Hypokalemia Disease: Causes, Treatment and Nursing Intervention

What is Hypokalemia Disease or Hypokalemia Liver Disease?

Hypokalemia disease consists of three words named hypo, Kal, and emia. The prefix Hypo- means “Under” Kal- refers to ‘’Kalium, the Neo-Latin for Potassium’’ and Emia- means “Condition of the blood’’. Potassium is one of the crucial primary Electrolytes for cell function and is concentrated within the cells of the body. Small changes in the serum levels of potassium can affect body function. It is necessary for nerve and muscle cell functioning. It is especially important for the functioning of muscle cells in the heart. The kidneys control potassium levels.

The most common causes are excess losses from the kidneys or GI tract. Serum Electrolytes is a diagnosis measurement and treatment is a supplement of K and managing the cause. Careful monitoring and skilled nursing interventions can help correct potassium levels and prevent associated complications.

Definition of Hypokalemia Disease:

Hypokalemia (Low Potassium) refers to the low concentration of potassium level in the blood. The normal level of potassium in the blood is 3.5-5.2mmol/L.

Less than 3.5mmol/L is considered low potassium (Hypokalemia). If potassium level below 2.5mmol/L is called extreme low potassium (Severe Hypokalemia).

Potassium is very important for the proper functioning of nerves and muscle especially heart muscle cells.

Hypokalemia Causes:

There are various types of causes for hypokalemia disease, those are mentioned below:

1. Chronic kidney disease,
2. Diabetic ketoacidosis,
3. Use of diuretics (Water / Fluid pills),
4. Diarrhea/vomiting,
5. Excessive sweating due to heat/exercise,
6. Excessive use of laxative, enema,
7. Eating disorders (Bulimia)/ low consumption of potassium,
8. Magnesium Deficiencies,
9. Antibiotics,
10. Hyperthyroidism,
11. Alcoholism,
12. Coughing syndrome,
13. Prolonged nasogastric suctioning,
14. NPO status,
15. Steroids,
16. Tissue injury,
17. Leukemia,
18. Post ileostomy surgery.

Sign and Symptoms of Hypokalemia Disease:

Various types of sign and symptoms for hypokalemia disease are mentioned in the following:

1. Arrhythmias,
2. Shallow respirations,
3. Increased urine output,
4. Weakness and fatigue,
5. Muscle cramps and pain,
6. Palpitations,
7. Delirium,
8. Hallucinations,
9. Paralytic ileus,
10. Anxiety,
11. Deep tendon Hyporeflexia,
12. Tingling or numbness,
13. Nausea and vomiting,
14. Hypotension,
15. Anorexia,
16. Thirst,
17. Coma.

Test and Diagnosis of Hypokalemia Disease:

There are different types of test and diagnosis for hypokalemia disease, those are given in the below:

1. S. Electrolytes / Potassium,
2. Magnesium, Calcium, Phosphorous,
3. TSH,
4. Aldosterone,
5. ECG,
6. Urine Potassium.

Treatment for Hypokalemia Disease:

The most important treatment of hypokalemia disease is to treat underlying causes. Various types of treatments for hypokalemia are mentioned in the following:

1. Treat diarrhea, vomiting.
2. Stop or changes diuretic (Use potassium-sparing diuretic if required. (E.g. Severe heart failure).
3. Discontinue laxatives.
4. Administer H2 blockers to patients receiving nasogastric suction.
5. Control Hyperglycemia if glycosuria is present.
6. Mild Hypokalemia (˃3.0mmol/L) can be treated with an oral potassium supplement. (tablet/liquid) and potassium ion rich diet including Leafy green vegetables, Tomatoes, Avocados, Baked potato, Bran, Carrots, Coconut water, Citrus fruits, Oranges, Bananas, and Milk.
7. In severe Hypokalemia (<2.5mmol/L) can be treated with both oral and intravenous potassium supplements with close follow-up and continuous ECG monitoring.

Hypokalemia Complications:

There are different types of complications for hypokalemia, those are mentioned below:

1. Thyrotoxic periodic paralysis,
2. Lung paralysis,
3. Sleepiness and irritability,
4. Dehydration,
5. Hyperglycemia,
6. Kidney damage,
7. Cellular damage,
8. Cardiac arrhythmias,
9. Fainting,
10. Cardiac arrest,
11. Death.

Nursing Intervention for Hypokalemia Disease:

There are different types of nursing interventions for hypokalemia, those are discussed in the following:

1. Record fluid intake and output hourly and observe for dehydration.
2. Check vitals sign hourly in the critical care unit with severe Hypokalemia.
3. Continue monitoring ECG and Identify ECG changes such as depressed T waves, peaking P-waves.
4. Give mouth care to reduce vomiting tendency.
5. Give antiemetic drugs in order.
6. Monitor for any complications such as paralysis, cardiac arrest, etc.
7. Check blood sugar 6 hourly and control by a hypoglycemic agent.
8. Provide oral potassium diluted in 4-8 oz of water or juice (decreased gastric mucosa irritation).
9. Dilute IV potassium 20-40mEq in 1L of IV fluids and use infusion pump (irritating to blood vessels and myocardium).
10. If the central venous line present can give a potassium supplement through a syringe pump 20mEq per hour.
11. Be careful that never administer bolus IV potassium.
12. Monitor IV site for phlebitis and infiltration if intravenous cannula present.
13. Provide a potassium rich diet and consult with a dietician.
14. Check neurological status hourly by GCS scale.
15. Observe for neuromuscular changes such as fatigue and muscular weakness.
16. Teach patient about potassium-rich foods and how to prevent excessive loss (abuse of laxatives and diuretics.
17. Provide a calm and quiet environment so that patient can sleep.
18. Give psychological support to reduce anxiety.

More questions related to this topic:

1. Hypokalemia: Practice Essentials, Background.
2. Hypokalemia – Endocrine and Metabolic Disorders.
3. Low Potassium: Get Facts About Hypokalemia Levels and Diet.
4. What is the Difference Between Hypokalemia and HYPOPOTASSEMIA?
5. Low Potassium (Hypokalemia) Related Diseases & Conditions.
6. Hypokalemia | Definition & Patient Education.
7. Low Potassium (Hypokalemia) Causes, Symptoms.
8. What Diseases Cause Low Potassium?
9. Can Low Potassium Cause Low Blood Pressure?
10. Low potassium (hypokalemia) Causes.
11. What Are the Causes of Low Potassium?
12. What Medications Can Cause Hypokalemia?
13. Causes of Hypokalemia Disease.
14. Hypokalemia Symptoms.

Maria Mona

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”