Page 244 - Saunders Comprehensive Review For NCLEX-RN

e. Replacement of isotonic fluid loss with
hypotonic fluids
f. Irrigation of wounds and body cavities
with hypotonic fluids

D. Assessment (see Table 8-1)

A client with acute kidney injury, chronic kidney disease, and heart failure is at

high risk for fluid volume excess.
E. Interventions
1. Prevent further fluid overload and restore normal
fluid balance.

2. Administer diuretics; osmotic diuretics may be

prescribed initially to prevent severe electrolyte
imbalances.
3. Restrict fluid and sodium intake as prescribed.
4. Monitor intake and output; monitor weight.

5. Monitor electrolyte values and prepare to

administer medication to treat an imbalance if
present.
V. Hypokalemia

The normal potassium level is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L).

A. Description
1. Hypokalemia is a serum potassium level lower than
3.5 mEq/L (3.5 mmol/L)
2. Potassium deficit is potentially life-threatening

because every body system is affected
B. Causes

1. Actual total body potassium loss
a. Excessive use of medications such as
diuretics or corticosteroids
b. Increased secretion of aldosterone, such
as in Cushing’s syndrome
c. Vomiting, diarrhea
d. Wound drainage, particularly
gastrointestinal
e. Prolonged nasogastric suction
f. Excessive diaphoresis

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