Can I use "Electrolyte Imbalance" instead of "Risk for..."

Intern67 · May 29, 2010

I honestly think that writing a plan for her hypokalemia would be more important, but not if that's not okay, since "Electrolyte Imbalance" is not on the list...
Thank you in advance for your help!

A great way to get on the bad side of your clinical instructor is to invent your own NANDA diagnosis.

If you really want to address the hypokalemia, you need to find out why the patient is hypokalemic in the first place (Ineffective Therapeutic Regimen Management? Imbalanced Nutrition? Self-Care Deficit?). A diagnosis and care plan for that condition will include interventions and outcomes that address the low lab value.

If I was writing a plan for a partial quadriplegic, I would use Maslow and ABCs to figure out what the primary actual diagnosis should be. I don't think I ever met a partial quadriplegic who did not have Risk for Impaired Skin Integrity as a very important potential diagnosis that required a closely followed care plan.

If you really think that hypokalemia is the most important issue, then use that, but you have to figure out why they are hypokalemic or you will have a hard time writing a care plan to address it.

Music in My Heart · May 30, 2010

Hi,
In writing a care plan for a patient with mild hypokalemia - 3.2 mEq/L (NO other s/sx of the condition), can I use the potential nursing diagnosis "Risk for Electrolyte Imbalance" as an actual ND "Electrolyte Imbalance" or would that make it a medical diagnosis? We are only allowed to write ONE potential ND (I chose "Risk for Infection").
If this is not okay, then my back-up choice is either "Activity Intolerance" or "Impaired Physical Mobility" ... which would be more appropriate for a partial quadriplegic?
I honestly think that writing a plan for her hypokalemia would be more important, but not if that's not okay, since "Electrolyte Imbalance" is not on the list...
Thank you in advance for your help!

3.2 is so close to normal I wouldn't worry about it beyond keeping an eye on it. I'd go with the mobility one since quads are at high risk for skin breakdown, pneumonia, and constipation... and need to be fed, cleaned, everything... total care.

LLSN · Apr 5, 2011

I don't mean to step on anyone's toes but my professor has stressed on multiple occasions the importance of electrolyte imbalances especially potassium since it has such catastrophic effects on the cardiac system. This is something I personally wouldn't overlook. Perhaps finding the cause of it would be better so you can help prevent your patient from having cardiac problems in the future or even use this opportunity to do some patient education :)

tothepointeLVN, LVN · Apr 5, 2011

It all depends on why he would be risk for electrolyte imbalance. What would be the underlying condition that may potentionally cause and imbalance.

Also if possible I would look and see how the potassium levels have been trending. Is the 3.2mEq/dl the only abnormal result? Has it been trending up or trending down?

It's been awhile since I had to hand in a careplan....

AggieNurse99, BSN, RN · Apr 6, 2011

K+ of 3.2 needs repleting - look up the evidence for electrolyte protocols.

The thing that took me a long time to figure out...the K+ level is your r/t or AEB part of your nursing diagnosis. That is the problem that can be fixed or the evidence of a problem.

Low potassium causes what? {cardiac conduction abnormalities, cramps, etc}

Low potassium is caused by what? [depleting meds, malnutrition, etc]

What does your assessment of your patient show? Use your critical thinking to extrapolate and correlate your assessment findings with your patient's clinical picture.