A patient with CKD has a potassium level of 63 which nursing intervention is priority
In order to function properly, the body requires several electrolytes, one of which is potassium. The majority of potassium is stored in the intracellular compartment. While some can be found in the bones, liver, and red blood cells, 98% is found in the muscle cells. Potassium regulates fluid and facilitates muscular contraction and nerve activity. It is also responsible for keeping the heartbeat regular and promotes the movement of nutrients into and waste out of the cells. Show
The normal blood potassium level is 3.5 – 5.0 mEq/L. Imbalances in blood potassium levels are referred to as hypokalemia and hyperkalemia.
Possible causes of hypokalemia include the following:
Possible causes of hyperkalemia include the following:
Signs and symptoms of potassium imbalance include:
The Nursing ProcessTo ensure proper functioning and homeostasis the body must maintain a dynamic equilibrium of fluids and electrolytes. Organ system dysfunction, such as life-threatening dysrhythmias, can occur when potassium is not balanced. Nurses must closely monitor patients’ lab results and correct imbalances to prevent complications. Nursing Care Plans Related to Hyperkalemia and HypokalemiaElectrolyte Imbalance Care PlanElectrolyte imbalance associated with potassium imbalance (hypokalemia/hyperkalemia) can be caused by conditions affecting the regulation, intake and excretion, and movement of potassium in the cellular space. Nursing Diagnosis: Electrolyte Imbalance Related to:
As evidenced by:
Expected outcomes:
Electrolyte Imbalance Assessment1. Monitor blood potassium levels. 2. Check renal function. 3. Review the patient’s current medications. 4. Review the patient’s diet. Electrolyte Imbalance Interventions1. Include or limit potassium in the diet. 2. Administer
prescribed potassium with precautions. 3. Monitor strict intake and output. 4. Treat underlying
conditions. Risk for Decreased Cardiac Output Care PlanRisk for decreased cardiac output associated with potassium imbalance is caused by a disruption in the electric signals in the myocardium resulting in dysrhythmias. Nursing Diagnosis: Risk for Decreased Cardiac Output Related to:
As evidenced by:A risk for diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred and nursing interventions are aimed at prevention. Expected outcomes:
Risk for Decreased Cardiac Output Assessment1. Determine cardiovascular status. 2. Monitor pulse rate and blood pressure. 3. Obtain ECG and observe signs of dysrhythmias. Risk for Decreased Cardiac Output Interventions1. Administer medications as ordered. 2.
Dilute potassium when given IV. 3. Implement safety measures when administering IV potassium. 4. Prevent sudden hypotension. Risk for Falls Care PlanRisk for falls associated with potassium imbalance is caused by a disruption in the electric signals in muscles resulting in muscle weakness, cramping, hyporeflexia, and paralysis. Nursing Diagnosis: Risk for Falls Related to:
As evidenced by:A risk for diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred and nursing interventions are aimed at prevention. Expected outcomes:
Risk for Falls Assessment1. Perform a fall risk assessment. 2. Assess the patient’s neuromuscular status. 3. Determine the patient’s independence in
performing activities. 4. Check for safety hazards in the patient’s environment.
5. Review the patient’s current medications. Risk for Falls Interventions1. Institute fall and safety measures. 2. Apply visible fall prevention signage. 3. Inform the healthcare team about the patient’s level of risk of falls. 4. Encourage physical therapy. 5. Position the patient therapeutically. References and Sources
What is the priority nursing intervention when working with a patient with chronic kidney disease?Regardless of CKD stage, the three main nursing care goals are: prevent or slow disease progression. promote physical and psychosocial well-being. monitor disease and treatment complications.
What should a nurse do if potassium is high?Nursing Management. Monitor ins and outs.. Check serum potassium levels.. Follow ECG closely to look for peaked T waves.. Educate patient on hyperkalemia.. Administer diuretics as ordered.. Administer insulin to lower potassium as ordered.. Check blood glucose when administering insulin.. Check BUN and creatinine levels.. What happens if potassium is high in CKD patients?When kidneys fail they can no longer remove excess potassium, so the level builds up in the body. High potassium in the blood is called hyperkalemia, which may occur in people with advanced stages of chronic kidney disease (CKD). Some of the effects of high potassium are nausea, weakness, numbness and slow pulse.
What would be the priority for a patient with hyperkalemia?After emergency management and stabilization of hyperkalemia, the patient should be hospitalized. Once the potassium level is restored to normal, the potassium-lowering therapies can be discontinued, and the serum potassium level can be monitored. Continuous cardiac monitoring should be maintained.
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