Which body system will the nurse monitor cautiously in clients with either hypo- or hyperkalemia?
The correct answer and explanation is:
The nurse will monitor the cardiovascular system cautiously in clients with either hypo- or hyperkalemia.
Potassium is a critical electrolyte for maintaining normal cellular function, particularly in muscle cells, including those of the heart. Both hypo- and hyperkalemia can significantly disrupt the normal electrical activity of the heart, leading to dangerous cardiac arrhythmias.
- Hypokalemia (low potassium levels): Potassium plays a key role in maintaining the resting membrane potential of cells. When potassium levels fall below normal, the resting potential becomes more negative, making it harder for the cell to depolarize and initiate an action potential. This can result in slowed conduction, leading to arrhythmias such as atrial fibrillation, ventricular tachycardia, or ventricular fibrillation. Clients with hypokalemia may also experience palpitations, irregular heartbeats, or muscle weakness as potassium deficiency affects both the heart and skeletal muscles.
- Hyperkalemia (high potassium levels): Conversely, elevated potassium levels reduce the membrane potential, making the cells more excitable. This can cause spontaneous depolarization, leading to tachycardia or bradycardia, and, if left untreated, can result in cardiac arrest. Hyperkalemia can also lead to peaked T-waves and other characteristic changes on an ECG. If potassium levels are too high, the electrical conduction system of the heart can become erratic, and severe arrhythmias, including asystole, can occur, which can be fatal without prompt intervention.
Because of these potential cardiac effects, it is crucial for the nurse to monitor heart rate, rhythm, and blood pressure frequently, as well as to observe for signs of arrhythmias. ECG monitoring is often recommended for clients with abnormal potassium levels to detect any irregularities early and provide appropriate treatment before a life-threatening event occurs.