INSTITUTE OF NURSING

BSN110- GROUP 39
S.Y. 2010-2011

PATIENT: Beronilla, Erminda Untrallan SN: Emmanuel Roy D.

Mata
AGE: 30 years old HOSPITAL: DJNRMC
DX: Periodic Hypokalemia DRUG STUDY DATE:
December 13, 2010
GENERIC/ DOSAGE/
CLASSIFICAT MECHANISM INDICATI CONTRAINDIC SIDE
TRADE FREQUEN NURSING RESPONSIBILITY
ION OF ACTION ON ATION EFFECTS
NAME CY
Potassium 20 mEq THERAPEUTI Maintain acid- Treatmen • Respiratory CNS: ASSESSMENT:
chloride added to C: base balance, t/ and metabolic confusion, • Assess for signs and symptoms of
(Kaochlor PLR ½ L x Mineral and isotonicity, preventio alkalosis restlessne hypokalemia (weakness, fatigue, U
Eff) 30gtts/mi electrolyte and n for ss, wave on ECG, arrhythmias, polyuria,
n replacements/ electrophysiol potassium • Urinary tract weakness polydipsia) and hyperkalemia
Supplements ogic balance deficiency infection . • Monitor pulse, blood pressure, and
of the cell. . ECG periodically during IV therapy
Pregnancy Activator in CV:
• Obstructed • Lab Test Considerations: Monitor
Category C many urinary tract ARRHYTH
serum potassium before and
enzymatic MIAS,
periodically during therapy. Monitor
reactions; • Patients with ECG
renal function, serum bicarbonate,
essential to slow gastric changes.
and pH. Determine serum
transmission emptying magnesium level if patient has
of nerve GI:
refractory hypokalemia;
impulses; abdomina
• Hyperkalemia; hypomagnesemia should be
contraction of l pain,
Severe renal corrected to facilitate effectiveness
cardiac, diarrhea,
impairment of potassium replacement. Monitor
skeletal, and flatulence
serum chloride because
smooth , nausea,
• Use Cautiously hypochloremia may occur if replacing
muscle; vomiting
in: potassium without concurrent
gastric
• Cardiac chloride
secretion;
renal function; disease; Renal • Toxicity and Overdose: Symptoms of
tissue impairment. toxicity are those of hyperkalemia
synthesis; and Hypomagnese (slow, irregular heartbeat; fatigue;
carbohydrate mia (may muscle weakness; paresthesia;
metabolism. make confusion; dyspnea; peaked T waves;
correction of depressed ST segments; prolonged
THERAPEUTI hypokalemia QT segments; widened QRS
C EFFECTS: more difficult) complexes; loss of P waves; and
Replacement. cardiac arrhythmias): Treatment
Prevention of • GI includes discontinuation of
deficiency. hypomotility potassium, administration of sodium
including bicarbonate to correct acidosis,
dysphagia dextrose and insulin to facilitate
passage of potassium into cells,
calcium salts to reverse ECG effects,
sodium polystyrene used as an
exchange resin, and/or dialysis for
patient with impaired renal function.

IMPLEMENTATION:
• High Alert: Medication errors
involving too rapid infusion or bolus
IV administration of potassium
chloride have resulted in fatalities
• For most purposes, potassium
chloride should be used, except for
renal tubular acidoses
(hyperchloremic acidosis), in which
other salts are more appropriate
(potassium bicarbonate, potassium
citrate, or potassium gluconate).
• IV: Assess for extravasation; severe
pain and tissue necrosis may occur
• High Alert: Never administer
potassium IV push or bolus.
• Continuous Infusion: High Alert:
Do not administer concentrations of
≥1.5 mEq/ml undiluted; fatalities
have occurred. Concentrated
products have black caps on vials or
black stripes above constriction on
ampoules and are labeled with a
warning about dilution requirement.
Each single dose must be diluted and
thoroughly mixed in 100–1000ml of
IV solution. Usually limited to
80mEq/L via peripheral line (200
mEq/L via central line).
• Rate: High Alert: Infuse slowly, at a
rate up to 10 mEq/hr in adults or 0.5
mEq/kg/hr in children in general care
areas. Check hospital policy for
maximum infusion rates (maximum
ate in monitored setting 40mEq/hr in
 adults or 1 mEq/kg/hr in children).
Use an infusion pump.
• Solution Compatibility: May be
diluted in dextrose, saline, Ringer’s
solution, LR, dextrose/saline,
dextrose/Ringer’s solution, and
dextrose/LR combinations.
Commercially available premixed
with many of the above IV solutions.

PATIENT/
FAMILY TEACHING:
• Explain to patient purpose of the
medication and the need to take as
directed, especially when concurrent
digoxin or diuretics are taken. Take
missed doses as soon as
remembered within 2 hr; if not,
return to regular dose schedule. Do
not double dose
• Instruct patient to report dark, tarry,
or bloody stools; weakness; unusual
fatigue; or tingling of extremities.
• Emphasize the importance of regular
follow-up exams to monitor serum
levels and progress
 INSTITUTE OF NURSING
BSN110- GROUP 39
S.Y. 2010-2011

PATIENT: Beronilla, Erminda Untrallan SN: Emmanuel Roy D.

Mata
AGE: 30 years old HOSPITAL: DJNRMC
DX: Periodic Hypokalemia DRUG STUDY DATE:
December 13, 2010
GENERIC/ DOSAGE/
CLASSIFICATI MECHANISM CONTRAINDIC SIDE
TRADE FREQUENC INDICATION NURSING RESPONSIBILITY
ON OF ACTION ATION EFFECTS
NAME Y
Cabocistei 500mg tab Mucolytic Decreases • Treatment • Active peptic • Nausea ASSESSMENT:
ne TID (8am- viscosity of of disorders ulcer • Observe degree of difficulty
(Solmux) 1pm-6pm) secretions of the • Headache associated with thick or
thereby respiratory • Concomitantly tenacious secretions
breaking the tract administered • Gastric
chains of associated antitussive discomfort • Assess for any history of GI
molecules with problems especially those
that causes excessive USE • Diarrhea conditions associated with
fewer or viscous CAUTIOUSLY: peptic ulcers
adherences mucus. • In patients • Gastrointe
to the with history of • Assess for GI discomforts. If
stinal
epithelial • Relief of peptic ulcer GI discomforts are felt,
bleeding
lining of the cough administer food to decrease
respiratory associated • In patients gastric irritation
• Skin
tract. Agents with with history of rashes
destructs excessive hypothyroidis • Assess for dizziness and
molecular and m headache. Maintain safety
binding • Dizziness
tenacious
between sputum or IMPLEMENTATION:
• In patients • Insomnia
molecules of phlegm. with duodenal • Advised to keep side rails up
the mucous ulcer • Palpitation and provide on supervision
which
s while taking drug to
facilitates
• In patients maintain safety
lysis.
with history of • Mild
gastrointestin hypoglyca • May be given sips of water if
al bleeding, emia dry mouth is experienced

• Dry mouth • Notify physician if adverse

drug reactions appears.
• Flatulence
PATIENT/FAMILY
• Atrial TEACHING:
Fibrillation • Should be given with food or
after meals to lessen GI
discomforts