Use this nursing diagnosis guide to help you create nursing interventions and care plan for patients with electrolyte imbalance risk.
Electrolytes regulate nerve and muscle function, hydrate the body, balance blood acidity and pressure, and further rebuild damaged tissue. Sodium, calcium, potassium, chloride, phosphate, and magnesium are all electrolytes. When these substances become imbalanced, it can lead to either muscle weakness or excessive contraction.
Electrolyte imbalance can occur due to several factors. Various disorders and their corresponding treatments may put the patient at risk for imbalances in serum electrolyte concentrations. Patients experiencing congestive heart failure frequently end up as rebound hospitalizations due to irregular sodium and potassium levels. Diabetes and hypertension may eventually place a patient in a calcium or magnesium imbalance. Electrolyte losses may occur from draining wounds and fistulas, particularly gastrointestinal fistulas. Irregularities in sodium and chloride concentrations happen frequently in situations associated with fluid imbalances, primarily gastrointestinal fluid losses such as vomiting, diarrhea, or suctioning.
Changes in the secretion of antidiuretic hormone and aldosterone can contribute to sodium imbalances. Patients receiving diuretics may be at risk for potassium imbalances. Thyroid and parathyroid problems place the patient at risk for calcium imbalances. Magnesium imbalances often occur in the same situations as calcium and potassium imbalances.
Electrolytes are vital for the normal functioning of the human body. A proper understanding of these imbalances is essential for current management and future prevention. This care plan and nurse study guide focus on sodium, potassium, calcium, and magnesium imbalances.
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Nursing Assessment for Risk for Electrolyte Imbalance
The following are the subjective and objective data you need to assess for a patient with a nursing diagnosis of Risk for Electrolyte Imbalance:
AssessmentRationaleMonitor serum electrolyte levels.The levels of electrolytes in the body can become too low or too high. Early detection of abnormality in serum electrolyte levels allows prompt initiation of measures to prevent further imbalances.- Sodium
- Potassium
- Chloride
- Total calcium
- Ionized calcium
- Magnesium
- Phosphate
- Dietary consumption
- Tissue trauma and wound drainage
- Renal dysfunction
- Drug therapy
- Gastrointestinal fluid losses
- Endocrine dysfunction
- Cancer
Nursing Interventions for Risk for Electrolyte Imbalance
The following are the therapeutic nursing interventions you can use for your care plan for Risk for Electrolyte Imbalance nursing diagnosis:
Nursing InterventionsRationaleSupply balanced electrolyte IV solutions as directed.Lactated Ringer’s solution has an electrolyte concentration similar to that of extracellular fluid. Isotonic saline (0.9% sodium chloride) may contribute to hypernatremia if used in a long period of time. Extreme use of sodium free IV solutions (e.g., D5W) puts the patient at risk for hyponatremia.Administer electrolyte replacements as prescribed.Oral or IV administration of electrolytes may be prescribed to keep electrolyte balance for patients at risk for imbalances.Consider measures to reduce excess electrolytes.Hyperkalemia is common in patients with end-stage renal disease and may result in serious electrocardiographic abnormalities. Dialysis is the definitive treatment of hyperkalemia in these patients. Intravenous calcium is used to stabilize the myocardium. Kayexalate may be indicated to patients at risk for electrolyte excesses such as potassium.Irrigate nasogastric tubes with isotonic saline, as prescribed.Irrigation of nasogastric tubes with plain water produces electrolyte losses. Plain water attracts electrolytes from mucosal tissue into the stomach, where they are eliminated with suctioning.Educate the patient about dietary sources of electrolytes.Electrolytes are salts and minerals, like sodium, potassium, calcium, magnesium, and chloride, in the body that maintain fluid balance and blood pressure. A balanced diet provides the patient with sources of electrolytes to prevent imbalances. Milk, yogurt, dark green, leafy vegetables, and legumes are excellent sources of electrolyte calcium. Whole grains, nuts, fruits, and vegetables are good sources for magnesium and potassium. Bananas are known to be the king of all potassium containing fruits and veggies. Vitamin D is needed for the absorption of calcium from the intestines.- Sodium
tomato juices, sauces, and soups
table salt
- Potassium
plain yogurt
banana
- Calcium
milk
ricotta
collard greens
spinach
kale
sardines
- Chloride
lettuce
olives
table salt
- Magnesium
pumpkin seeds
spinachEducate the patient about dietary sources of sodium and the use of salt substitutes.Patients need to learn to read labels to identify all sources of sodium in foods. Changing from table salt to a potassium-based salt substitute is another way to shift your sodium-potassium balance, and some preliminary study implies that making this switch may have benefits for the heart. But these potassium-based salt substitutes are not for everyone: Excess potassium can be fatal for people who have kidney disease or who are taking medications that can increase potassium levels in the bloodstream.Educate the patient using potassium-wasting about potassium replacements.To prevent hypokalemia, the patient needs to understand the importance of potassium replacements that include dietary sources and prescribed oral replacements such as potassium chloride (KCl).Educate the patient about limiting the use of over-the-counter antacids and laxatives.Excessive use of antacids that contain magnesium has a laxative effect that may cause diarrhea, and in patients with renal failure, they may cause increased magnesium levels in the blood, because of the reduced ability of the kidneys to eliminate magnesium from the body in the urine.
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