Surgical intervention is required only with certain etiologies, such as the following: Renal artery stenosis Adrenal adenoma. Hyponatremia (decreased sodium in blood) OR hypernatremia (increased sodium in the blood) could be present depending on the types of fluid lost. Nursing Diagnosis: Electrolyte Imbalance related to hypokalemia secondary to hyperaldosteronism as evidenced by serum potassium level of 2.9 mmol/L, high aldosterone levels, polyuria, increased thirst, weakness, tachycardia, and fatigue Desired Outcome: Patient will be able to re-establish a normal electrolyte and fluid balance. Beta-blockers. Nursing Intervention for Hypokalemia Disease: There are different types of nursing interventions for hypokalemia, . 11. Distended neck and peripheral veins. Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). If administering IV, infuse secondarily to a compatible IV solution such as 0.9% normal saline to minimize burning at the IV site. Encourage physical therapy.Encourage participation in physical and occupational therapy sessions as ordered to regain strength and adapt to changes. Check renal function.Excess potassium can build up in the body if damaged kidneys are unable to eliminate it. If the patient is on diuretics regimen, switch to potassium-sparing diuretics as prescribed. The patient thought apples were high in potassium. Buy on Amazon. Identification and treatment of concurrent hypomagnesemia are also important because magnesium depletion impedes potassium repletion and can exacerbate hypokalemia-induced rhythm disturbances.16,17. For the past few nights, he has had severe leg cramps that have woken him up. Some blood pressure medications such as angiotensin-converting enzymes inhibitors, beta blockers, and angiotensin-receptor blocker are known to cause hyperkalemia. Determine the patients independence in performing activities.Promote and assist in patient ambulation and independence in self care. Potassium also maintains normal neuromuscular contraction by participation in the sodium-potassium pump. The most reliable method for shifting potassium intracellularly is administration of glucose and insulin. Conditions that cause hypoaldosteronism, such as adrenal insufficiency and hyporeninemic hypoaldosteronism (a common complication of diabetic nephropathy and tubulointerstitial diseases), can lead to hyperkalemia. Here are some nursing interventions for patients with hyperkalemia: 1. Views on topics do not generally reflect that of the entire community. Hypokalemia may result from inadequate potassium intake, increased potassium excretion, or . A risk for diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred and nursing interventions are aimed at prevention. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. Some types of diuretics increase potassium excretion through the kidneys. Potassium supplements are used to treat severe hypokalemia. Insulin and Glucose. Potassium is mainly excreted in the kidneys. (fatigue) NURSING DIAGNOSIS Hypokalemia RATIONALE Potassium is essential for many body functions. Prevent sudden hypotension.Changes in blood potassium levels can cause hypotension due to decreased levels of aldosterone, vasopressin, and responsiveness to the effects of angiotensin II. It should ideally be done at the same time and same method (standing, bed weight, etc.) Please read our disclaimer. Also, large amounts of potassium found in the intestinal fluids are excreted during episodes of diarrhea. 3. However, case reports linking the concomitant use of sodium polystyrene sulfonate and sorbitol to GI injury prompted a U.S. Food and Drug Administration boxed warning.41,42 More recent reports implicate sodium polystyrene sulfonate alone.43 Therefore, use of the drug with or without sorbitol should be avoided in patients with or at risk of abnormal bowel function, such as postoperative patients and those with constipation or inflammatory bowel disease.42, There is no evidence supporting the use of diuretics for the acute treatment of hyperkalemia. 