Review: Spend at least ten minutes every week reviewing all your previous notes. medications. Treatment – Low K diet, Kayexalate po or enemas, Lasix , Check I&O, IV infusion of glucose & insulin solution to move K back into the cells, create, study and share online flash cards, Click here to study/print these flashcards, Normal:  80 - 98/um3 (cubic micro meters) Size of RBC. This could be due to liver failure because of the inability to convert ammonia to urea. Our hottest nursing game is out now in the App Store. https://twitter.com/gitelmansuk/status/668416488211136512, Urinary Tract Infection Nursing Care Plan, Benign Prostatic Hyperplasia – BPH Nursing Care Plan, NCLEX-RN: Diabetes Mellitus Questions and Rationale, Nursing Personal Statement: Your Voice in Writing, Evidence-Based Practice in Nursing: Beyond the Scientific Proof of Care, Percutaneous Endoscopic Gastrostomy and Tube Placement, How BetterHelp Can Connect with Someone Who Has Depression, Impaired concentrating ability – Dizziness and fainting, Increased ammonia production – Increased frequency in urination, Increased bicarbonate reabsorption – extreme thirst, Altered sodium reabsorption – seizure and coma, Hypokalemic nephropathy – Unable to hold urine, Serum potassium levels less than 3.5 mEq/L, ECG changes- flat/inverted T waves, depressed ST segment, elevated U wave, Urinary potassium excretion test exceeding 20 mEq/day.

We take in protein, it’s broken down into amino acids, and converted to ammonia. For maintenance therapy, drugs such Monitor for signs and symptoms of hypokalemia: Assist client in selecting foods rich in potassium as such as banana, fruit juices, melon, citrus fruits,and fresh vegetables. Collect blood cultures before giving antimicrobial agents whenever possible because previous or current antimicrobial therapy may give false-negative results. Our goal is to give you clear and concise information so you can enjoy your nursing journey.

less acidic.

This may lead to serious heart problems, heart attack or death. an important role in teaching patients and families about Also if your patient’s dehydrated, that can cause slight increases in BUN.

If using broth, add blood to each bottle until achieving a 1:5 or 1:10 dilution.

Participate in the treatment regimen. Monitor for signs and symptoms of hypokalemia: Fatigue; Anorexia

If you’re BUN is decreased, look at causes for why there’s no urea production, and that would be primarily in the liver or even over-hydration. In addition to dietary modifications, substances that increase the potential for electrolyte or Ammonia is converted to urea in the liver and is eventually excreted in the kidneys. Blood urea nitrogen (BUN) measures the amount of urea in the blood. Elevated levels can indicate there is either acute or chronic kidney disease. Start a trial to view the entire video. Short term goals: After 1 hour of health teaching, client will be able to: Identify measures to prevent hypokalemia. The nurse should consider the BUN level, along with the patient's vital signs, intake and output, weight, and skin turgor as potential indicators of dehydration. BUN values normally range form 8 to 20 mg/dl (SI, 2.9 to 7.5 mmol/L) In elderly patients, BUN will show slightly higher values, possibly to 69 mg/dl (SI, 25.8 mmol/L). That Time I Dropped Out of Nursing School. A creatinine that shows more than 1.2 mg will equate to a BUN that’s thrice as much. When protein is broken down ammonia is formed. Interventions for Hyponatremia, low Na - Sodium levels in the blood 1. Also, large amounts of potassium found in the intestinal fluids are excreted during episodes of diarrhea. BUN values normally range form 8 to 20 mg/dl (SI, 2.9 to 7.5 mmol/L). Now, my body feels very weak.”, Vomitus of yellowish fluid approximately 70 cc times three episodes for two days, Diarrhea; Watery stools times 4 episodes for two days, Presence of an elevated U wave on ECG result, Altered electrolyte balance related to active fluid loss secondary to vomiting and diarrhea.

(2015 Nov 22). Inhibits renal potassium excretion, can ameliorate some of the hypokalemia that thiazide and loop diuretics can cause. Beans, nuts and grains have moderate amounts of protein, and fruits generally have no protein. Nursing Interventions. Urea is the chief end product of protein metabolism. Check patient for S&S of allergies5. Instead they should know how to get the right ratio in their diet. : Davis's Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing Implications, 3rd Edition.

Clean the diaphragm tops of the culture bottles with alcohol or iodine and change the needle on the syringe. Administered when potassium levels need to be replenished, as well as, in patients with ongoing potassium loss when it must be maintained. To detect most causative agents, it’s best to perform the blood cultures on 2 consecutive days. Tell the patient that the BUN test is used to evaluate kidney function. Start studying Nursing Labs.

