Hypokalemia Overview

Introduction

• Presented by Sarah from RegisteredNurseAriene.com
• Focus on simplifying hypokalemia for exams, including NCLEX
• Tips and tricks for remembering causes and symptoms
• Encouragement to take a free quiz on hypokalemia and hyperkalemia at RegisteredNurseAriene.com

Understanding Hypokalemia

• Definition: Low potassium levels in the blood
  • Hypo: Low
  • Kal: Potassium
  • Emia: Blood
• Normal Potassium Levels: 3.5 to 5.1 (varies slightly by lab)
  • Dangerous if <2.5, requires major intervention

Cellular Level Explanation

• Potassium prefers the intracellular environment
• Blood tests measure extracellular potassium
• Hypokalemia: Low potassium in extracellular fluid, probably shifted intracellularly
• Role of Potassium:
  • Nerve impulse conduction
  • Muscle contraction

Causes of Hypokalemia

• Mnemonic: D.I.T.C.H.
  • D: Drugs (Diuretics, Laxatives, Corticosteroids)
  • I: Inadequate intake (NPO status, Anorexia, Illness)
  • T: Too much water (Dilutional effects)
  • C: Cushing’s Syndrome (Excessive aldosterone)
  • H: Heavy fluid loss (Vomiting, Diarrhea, NG suction, Wound drainage)
• Other Causes:
  • Alkalosis
  • Hyperinsulinism

Signs and Symptoms

• General Idea: Everything is slow and low due to lack of potassium
• Symptoms:
  • Weak, irregular pulse
  • Orthostatic hypotension
  • Decreased bowel sounds
  • Decreased deep tendon reflexes
  • Flaccid paralysis
  • Confusion
  • Weakness
  • Shallow respirations and diminished breath sounds
  • EKG Changes:
    • Depressed ST segment
    • Flat or inverted T wave
    • Prominent U wave

Nursing Interventions

• Monitor:
  • Heart rhythm, respiratory status, GI and renal status
  • Urinary output, BUN, Creatinine levels
  • Magnesium, glucose, calcium, sodium levels
• Administer Potassium:
  • Oral supplements for levels 2.5 to 3.5
  • Infusions for levels <2.5 (never IV push)
  • Monitor for phlebitis and infiltration
• Medication Considerations:
  • Hold diuretics like Lasix if potassium is low
  • Monitor digoxin use to avoid toxicity
  • Consider potassium-sparing diuretics
• Diet:
  • Ensure adequate potassium intake through diet
  • Mnemonic for Potassium-rich foods: POTASSIUM
    • P: Potatoes, Pork
    • O: Oranges
    • T: Tomatoes
    • A: Avocados
    • S: Strawberries, Spinach
    • I: Fish
    • U: Mushrooms
    • M: Muskmelons (Cantaloupe)
    • Additional: Carrots, Raisins, Bananas

Conclusion

• Encouragement to watch the hyperkalemia video
• Suggestion to take the knowledge quiz
• Reminder to subscribe to the YouTube channel for more tutorials