3. Sample Osteoporosis Nursing Care Plans |NANDA Nursing Diagnosis |Interventions with Rationales, Clopidogrel Bisulfate (Plavix) Nursing Implications |Patient Teachings, 19 NANDA Nursing Diagnosis for Fracture |Nursing Priorities & Management, 25 NANDA Nursing Diagnosis for Breast Cancer, 5 Stages of Bone Healing Process |Fracture classification |5 Ps, 9 NANDA nursing diagnosis for Cellulitis |Management |Patho |Pt education, 20 NANDA nursing diagnosis for Chronic Kidney Disease (CKD). If you continue to use this site we will assume that you are happy with it. However, potassium will need to be given intravenously in the following conditions: Treating of underlying disease. Other recommended site resources for this nursing care plan: Other nursing care plans related to endocrine system and metabolism disorders: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Matt Vera, a registered nurse since 2009, leverages his experiences as a former student struggling with complex nursing topics to help aspiring nurses as a full-time writer and editor for Nurseslabs, simplifying the learning process, breaking down complicated subjects, and finding innovative ways to assist students in reaching their full potential as future healthcare providers. Patients with a history of congestive heart failure or myocardial infarction should maintain a serum potassium concentration of at least 4 mEq per L (4 mmol per L). The patient says: Ive been on Lasix for years now so I know what to expect, but I still think Ive been urinating more than usual. He also reports thirst and constipation, but he was careful not to drink excess water because of his heart failure. Too much potassium supplementation can cause hyperkalemia. Further progression can lead to ST-interval depression, T-wave inversions, PR-interval prolongation, and U waves. While some can be found in the bones, liver, and red blood cells, 98% is found in the muscle cells. The patient has a past medical history of heart failure and takes furosemide (Lasix) daily. Further replenishment can proceed more slowly, and attention can turn to the diagnosis and management of the underlying disorder.15 Patients with a history of congestive heart failure or myocardial infarction should maintain a serum potassium concentration of at least 4 mEq per L (4 mmol per L), based on expert opinion.15. Although hypokalemia can be transiently induced by the entry of potassium into the cells, most cases result from unreplenished gastrointestinal or urinary losses due, for example, to vomiting, diarrhea, or diuretic therapy []. The recommended dietary replacement for potassium is 40 to 60 mEq/L/day. ANTHONY J. VIERA, MD, MPH, AND NOAH WOUK, MD. 4. Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical conditions can also cause abnormal potassium levels; therefore, treatment also includes correcting the main cause of abnormal potassium levels. Elsevier Health Sciences. This includes the heart muscle wherein when the potassium level is depleted abnormal heart waves are formed. No edema is noted, and in fact, mild tenting is noted on the back of the patients hand. It should be noted that the recommended dose of nebulized albuterol (10 to 20 mg) is four to eight times greater than the typical respiratory dose. Nursing Diagnosis: Deficient Knowledge related to new diagnosis of hyperkalemia as evidenced by patients verbalization of I want to know more about my new diagnosis and care. Other diagnostic tests that may be performed are as follows: Potassium replacement. Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client CareIdentify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Rapid administration of IV potassium can cause cardiac arrest so an IV pump should always be used. Elsevier. Including the client in the plan of care elicits participation. When intravenous potassium is used, standard administration is 20 to 40 mmol of potassium in 1 L of normal saline. Weakness, nausea, and fatigue- hypokalemia causes weak muscle contractions and affects the bodys way of using nutrients, leading to weakness and fatigue. NURSING DIAGNOSES: Definitions and Classifications 2021-2023 (12th ed.). Severe or symptomatic hypokalemia can be treated promptly with oral and IV potassium. 1. 4. Nursing care plans: Diagnoses, interventions, & outcomes. Imbalanced levels can be caused by alterations in the intake and excretion of potassium. In response to acidosis, extracellular hydrogen is exchanged for intracellular potassium, although the net result is highly variable and depends in part on the type of acidosis; metabolic acidosis produces the greatest effect.26 Because 98% of total body potassium is intracellular, any process that increases cell turnover, such as rhabdomyolysis, tumor lysis syndrome, or red blood cell transfusions, can result in hyperkalemia. It gets potassium through the food you eat. Potassium pills are quite large if the patient has a difficult time swallowing, consider potassium powder or IV administration. Monitor laboratory results, such as serum potassium and arterial blood gases, as indicated.Evaluate therapy needs and effectiveness. The effect can cause slow peristalsis which can lead to constipation. 