Question

PN 105 diuretics/hypokalemia

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 1 L 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?
I need help 5, 6, 7, 8

Answer 1

5) Method for diluting KCL in IV fluids:-

--The potassium concentration in the infusion fluid should not exceed 40mmol/L

-Mix thoroughly the potassium and the 0.9% sodium chloride solution by inverting at least 5 times the infusion bottle .

Never use KCL by IV or IM or SC injection.Potassium chloride must always be administered by slow IV infusion diluted in 0.9% Sodium chloride.

6)Nurse should instruct the JS to take the medicine with food or just after a meal.Do not crush, chew or suck on a tablet or capsule as it could irritate mouth or throat.

7)If JS urine output is decreased while on IV fluids with oral potassium ,it means their is impaired potassium regulation and distal renal tubular flow is compromised leading to hyperkalemia.Nurse should check whether patient is taking oral potassium regularly or not and their doses.

8)Nurse should instruct patient to take diuretic and digoxin regularly even when feeling well.

Maintain adequate hydration as toxicity is more likely when dehydrated.