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Hypokalemia is a serum potassium level less than 3.5 mEq/L or 3.5 mmol/L.  This indicates depletion in the normal potassium levels in the body, a potential life-threatening emergency and can be fatal.

Causes

  1. Gastrointestinal losses
  2. Vomiting
  3. Diarrhea
  4. Prolonged nasogastric suctioning
  5. Nutrition and metabolism
  6. Low potassium diet
  7. Starvation
  8. NPO status
  9. Crash diets
  10. Alcoholism
  11. Elimination
  12. Laxative abuse
  13. Potassium- depleting diuretics
  14. Enema
  15. Steroids
  16. Skin or cellular integrity
  17. Trauma
  18. Tissue injury
  19. Surgery

Clinical Manifestations

  • Altered level of consciousness
  • Anxiety
  • Lethargy, confusion, coma
  • Skeletal muscle weakness which may lead to flaccid paralysis
  • Deep tendon hyporeflexia
  • Thready, weak, irregular pulse
  • Shallow respirations
  • Dysrythmias
  • Decreased bowel motility
  • Paralytic ileus
  • Decreased specific gravity
  • Increased urine output

Laboratory and Diagnostic Findings

  • Serum potassium levels less than 3.5 mEq/L
  • ECG changes- flat/inverted T waves, depressed ST segment, elevated U wave
  • Metabolic alkalosis
  • Urinary potassium excretion test exceeding 20 mEq/day

Hypokalemia Nursing Care Plan

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