(^432) Medical-Surgical Nursing Demystified
- Encourage potassium-rich foods.
- Administer potassium supplements.
- Administer potassium in intravenous fluids:
- Avoid glucose in fluid which will shift potassium into cells.
- Potassium concentration of no more than 40 mEq/L in peripheral lines.
- Monitor cardiac rhythm.
NURSING DIAGNOSIS
- Activity intolerance
- Decreased cardiac output
- Fatigue
NURSING INTERVENTIONS
- Monitor vital signs for change.
- Monitor cardiac system for rate, rhythm, and pulse deficit.
- Monitor intake and output.
- Monitor intravenous site for redness, swelling, warmth, and pain.
- Teach patient about medication and diet changes:
- Foods rich in potassium (bananas, tomatoes, orange juice)
Hyperkalemia
WHAT WENT WRONG
Hyperkalemia is an elevated level of potassium in the blood. Dietary intake is the
main source of potassium. Patients are at risk for hyperkalemia when there is exces-
sive ingestion of potassium-rich foods or salt substitutes, they are on medications
that cause potassium retention (ACE inhibitors, angiotensin receptor blockers,
potassium-sparing diuretics such as amiloride or spironolactone, NSAIDs, tri-
methoprim, pentamidine), or there is excess release of potassium from the cells
(hemolysis, acidosis, low insulin levels, beta blocker use, digoxin overdose,
succinylcholine, or rhabdomyolysis).6