1. Figure 3 is an algorithm for the management of hyperkalemia, and Table 322,30,36 summarizes medications used in the treatment of the condition. Relative insulin deficiency or insulin resistance, which also occurs in persons with diabetes, prevents potassium from entering cells. The infusion should be discontinued immediately if this occurs. Boiling potatoes and cutting vegetable sin small pieces are also recommended. ECG should be considered if the potassium level is greater than 6 mEq per L; if there are symptoms of hyperkalemia; if there is suspicion of rapid-onset hyperkalemia; or among patients with underlying kidney disease, heart disease, or cirrhosis who have a new case of hyperkalemia. A 12-lead ECG is performed and shows sinus tachycardia with PVCs. Increased thirst -as a result of polyuria, the body will try to compensate to avoid dehydration by increasing the thirst signal. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). 1. Obtain ECG and observe signs of dysrhythmias.A potassium imbalance may result in alterations in ECG findings since potassium is essential for both depolarization (contraction) and repolarization (relaxation) of the heart. Potassium replacement is primarily indicated when hypokalemia is due to potassium loss, and there is a . Hypokalemia and Hyperkalemia NCLEX Review and Nursing Care Plans. Potassium is an electrolyte needed primarily for muscle and nerve tissue function. 2. Adjust the IV potassium dose and rate depending on the available IV access. IV fluids with added potassium would be appropriate for dehydrated and hypokalemic patients, or if the patient required ongoing diuretic administration despite low potassium. A detailed medication list is vital as abnormal potassium levels can be caused by certain medications. The patient needs to avoid foods high in potassium such as bananas. High potassium occurs due to lack of insulin. Wound Care & Infection Nursing Diagnosis & Care Plan, Parkinsons Disease Nursing Diagnosis & Care Plan, Hypokalemia serum potassium level < 3.5 mEq/L (3.5 mmol/L), Hyperkalemia serum potassium level > 5.0 mEq/L (5.0 mmol/L), Excessive use of potassium-wasting diuretics, Increased production of aldosterone (water and salt regulating hormone) (such as in Cushings syndrome), Kidney disease impairing the reabsorption of potassium, Poor potassium intake such as through eating disorders. Excessive alcohol intake is known to reduce potassium levels. Repeat measurement of serum potassium can help identify pseudohyperkalemia, which is common and typically results from potassium moving out of cells during or after sample collection.31 Other laboratory studies include measurement of serum blood urea nitrogen and creatinine, measurement of urine electrolytes and creatinine, and assessment of acid-base status. Bradycardia can progress to cardiac fibrillation and arrest. Desired Outcome: The patient will be able to achieve a weight within his/her normal BMI range, demonstrating healthy eating patterns and choices. Below is a list of other common causes of hypokalemia: I have been vomiting and experiencing diarrhea for the past few days. This content is owned by the AAFP. Patients with chronic hyperkalemia should be counseled to reduce dietary potassium. Infuse potassium-based medication or solutions slowly.Prevents administration of concentrated bolus, allows time for kidneys to clear excess free potassium. 9. 3. Swearingen, P. (2016). A low serum potassium concentration is perhaps the most common electrolyte abnormality encountered in clinical practice. Encourage the patient to stand up and reposition slowly to prevent faintness and falls. There are different types of test and diagnosis for hypokalemia disease, those are given in the below: S. Electrolytes / Potassium, Magnesium, Calcium, Phosphorous, TSH, Aldosterone, ECG, . 2. While others spare potassium from being excreted through the kidneys. Centrally potassium can be administered more quickly and in larger doses via this route. The patient is tachycardic and PVCs are noted on ECG. Breathing requires many muscles, particularly the diaphragm, which require potassium in order to work properly. Educate the patient about the role of potassium in the body. All rights reserved. Insulin and glucose . Deficient knowledge related to diuretic side-effects and hypokalemia as evidenced by the patient thinking apples were high in potassium. Medication use is a common cause of hyperkalemia, particularly in patients with baseline renal dysfunction or hypoaldosteronism.27 Medication-induced hyperkalemia is most often a result of the medication interfering with potassium excretion. Therefore, a first priority is determining the need for urgent treatment through a combination of history, physical examination, laboratory, and electrocardiography findings. if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[468,60],'nurseship_com-large-mobile-banner-1','ezslot_4',646,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-large-mobile-banner-1-0'); The patient is admitted to the hospital for Hypokalemia. When defined as a value of less than 3.6 mmol of potassium per . Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are common causes of hyperkalemia. Urinalysis can also show the presence of potassium in the urine. Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of hyperkalemia and its management. Potassium is an essential mineral that is responsible for fluid balance, regulating nerve signals, and muscle contraction. A more recent article on potassium disorders is available. You have diarrhea. Hypokalemia. Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal, usually greater than 5.0 mEq/L to 5.5 mEq/L. 2. Intravenous insulin and glucose, inhaled beta agonists, and dialysis are effective in the acute treatment of hyperkalemia. F A Davis Company. IV potassium can cause serious extravasation and vein irritation. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. The combination of furosemide and beta-blocker may reduce blood pressure and decrease heart rate. Excessive sweating. Muscular weakness can affect respiratory muscles and lead to respiratory complications. 1. Hemolysis or breakdown of red blood cells, Rhabdomyolysis or the breakdown of muscle tissues, Burns, trauma, and other tissue injuries can also cause the release of potassium from the cells. Monitor pulse rate and blood pressure.Hyperkalemia can cause irregular pulse rates and reduces blood artery wall tension which lowers blood pressure. It may have a role as adjuvant therapy, particularly among patients with concurrent metabolic acidosis.24,39,40, Potassium can be removed via the GI tract or the kidneys, or directly from the blood with dialysis. Imbalanced Nutrition Less than Body requirements, BPH Nursing Diagnosis and Nursing Care Plan, Legionnaires Disease Nursing Diagnosis and Nursing Care Plan. 6. This is commonly done through the administration of oral potassium supplement and high potassium diet. and, i didn't Psychiatric Nursing . Administer the following drugs, as prescribed: Also, potassium-rich foods in the diet help maintain potassium balance. Renally mediated hyperkalemia results from derangement of one or more of the following processes: rate of flow in the distal nephron, aldosterone secretion and its effects, and functioning potassium secretory pathways. Hyperkalemia & Hypokalemia (Potassium Imbalances) Nursing Care Plans, Hyperkalemia: Risk for Electrolyte Imbalance, Hypokalemia: Risk for Electrolyte Imbalance, All-in-One Nursing Care Planning Resource E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health, Nursing Care Plans (NCP): Ultimate Guide and Database, Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing, Fluid Balance: Hypervolemia & Hypovolemia, Potassium (K) Imbalances: Hyperkalemia and Hypokalemia, Sodium (Na) Imbalances: Hypernatremia and Hyponatremia, Magnesium (Mg) Imbalances: Hypermagnesemia and Hypomagnesemia, Calcium (Ca) Imbalances: Hypercalcemia and Hypocalcemia, Hypervolemia & Hypovolemia (Fluid Imbalances) Nursing Care Plans, Hypermagnesemia & Hypomagnesemia (Magnesium Imbalances) Nursing Care Plans. Obtain daily blood sample from the patient. Abnormal heart rhythm and palpitation- the brain sends nerve signals to the heart muscles to make them contract and beat. Nurses Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. Elsevier/Mosby. Monitor respiratory rate and depth. It also decreases the risk of falls and fall related injuries. Administer a slow intravenous potassium solution as prescribed. Increased plasma osmolality, such as with uncontrolled diabetes mellitus, establishes a concentration gradient wherein potassium follows water out of cells. Treating these conditions involves monitoring and preventing hypo/hyperkalemia. Symptoms usually develop at higher levels, 6.5 mEq/L to 7 mEq/L, but the rate of change is more important . Ackley, B., Ladwig, G., Makic, M., Martinez-Kratz, M., & Zanotti, M. (2020). 7. Review drug regimen for medications containing potassium or affecting potassium excretion such as spironolactone (Aldactone), hydrochlorothiazide (Maxzide), amiloride (Midamor), and penicillin G.Requires regular monitoring of potassium levels and may require alternate drug choices or changes in the dosage or frequency. Various mechanisms promote the exit of potassium from cells or impede its entrance, thereby raising the plasma potassium concentration (redistributive hyperkalemia). Hypokalemia (decreased potassium in the bloodstream) is commonly caused by vomiting, diarrhea, excessive sweating, or renal (kidney) disorder. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Planning:- The nurse will monitor for dysrrythmias, assess electrocargraphic Recordings and report changes that are related to cardiopulmonary resuscitation may be required but is seldom successful with severe hypokalemia because the heart muscle wil, respond. Data Sources: An Essential Evidence search was conducted. Elevate the head of the bed.Clients may hypoventilate and retain carbon dioxide resulting in respiratory acidosis. Interprofessional patient problems focus familiarizes you with how to speak to patients. Hypokalemia Case Scenario A 57-year old male presents to the ED with complaints of nausea, weakness, heart palpitations, and mild shortness of breath. It can result in serious injury or death if it becomes too high or too low. The patient thought his potassium might be low, so he ate 2 apples with no improvement noted. Searches of PubMed, the Cochrane Database of Systematic Reviews, and the National Guideline Clearinghouse were completed using the key terms hypokalemia and hyperkalemia. Hypokalemia occurs when potassium falls below 3.6mmol/L and hyperkalemia occurs when potassium level in the blood is greater than 5.2mmol/L. https://twitter.com/gitelmansuk/status/668416488211136512, Urinary Tract Infection Nursing Care Plan, Impaired concentrating ability Dizziness and fainting, Increased ammonia production Increased frequency in urination, Increased bicarbonate reabsorption extreme thirst, Altered sodium reabsorption seizure and coma, Hypokalemic nephropathy Unable to hold urine, Serum potassium levels less than 3.5 mEq/L, ECG changes- flat/inverted T waves, depressed ST segment, elevated U wave, Urinary potassium excretion test exceeding 20 mEq/day. Author disclosure: No relevant financial affiliations. However, diuretics, particularly loop diuretics, may play a role in the treatment of some forms of chronic hyperkalemia, such as that caused by hyporeninemic hypoaldosteronism.39,44 Fludrocortisone is an option for hyperkalemia associated with mineralocorticoid deficiency, including hyporeninemic hypoaldosteronism.29. Be aware that cardiac arrest can occur.Potassium excess depresses myocardial conduction. Hypokalemia is treated with oral or intravenous potassium. Assess the patients neuromuscular status.Potassium is utilized by muscles to transmit electrical signals to the brain leading to muscle contraction. The patient is experiencing weakness, heart palpitations, and shortness of breath. Create a daily weight chart and a food and fluid chart. 5. Low potassium diet include eating apples, berries, pineapple, breads, and cereals. Common acute manifestations are muscle weakness and ECG changes. Pills should not be crushed but can be dissolved in 3.8 ounces of cold water or juice. Prepare for and assist with dialysis.May be required when more conservative methods fail or are contraindicated such as severe heart failure. The most common cause of excessive loss of Potassium is often associated with heavy fluid losses that flush Potassium out of . Monitor for signs and symptoms of hypokalemia: Assist client in selecting foods rich in potassium as such as banana, fruit juices, melon, citrus fruits,and fresh vegetables. You vomit a lot. Compromised regulatory mechanism. Fluid loss from the body such as vomiting and diarrhea causes depletion of the electrolyte potassium partly because potassium is actually lost with gastric fluid. Possibly evidenced by Ascites. Strategies to prevent chronic hyperkalemia include instructing patients to eat a low-potassium diet, discontinuing or adjusting medications, avoiding nonsteroidal anti-inflammatory drugs, and adding a diuretic if the patient has sufficient renal function. Read theprivacy policyandterms and conditions. If after five minutes, follow-up ECG continues to show signs of hyperkalemia, the dose should be repeated.37 Clinicians should be aware that intravenous calcium has a short duration, ranging from 30 to 60 minutes. Nurses must closely monitor patients lab results and correct imbalances to prevent complications. The physical examination should include assessment of blood pressure and intravascular volume status to identify potential causes of kidney hypoperfusion, which can lead to hyperkalemia. Hyperkalemia affects this process therefore causing inadequate nerve impulses to signal the heart muscles to contract properly causing arrhythmia and palpitations. Monitor urine output.In