GI Tests – iodine contrast dyes should be scheduled before barium studies, 2. For patients whose hyperuricemia is due to waste products. Send each sample to the laboratory immediately. Perform a venipuncture and draw 10 to 20 ml of blood for an adult, or 2 to 6 ml for a child. Moderately increased – cirrhosis, hepatic tumor, drug toxicity, obstructive jaundice, severe burns, 3. Patients receiving digitalis should be monitored closely for signs of digitalis toxicity because hypokalemia potentiates the action of digitalis. If it’s decreased, we need to look at other reasons why it’s low. The ECG can provide useful information for hypokalemia. Clean the venipuncture site first with an alcohol swab and then with a providone-iodine swab, starting at the site and working outward in a circular motion. That’s going to be detectable with the blood urea nitrogen, or the b u n test. Now, go out and be your best selves today. the need for dietary modifications and appropriate use of Medications such as sodium bicarbonate or During this process, the amino acids are broken down further and we’re left with ammonia. Well that means that urea is not going to be excreted, and it’s going to build up in the blood.

Handle the sample gently to prevent hemolysis. Low BUN levels occur in severe hepatic damage, malnutrition, and overhydration. physician may order colchicine or indomethacin to relieve Large increase – cirrhosis, extra hepatic and intrahepatic obstructive biliary disease, 2. Depletion of potassium occurs and then leads to altered electrolyte balance in the body. If you have patients that are overhydrated, there BUN can go down as well. So as we eat food, we take in different types of protein and that protein is broken down into amino acids. One of the main purposes of the kidneys is … BUN and creatinine ratio – if creatinine and BUN have increased ratio. Interpretation of Urinalysis Abnormalities Cont. Hypokalaemia ECG Changes. Use alcohol to remove the iodine from the venipuncture site. Hypokalemia can be life-threatening. Module Med Surg Nursing Sciences & Labs for the NCLEX®, 01.01 ABG (Arterial Blood Gas) Normal Lab Value Levels, 01.02 ABG (Arterial Blood Gas) Interpretation-The Basics, 01.06 Hypertonic Solutions (IV solutions), 02.01 Potassium-K (Hyperkalemia, Hypokalemia), 02.02 Sodium-Na (Hypernatremia, Hyponatremia), 02.04 Chloride-Cl (Hyperchloremia, Hypochloremia). Significantly increased - hepatitis, liver necrosis or ischemia, 2. Give IV fluids to the dehydrated pt.3. Check UO for pt. BUN is also elevated by blood loss, dehydration, high protein diets and/or strenuous exercise which may temporarily and artificially raise levels. Potassium helps in utilizing carbohydrates and protein to produce energy. We use cookies to ensure that we give you the best experience on our website. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, there are instances where this has been observed in those who are excessively hydrated. The nurse is caring for a client in the emergency department following prolonged exposure to sun and heat. Same as EosinophilsDecreased Values - allergic reaction, hyperthyroidism, stressIncreased Values - Myeloproliferative diseases (cancer), leukemia, inflammatory process, healaing process, post surgery, asthma, cold. patient's lifetime.

Mildly increased – myositis, pancreatitis, MI, CHF, shock, mononucleosis, C. Interventions - monitor liver enzyme lab values & for jaundice, check patient’s medication profile for liver toxic medications, Liver enzymeC. [Twitter moment] Retrieved from. If your kidneys are unable to filter protein properly, reduce your protein intake to lower your BUN levels. Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. The BUN test measures the nitrogen fraction. GI Tests – NPO 8 hours before the test, a. ask the patient if (s)he is allergic to shellfish or iodine, b. the patient should be well-hydrated before & after the exam, 3. The nurse should consider the BUN level, along with the patient's vital signs, intake and output, weight, and skin turgor as potential indicators of dehydration. acid-base imbalance. Below is a list of other common causes of hypokalemia: “I have been vomiting and experiencing diarrhea for the past few days. A low BUN level may be the result of liver disease, a low protein diet, pregnancy, or drinking an extreme amount of water (dilution). All references to such names or trademarks not owned by NRSNG, LLC or TazKai, LLC are solely for identification purposes and not an indication of affiliation. 5 Steps to Writing a (kick ass) Nursing Care Plan, Dear Other Guys, Stop Scamming Nursing Students, The S.O.C.K. Inform the patient that he need not to restrict food and fluids, but should avoid diet high in meat. Interventions. Example, if you have a creatinine level of 3 mg, your BUN will be 60 mg/dL.

This lesson is part of the NURSING.com NCLEX Prep Academy.

Select all that apply. Announcement!! Conditions such as alcoholism, eating disorders and renal disorders can cause severe case of hypokalmia.

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