NURSING CARE PLAN

Name of the Patient: MS. SG Age: 20 Y/O Sex: F Name of Student: PENGSON,ANGELA N.
Civil Status: Religion: ______________ Rm/Bed No. _________________ Area: __________________________ Level/ Block: III-B
Address : _________________________________________________________________ Date Submitted: SEPTEMBER 23,2022
Date of Admission: _____________________ Diagnosis: ____________________________ Rating: ___________________________________________________

CUES Nursing Diagnosis Nursing Objectives Nursing Interventions Rationale Expected Outcomes

Subjective/ Objective

SUBJECTIVE CUES: Electrolyte imbalance
related to hypokalemia
 Client has been secondary to vomiting
vomiting and
and diarrhea as evidenced
having diarrhea
 Weak and with a by:
complaint of
 bilateral leg
bilateral leg
weakness
weakness
 Weight control
 Weight control
problem and
problem and
eating disorder
eating disorder
 Anorexic
 Anorexic
 Low of blood
potassium level
 Thready and
OBJECTIVE CUES:
irregular pulse rate
Laboratory results:
After 8-hours of INDEPENDENT : INDEPENDENT : After 8-hours of
independent, and independent, and
dependent nursing  Establish rapport  To build a trusting dependent nursing
to the client and relationship between the
intervention, the client intervention, the goals
S/O nurse and client and to
will be able to: relieve their anxiety prior were partially met as
any procedure evidenced by:
 maintain serum
potassium levels
within normal  Monitor the Vital  To monitor the
 maintain serum
range Signs specifically effectiveness of our
potassium levels
 Identify measure the Pulse Rate and nursing care done to our
to treat and Body Temperature client.  Can identify the
measure to treat
prevent
hypokalemia and prevent
 Participate in the  Monitor for signs hypokalemia
 Hypokalemia can be life
treatment regimen and symptoms of  Can participate in
threatening. Careful
hypokalemia the treatment
Assessment for its early
regimen
  Na+ - 128 mEq/L Scientific definition: -fatigue presence is needed
 K+ - 2.8 mEq?L -Anorexia especially for high-risk
 CI - 90 mEq/L Electrolyte imbalance is -Muscle weakness patients
Vital Signs: susceptible to changes in -Decrease bowel
serum electrolyte levels, mobility
 Body Temp. – 38.6C which can compromise -Dysrhythmias
 PR – 65bpm, thready health.
and sometimes -Shallow
irregular respiration
RR – 16bpm -weak thread pulse
rate

 Monitor ECG  The ECG can provide

continuously useful information for
hypokalemia. Patients
receiving digitalis should
be monitored closely for
signs of digitalis toxicity
because hypokalemia
potentiates the action of
digitalis

 Strict monitoring  Careful monitoring of

of intake and fluid intake and output is
output. necessary because 40
mEq of potassium is lost
for every liter of urine.

 Assist client in  Including client in the

selecting foods plan of care elicits
rich in potassium participation. Also,
 such as banana, potassium-rich foods in
fruit juices, melon, the diet help patient to
citrus, fruits, and maintain potassium
fresh vegetables balance

 Monitor serum  Evaluate the

potassium levels effectiveness of therapy

 Monitor BUM and  Renal function should be

creatinine levels monitored for patients
receiving potassium
replacement

DEPENDENT : DEPENDENT :
Administered the
following drugs as
prescribed:

 oral and  Administered when

Intravenous potassium levels need to
potassium level be replenished, as well as
in patients with on going
potassium loss when it
must be maintained.
Also, used in the
treatment of potassium
deficiency when oral
replacement is not
feasible
 ACE inhibitor  Inhibits renal potassium
excretion, can ameliorate
some of the hypokalemia
that thiazide and loop
diuretics can cause

 Potassium-sparing
 Facilitates excretion of
diuretic
sodium and water while
sparing potassium.