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

1.

• Vomiting
• Diarrhoea
• Dizziness
• Hypotension
• Abdominal distension
• Muscles become flabby and weak.

2. Digoxin and hydrochlorothiazide interaction results hypokalemia.

3.Hypokalemia is treated with oral and intravenous potassium

4.interaction with both the drug decreases potassium level.

5. Kcl is dilute with 0.9% NS solution. It shouldn't administer by IV push or IM or SC. Administer as slow IV infusion

6. Oral potassium usually taken with meals and fluids to avoid intestinal problems.

7.

• Closely monitor the patient
• Central venous monitoring
• Stop administering potassium when oliguria persists
• Check vital signs
• Maintain intake and output chart.
• Bladder catheterization

8. Avoid taking drug together.