Fluid & Electrolyte Q 34

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Which of the following findings would the nurse expect to assess in a patient with hypokalemia?

  

    A. Hypertension

    B. pH below 7.35

    C. Hypoglycemia

    D. Hyporeflexia

    

    

Correct Answer: D. Hyporeflexia

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Hyporeflexia is a symptom of hypokalemia. Significant muscle weakness occurs at serum potassium levels below 2.5 mmol/L but can occur at higher levels if the onset is acute. Similar to the weakness associated with hyperkalemia, the pattern is ascending in nature affecting the lower extremities, progressing to involve the trunk and upper extremities, and potentially advancing to paralysis.

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Option A: Hypokalemia can result in a variety of cardiac dysrhythmias. Although cardiac dysrhythmias or ECG changes are more likely to be associated with moderate to severe hypokalemia, there is a high degree of individual variability and can occur with even mild decreases in serum levels.

Option B: Prolonged hypokalemia can cause structural and functional changes in the kidney that include impairing concentrating ability, increased ammonia production, altered sodium reabsorption and increased bicarbonate absorption. Hypokalemia can also result in glucose intolerance by reducing insulin secretion.

Option C: Hypomagnesemia often occurs with and may worsen hypokalemia especially in the presence of chronic diarrhea, alcoholism, genetic disorders, diuretic use, and chemotherapy. Both promote the development of cardiac dysrhythmias. The combination of hypokalemia and hypomagnesemia is associated with an increased risk of torsades de pointes, particularly in individuals receiving QT-prolonging medications.

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