Potassium/sodium

Question 1

Sx of hypokalemia (LOW AND SLOW)

Answer 1

1. muscle weakness
2. fatigue
3. N/V
4. irritability, confusion
5. decreased bowel motility
6. paresthesia
7. dysrhythmias
8. flat and/or inverted T waves

Question 2

Interventions for hypokalemia

Answer 2

1. monitor resp status
2. initiate fall precautions
3. initiate and monitor K+ replacement (oral, IV)
4. monitor ECG
5. Monitor I&O
6. Monitor arterial HCO3 and pH
7. provided education and dietary resources

Question 3

When should K+ not be given?

Answer 3

1. it should NEVER be given IV push, IM injection, or IV bolus (must be dilutes
2. “No P= No K”, if the pt is not urinating, do NOT give K+

Question 4

What can cause hyperkalemia ( HINT: hold it in)?

Answer 4

1. renal failure
2. adrenal insufficiency
3. acidosis
4. excessive potassium intake
5. meds (potassium-sparing diuretics, ACE inhibitors)

Question 5

Manifestations of hyperkalemia

Answer 5

1. peaked T-waves
2. Ventricular dysrhythmias
3. muscle twitching
4. ascending muscle weakness
5. increase bowel motility

Question 6

Interventions fo hyperkalemia

Answer 6

1. monitor ECG
2. Monitor bowel sounds
3. Initiate dialysis
4. Dietary restriction and teaching
5. Administer meds (kayexalate, 50% glucose with insulin, calcium gluconate, bicarbonate, loop diuretics)

Question 7

What things can cause hyponatremia?

Answer 7

1. GI loss
2. SIADH
3. Adrenal insufficiency
4. NPO status
5. restricted sodium diet
6. water intoxication
7. excessive diaphoresis
8. Medications (diuretics, anticonvulsants, SSRIs, Lithium, demeclocycline)

Question 8

Manifestations of hyponatremia

Answer 8

1. weakness
2. lethargy
3. confusion
4. seizures
5. headache
6. anorexia, n/v
7. muscle cramps, twitching
8. hypotension
9. tachycardia
10. weight gain, edema

Question 9

Interventions for hyponatremia

Answer 9

1. sodium replacement
2. restrict oral fluid intake (so as not to dilute the sodium in the body)
3. daily weight/I&O
4. meds (conivaptan HCl)
5. seizure precautions

Question 10

What can cause hypernatremia?

Answer 10

1. dehydration
2. GI loss
3. hyperaldosteronism
4. hypertonic tube feedings
5. Diabetes insipidus
6. Kidney failure
7. burns
8. heatstroke
9. corticosteroids

Question 11

Manifestations of hypernatremia

Answer 11

1. fever
2. swollen, dry tongue
3. sticky mucous membranes
4. hallucinations
5. lethargy, restlessness, irritability
6. seizures
7. tachycardia
8. HTN
9. hyperreflexia, twitching
10. pulmonary edema

Question 12

Interventions for hyprenatremia

Answer 12

1. daily weight
2. I&O
3. seizure precautions
4. IV infusion of hypotonic or isotonic fluids
5. Diuretics
6. Dietary sodium restriction and education
7. Increased oral fluid intake