The nurse in the medical unit is caring for a 66-year-old male client.
Day 1
0700:History of chronic kidney disease and heart failure. Takes furosemide and lisinopril. Vomiting for 3 days. Both legs weak. Pulse irregular. Electrocardiogram (ECG) shows flattened T waves and U waves. IV potassium chloride started.
Day 3
0700:Legs heavy and weak. Urine output 15 mL/h over the past 6 hours. Pulse 52/min and irregular. ECG shows tall, peaked T waves.
The nurse has reviewed the Nurses' Notes from 0700 and the Laboratory Results from 0600 on Day 1 and Day 3.
For each nursing consideration below, click to specify the potassium imbalance to which the consideration applies. Each consideration may apply to more than 1 imbalance.
| Nursing Considerations | Hypokalemia | Hyperkalemia |
|---|---|---|
| Expect IV calcium gluconate to protect the heart. | ||
| Use cardiac monitoring for dysrhythmia risk. | ||
| Expect potassium replacement by mouth or by IV. | ||
| Hold potassium supplements and clarify the prescription. | ||
| Check for low magnesium and expect it to be corrected too. | ||
| Expect a potassium binder or dialysis to remove potassium. |
Note: Each column must have at least 1 response option selected.