Electrolyte Imbalance
Electrolyte 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
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Related to:
- Changes in the regulation of potassium
- Changes in the intake of potassium
- Difficulty excreting potassium
- Conditions that affect the movement of potassium in the cellular space
As evidenced by:
- Alterations in the electrical conductivity of the heart
- Ineffective respirations
- Muscle weakness and cramps
- Neuromuscular alterations
- Changes in bowel habits
Expected outcomes:
- Patient will demonstrate serum potassium levels within normal limits.
- Patient will verbalize the absence of muscle pain or cramping.
- Patient will not experience dysrhythmias.
Assessment:
1. Monitor blood potassium levels.Serum potassium levels should be monitored closely and redrawn as ordered to monitor for hypo/hyperkalemia.
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2. Check renal function.Excess potassium can build up in the body if damaged kidneys are unable to eliminate it. Assess urine output and kidney function through BUN, GFR, and creatinine levels.
3. Review the patient’s current medications.Imbalanced potassium levels can be caused by drugs including diuretics, beta-blockers, and aminoglycosides. Hyperkalemia can result from taking potassium chloride or salt substitutes.
4. Review the patient’s diet.Potassium levels can be influenced by the amount of potassium that is being consumed. Eating disorders such as bulimia nervosa and anorexia nervosa can lead to deficits in potassium.
Interventions:
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1. Include or limit potassium in the diet.Educate the patient on their prescribed diet depending on the condition. Potassium can be obtained as a dietary supplement but is naturally available in many foods. Bananas, spinach, broccoli, and some fish are high in potassium. If experiencing hyperkalemia, limit these foods in the diet.
2. Administer prescribed potassium with precautions.Potassium can be administered IV or PO. If administering IV, infuse secondarily to a compatible IV solution such as 0.9% normal saline to minimize burning at the IV site.
3. Monitor strict intake and output.Monitor urine output as well as bowel movements. Imbalanced levels can be caused by alterations in the intake and excretion of potassium.
4. Treat underlying conditions.Potassium imbalances can be caused by kidney disease, diabetes, alcoholism, Addison’s disease, and more. Treating these conditions involves monitoring and preventing hypo/hyperkalemia.
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