Hypokalemia is the occurrence of low serum potassium, often due to diuretic use, gastrointestinal loss, or an inadequate dietary intake. Potassium treatment can be done through either oral or intravenous supplementation, which should be administered with caution and monitoring to avoid possible complications in the heart. Therefore, the nurse is expected to conduct tests on potassium levels regularly, assess the cardiac status, and educate the patient about food with higher potassium
Hyperkalemia signifies increased potassium level in serum due to renal failure, potassium overdose, or certain medications. Clinical symptoms include muscle weakness and cardiac dysrhythmias. Treatment consists of restricted dietary potassium, drugs to increase potassium excretion, and possibly dialysis in severe cases (Hinkle et al., 2018). A nurse is supposed to monitor carefully the levels of potassium, the health of the heart, and the educating of the patients about their restriction in potassium.
Sodium imbalances encompasses hyponatremia (deficiency of serum sodium) and hypernatremia (excess of serum sodium). Hyponatremia may occur following hyperhydration or from depletion of sodium, while hypernatremia is most commonly due to inadequate intake of fluid. Symptoms vary but may include confusion and thirst. Treatment involves correcting fluid and electrolyte balance, with nurses monitoring levels and neurological status.
Calcium Imbalances include hypocalcemia (low serum calcium) and hypercalcemia (high serum calcium). The causes of hypocalcemia may include hormonal problems or dietary lack leading to muscle fatigue. Treatment includes either an increase of calcium or a reduction with dietary education, and monitoring of the levels by nursing staff.
Fluid Volume Deficit arises from decreased amount of the extracellular fluid in the body, resulting from factors such as vomiting, diarrhea, and an inadequacy of fluid intake. Signs could be dryness of the mucous membrane and concentrated urine. Management involves fluid resuscitation with isotonic solutions and correcting the underlying cause (Hinkle et al., 2018). The nurse should monitor the fluid input and output, the vital signs, and the signs of dehydration in the patient.
Metabolic Acidosis leads to a lowering of pH as well as of bicarbonate in blood and is generally associated with conditions such as diabetic ketoacidosis or renal failure. Signs might be Kussmaul’s respiration and confusion. Treatment includes correction of the underlying cause and the use of bicarbonate in severe cases.
Respiratory acidosis leads to decrease in carbon dioxide excretion and decreased blood pH. Its signs and symptoms may include headache and hypoventilation. It entails proper ventilation optimization and the treatment of the cause. The nurse will be able to observe his respiratory status and support it as necessary.
Respiratory Alkalosis is when there is excessive blowing out of carbon dioxide, usually due to hyperventilation. There would be associated symptoms of dizziness and palpitations. Its treatment would be more centered on the etiologic factor and in hyperventilation, such as what happens in panic attacks, through the promotion of relaxation techniques (Hinkle et al., 2018). The nurse would monitor the rate and rhythm of respiration and provide emotional support.
Acid-Base Balance is an intricate mechanism of compensation by the respiratory and renal systems of the body to maintain the pH in a very narrow range. The nurse measures arterial blood gases and electrolytes and monitoring vital signs that will reflect acid-base status and intervenes to normalize these deviations.
Intravenous Fluids Selection depends upon the fluid and electrolyte requirement of the patient. Isotonic solutions are given for hypovolemia, hypertonic or hypotonic solutions for specific electrolyte imbalance. Assessment of the state of fluid, electrolytes, and on-going losses is done to determine the proper fluid therapy.
Reference
Hinkle, J. L., Cheever, K. H., & Overbaugh, K. (2018). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (15th ed.). Wolters Kluwer Health.
write