Primary Nursing Diagnosis

Decreased cardiac output related to ineffective cardiac pumping and cardiac arrest

OUTCOMES. Electrolyte and acid-base balance; Cardiac pump effectiveness; Circulatory status; Tissue perfusion: Abdominal organs and peripheral; Vital signs status

INTERVENTIONS. Electrolyte management: Hyperkalemia; Medication management; Medication administration; Fluid/electrolyte management; Cardiac care: Acute; Code management; Airway management; Dysrhythmia management

H PLANNING AND IMPLEMENTATION Collaborative

If hyperkalemia is not severe, it can often be remedied by simply eliminating potassium supplements or potassium-sparing diuretics and drugs that lead to the disorder.

In more serious situations, pharmacologic therapy is important. Be aware of concerns related to sodium retention when using sodium polystyrene sulfonate. Monitor the patient's response to the medication; if no stools result, notify the physician. Emergency management of hyper-kalemia is threefold with administration of IV calcium gluconate, glucose, and insulin. Excess potassium can also be removed by dialysis. This approach is reserved for situations in which less aggressive techniques have proved ineffective. Hemodialysis takes longer to initiate but is more effective than peritoneal dialysis.

Pharmacologic Highlights

Medication or Drug Class

Dosage

Description

Rationale

Calcium gluconate

10 mg of a 10% solution

Electrolyte

Decreases membrane

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