body potassium stores. Serum potassium levels are determined by the shift of potassium between intracellular and extracellular fluid compartments, as well as by total-body potassium homeostasis. Several factors regulate the distribution of potassium between th…
Pathogenetic Mechanisms
- Hyperkalemia can result from any of the following: 1. Excessive intake of potassium 2. Decreased excretion of potassium 3. A shift of potassium from the intracellular to the extracellular space In many cases a combination of these factors is involved. For example, a person with a GFR of less than 45 mL/min who consistently eats large amounts of hig...
Cardiac and Skeletal Muscle Effects
- High levels of potassium cause abnormal heart and skeletal muscle function by lowering cell-resting action potential and preventing repolarization, leading to muscle paralysis. Classic ECG findings begin with tenting of the T wave, followed by lengthening and eventual disappearance of the P wave and widening of the QRS complex.[29] However, varying degrees of heart block are al…