kidney failure, potassium is retained because of improper excretion. Volume depletion. Save my name, email, and website in this browser for the next time I comment. Encourage intake of carbohydrates and fats and low potassium food such as pineapple, plums, strawberries, carrots, cauliflower, corn, and whole grains.Reduces exogenous sources of potassium and prevents metabolic tissue breakdown with the release of cellular potassium. Hypokalemia and Hyperkalemia are conditions that refer to abnormal levels of potassium in the blood. Hypokalemia can become life threatening if it affects the heart muscle, causes paralysis, or impairs the functioning of the lungs. Significant leukocytosis (> 75,000 cells per mm, Acute kidney injury/chronic kidney disease, Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, Calcium chloride, 10 mL of 10% solution IV over 5 to 10 minutes, or calcium gluconate, 30 mL of 10% solution IV over 5 to 10 minutes, Stabilizes cardiac muscle cell membrane; no effect on serum potassium or total body potassium, May potentiate digoxin toxicity; calcium chloride can cause phlebitis and tissue necrosis, Regular insulin, 10 units IV followed immediately by 50 mL of 50% glucose (25 g) IV, Shifts potassium into cells; no effect on total body potassium, May cause hypoglycemia; glucose is unnecessary if serum glucose level is > 250 mg per dL (13.9 mmol per L); additive effect when combined with albuterol, Can cause tachycardia and thus should be used with caution in patients with underlying heart disease; potassium-lowering effect not reliable in all patients; additive effect when combined with insulin, Sodium polystyrene sulfonate (Kayexalate), Binds potassium in exchange for sodium; lowers total body potassium, Association with gastrointestinal complications, particularly when combined with sorbitol; should be avoided in patients at risk of abnormal bowel function. Typically, the first ECG manifestation of hypokalemia is decreased T-wave amplitude. each day. Some of the potassium ions are lost when vomiting occurs. The normal serum potassium concentration ranges from 3.5 to 5.0 mEq/L. Kathleen Salvador is a registered nurse and a nurse educator holding a Masters degree. This indicates depletion in the normal potassium levels in the body, a potential life-threatening emergency and can be fatal. As a portion of daily potassium is excreted in the colon, lower GI losses in the form of persistent diarrhea can also result in hypokalemia and may be accompanied by hyperchloremic acidosis.6, Hypokalemia is often asymptomatic. Hypokalemia is a serum potassium level less than 3.5 mEq/L or 3.5 mmol/L. Potassium supplementation is the main treatment for hypokalemia. Apply visible fall prevention signage.Informing the patient and the caregiver about fall prevention measures will promote participation and lower the risk for falls. Causes of potassium loss include: Alcohol use (excessive) Chronic kidney disease. The normal serum potassium level is between 3.5 to 5.2 mmoL/L. 3. Priority nursing diagnoses allnurses. Start a strict input and output monitoring. Neurologic signs of hypokalemia include generalized weakness and decreased deep tendon reflexes.11. Ackley and Ladwigs Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning CareWe love this book because of its evidence-based approach to nursing interventions. Intravenous potassium should be reserved for patients with severe hypokalemia (serum potassium < 2.5 mEq per L [2.5 mmol per L]), hypokalemic ECG changes, or physical signs or symptoms of hypokalemia, or for those unable to tolerate the oral form. We may earn a small commission from your purchase. St. Louis, MO: Elsevier. Hypokalemia or potassium levels can impair the kidneys function to concentrate urine, which may result to polyuria. Potential health risks are avoidable as long as the potassium levels are kept at a normal level. Studies suggest that some antibiotics can cause high potassium levels. Furosemide is a potassium wasting diuretic but diuretics such as Spironolactone (Aldactone) or Amiloride (Midamor) are potassium-sparing diuretics. Low magnesium levels. Bananas, spinach, broccoli, and some fish are high in potassium. Now, my body feels very weak., Vomitus of yellowish fluid approximately 70 cc times three episodes for two days, Diarrhea; Watery stools times 4 episodes for two days, Presence of an elevated U wave on ECG result, Altered electrolyte balance related to active fluid loss secondary to vomiting and diarrhea. (See "Causes of hypokalemia in adults".). Dilute potassium when given IV.For patients who cannot take PO medications, IV potassium will be administered.