HYPOKALEMIA

Presented by:
Group 4
DOLFO, DOMINISE, EJERCITO, FLORALDE
1. ETIOLOGY/PATHOPHYSIOLOGY
2. CLINICAL MANIFESTATIONS
3. ASSESSMENT & DIAGNOSTICS
4. MEDICAL MANAGEMENT
5. NURSING MANAGEMENT
 HYPO- Lower than normal
KAL- Potassium
EMIA- Blood
Hypokalemia
Means hypokalemia is a deficit in total potassium stores
.
Hypokalemia
oIs a deficit in total potassium stores.

oHowever it may occurs with normal potassium

stores when alkalosis (high blood pH) and temporary
shift of serum potassium into cell occurs.

oSerum potassium level below 3.5mEq/L

(milliequivalent per Litre) the normal is 3.5-5.1 mEq/L
 Potassium-Losing Diuretics such as Thiazides and
loop diuretics can induce hypokalemia

Other medications that can cause hypokalemia:

oSodium penicillin
oCorticosteroids
ETIOLOGY oCarbenicillin
oAmphotericin B
- By product of sodium retention medication that
cause renal potassium loss
 GI loss of potassium or Gastrointestinal loss of potassium
o prolonged vomiting, diarrhea, or gastric suction induces
hypokalemia because potassium is lost when gastric fluid is
excreted from the body such as in urine or stool.

Hyperaldosteronism
o Eating disorder of adrenal glands creating too much aldosterone
in body.
Etiology o Increase of aldosterone causes excretion of potassium or
potassium loss in the body

Osmotic Diuresis
o causes potassium loss through shift of concentration from ECF to
ICF which is an exchange of hydrogen ions or movement of K into
cells that promotes excretion of K out of the body.
CLINICAL MANIFESTATION

Severe Hypokalemia
 Cardiac arrest and respiratory arrest
CLINICAL
MANIFESTATION
Mild Hypokalemia
 muscle weakness
 vomiting
 anorexia
 decreased bowel sounds and
bowel motility
 weak and irregular pulse
 Laboratory Findings
CLINICAL  Serum potassium level <3.5 mEq/L
MANIFESTATION  Arterial blood gases (Alkalosis)
 Depression on ECG
ASSESSMENT &
DIAGNOSTIC FINDINGS
In hypokalemia, the serum
potassium concentration is less
than the lower limit of normal.
 Electrocardiographic (ECG)
changes can include flat T
waves or inverted T waves or
both, suggesting ischemia,
and depressed ST segments.

* An elevated U wave is specific to

hypokalemia.
 ASSESSMENT & DIAGNOSTIC FINDINGS
 Hypokalemia increases sensitivity to digitalis,
predisposing the patient to digitalis toxicity at lower
digitalis levels.

 Metabolic alkalosis is commonly associated with

hypokalemia (Her, 2007). The source of the potassium
loss is usually evident from a careful history.

 However, if the cause of the loss is unclear, a 24-hour

urinary potassium excretion test can be performed to
distinguish between renal and extrarenal loss. Urinary
potassium excretion exceeding 20 mEq/day with
hypokalemia suggests that renal potassium loss is the
cause.
 • Medications like diuretics
• Medical condition like (Heart failure,
Hypertension)
• Eating disorders ( anorexia nervosa,
RISK Bulimia)
FACTORS
• Patients with alcoholism
• Vomiting, Diarrhea, Cushing
syndrome, and any condition that
cause increase potassium loss
MEDICAL MANAGEMENT
IV replacement therapy
Oral supplement
Potassium Chloride
Potassium Acetate
Potassium Phosphate
 Preventing Hypokalemia

 Encouraging the patient at risk to eat foods rich

in potassium (when the diet allows).
 Patient education if the hypokalemia is caused
NURSING
by abuse of laxatives or diuretics
MANAGEMENT
 Careful monitoring of fluid I&O is necessary

 ECG is monitored for changes, and arterial

blood gas values are checked for elevated
bicarbonate and pH levels.
Correcting Hypokalemia
Care should be exercised when administering potassium,
particularly in older adults, who have lower lean body mass and
total body potassium levels and therefore lower potassium
requirements. In addition, because of the physiologic loss of
renal function with advancing years, potassium may be retained
more readily in older than in younger people.
NURSING
MANAGEMENT
NURSING ALERT
Oral potassium supplements can produce small bowel
lesions; therefore, the patient must be assessed for and
cautioned about abdominal distention, pain, or GI bleeding.
 Administering Intravenous Potassium
 Potassium should be administered only after adequate urine flow has
been established.
 Concentrations of potassium greater than 20 mEq/100 mL should be
administered through a central IV catheter using an infusion pump with
the patient monitored by ECG.
 Caution must be used when selecting the correct premixed solution of
NURSING IV fluid containing potassium chloride as the concentrations range
from 10 to 40 mEq/100 mL.
MANAGEMENT
 Renal function should be monitored through BUN and creatinine levels
and urine output if the patient is receiving potassium replacement.

NURSING ALERT
Potassium is never administered by IV push or
intramuscularly to avoid replacing potassium too quickly. IV
potassium must be administered using an infusion pump.
 Monitor respiratory rate, depth, and
effort. Encourage deep breathing and
coughing exercise. Encouraged frequent
re-positions.
NURSING
 Monitor heart rate and rhythm. MANAGEMENT
 Note for signs of metabolic alkalosis
such as tachycardia, dysrhythmias,
hypoventilation, tetany, and changes in
mentation.
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