Studying hypokalemia and want to know how to remember hypokalemia and how it is different from hyperkalemia?
In this article, I want to give you some super easy ways on how to remember the causes of hypokalemia, signs and symptoms, and the nursing interventions for this condition. I want to highlight the material you will be tested on in lecture class or the NCLEX exam.
After you read these notes, be sure to take the quiz on hypokalemia and hyperkalemia.
Video Teaching Tutorial on Hypokalemia
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You will learn the following:
- Causes (easy mnemonics to remember it)
- Signs & Symptoms (tricks on how to easily remember)
- Nursing Intervention…things that NCLEX and lecture exams look for
Kal= root word for potassium….. don’t get it confused with cal= calcium
Meaning of hypokalemia: Low Potassium in the Blood
Normal Potassium Level 3.5-5.1 (2.5 or less is very dangerous)
Most of the body’s potassium is found in the intracellular part of the cell compared to the extracellular which is where sodium is mainly found. Blood tests measure potassium levels via the outside of the cell (extracellular fluid).
Remember potassium is responsible for nerve impulse conduction and muscle contraction.
Causes of Hypokalemia
“Your Body is trying to DITCH potassium”
Drugs (laxatives, diuretics, corticosteroids)
Inadequate consumption of Potassium (NPO, anorexia)
Too much water intake (dilutes the potassium)
Cushing’s Syndrome (during this condition the adrenal glands produce excessive amounts of aldosterone (remember aldosterone causes the body to retain sodium/water but waste potassium) which in turn if too much aldosterone is produced this will cause the kidneys to excrete excessive amounts of potassium….which depletes the blood level of potassium.
Heavy Fluid Loss (NG suction, vomiting, diarrhea, wound drainage, sweating)
(Other causes: when the potassium moves from the extracellular to the intracellular with alkalosis or hyperinsulinism (this is where too much insulin in the blood and the patient will have symptoms of hypoglycemia)
Signs & Symptoms of Hypokalemia
Try to remember everything is going to be SLOW and LOW. Don’t forget potassium plays a role in muscle and nerve conduction so muscle systems are going to be messed up and effect the heart, GI, renal, and the breathing muscles for the lungs.
- Weak pulses (irregular and thread)
- Orthostatic Hypotension
- Depression ST, flat or inverted T wave and prominent u-wave
- Shallow respirations with diminished breath sounds….due to weakness of accessory muscle movement to breath)
- Confusion, weak
- Flaccid paralysis
- Decrease deep tendon reflexes
- Decreased bowel sounds
Easy way to Remember 7 L’s
- Lethargy (confusion)
- Low, shallow respirations (due to decreased ability to use accessory muscles for breathing)
- Lethal cardiac dysrhythmias
- Lots of urine
- Leg cramps
- Limp muscles
- Low BP & Heart
Nursing Interventions for Hypokalemia
Watch heart rhythm (place on cardiac monitor…most are already on telemetry), respiratory status, neuro, GI, urinary output and renal status (BUN and creatinine levels)
Watch other electrolytes like Magnesium (will also decrease…hard to get K+ to increase if Mag is low), watch glucose, sodium, and calcium all go hand-in-hand and play a role in cell transport
Administer oral Supplements for potassium with doctor’s order: usually for levels 2.5-3.5…give with food can cause GI upset
IV Potassium for levels less 2.5 (NEVER EVER GIVE POTASSIUM via IV push or by IM or subq routes)
-Give according to the bag instruction don’t increase the rate…has to be given slow…patients given more than 10-20 meq/hr should be on a cardiac monitor and monitored for EKG changes
-Cause phlebitis or infiltrations
Don’t give LASIX, demadex , or thiazides (waste more Potassium) or Digoxin (cause digoxin toxicity) if Potassium level low…notify md for further orders)
Physician will switch patient to a potassium sparing diuretic Spironolactone (Aldactone), Dyazide, Maxide, Triamterene
Instruct patient to eat Potassium rich foods
Remember POTASSIUM to help you remember the foods
- Potatoes, pork
- Musk melons: cantaloupe
Also included are: (carrots, raisins, bananas)
Don’t forget to take the Hypokalemia Quiz