Question

PN 105 Fundamentals of Nursing I Diuretics/Hypokalemia JS 72 years of age has had vomiting and diarrhea for two days. He is on digoxin 0.25 mg per day and hydrochlorothiazide 50 mg per day. He complains of being dizzy. His blood pressure slightly is lower than usual. His serum potassium level is 3.2 mEq. The nurse assesses his physical status and note his muscles are weak and flabby, his abdomen is distended, and peristalsis is diminished. 1. What are the signs and symptoms of hypokalemia and note those that the patient is demonstrating. 2. What contributing factors caused JS's potassium imbalance? 3. What interventions should be performed for alleviating this potassium imbalance? 4. Describe the relationship of hypokalemia, digoxin and hydrochlorothiazide and why this is serious for this patient? JS is ordered IV infusions of 1 L of D5%/W with 30 mEq of potassium chloride and IL of 5%D/45%NS. He is also prescribed oral KCL 15 mEq three times per day for 2 days. Oral KCL is available in 15mEq/10mL 5. Explain the method for diluting KCL in IV fluids. Can KCL be given IM? SQ? IV push? Explain your rationale for your answer. 6. What instructions should the nurse give JS for taking oral potassium supplements? 7. What happens if JS urine output decreases while he is receiving IV fluids and oral potassium? What would be the nurse's responsibility? 8. Because JS is taking a diuretic and digoxin what should the nurse include in her teaching plan being sure to state your rationale? Reviewed 9/19

Answer 1

>Answers to your questions are as follows:

-First lets see what does the question say:-

•JS, 72years of age

•Complaints of Diarrhea and Vomiting for 2 days.At present, Dizzy.

•Present medication- Tab Digoxin 0.25mg and hydrochlorothiazide 50mg per day

•Current S.Potassium- 3.2mEq( Normal- 3.5-5 mEq)

•On physical examination- Weak and Flabby muscles, distended abdomen, decreased peristalsis( All features of Hypokalemia) , low Bp

1. Clinical features of hypokalemia are:

Clinical features of Hypokalemia	Patient picture
Muscle weakness	√
Constipation or decreased peristalsis	√
Muscle cramps or twitching
Arrhythmia
Fatigue

2. Potassium is lost typically from the digestive system. So the contributing factors include vomiting, diarrhea and use of diuretics ie. Hydrochlorothiazide

3. Interventions such as IV potassium with IV fluids like D5% followed by oral KCL

4. Hydrochlorothiazide is a thiazide diuretic which excretes potassium out of the body via urine leading to Hypokalemia. Digoxin if taken in hypokalemic state, can lead to digoxin toxicity which can be fatal.