A client is at risk of developing potassium deficit due to?

IGNOU Post B. SC. Nursing entrance -2021

Medical & Surgical Nursing

Hard

Appeared in: IGNOU Post B. SC. Nursing entrance -2021

Explanation

Repeated nasogastric (NG) suction removes gastric fluid, which is rich in potassium, leading to direct loss from the body.
The removal of hydrochloric acid via NG suction can cause metabolic alkalosis.
In response to metabolic alkalosis, the kidneys excrete potassium to conserve hydrogen ions, further depleting the body's potassium stores.
This combination of direct loss and increased renal excretion makes repeated NG suction a significant risk factor for hypokalemia (potassium deficit).

Option A: Sustained tissue damage (e.g., from burns, crush injuries, or rhabdomyolysis) causes cell lysis, which releases large amounts of intracellular potassium into the bloodstream.
Option C: Addison's disease is characterized by adrenal insufficiency, leading to decreased aldosterone production. Aldosterone promotes potassium excretion; therefore, its deficiency causes potassium retention.
Option D: Potassium-retaining (or potassium-sparing) diuretics are specifically designed to prevent the kidneys from excreting potassium, thus increasing its level in the blood.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Causes of Potassium Deficit (Hypokalemia) as background academic context rather than a clinical decision trigger.
Nurses must diligently monitor the electrolyte levels of any patient with an NG tube set to suction, as hypokalemia can develop quickly and have serious consequences, particularly for cardiac function.
Recognizing the ECG changes associated with potassium imbalances is a critical nursing skill, as it can be the first sign of a life-threatening electrolyte disturbance.
Patient safety is paramount. Never administer potassium via IV push. Always dilute it in a larger volume of fluid and infuse it slowly, as per protocol, to prevent cardiac arrest.

How to Approach the Question

First, identify the key concept in the question: 'potassium deficit,' which is another term for hypokalemia (low potassium).
The question asks for a cause or risk factor. Your goal is to evaluate which of the given options leads to a loss of potassium from the body.
Analyze Option A (Sustained tissue damage): Think about what's inside cells. Potassium is a major intracellular ion. Damage to cells would release potassium, causing high levels (hyperkalemia), not low.
Analyze Option B (Repeated nasogastric suction): Consider what is being removed. Gastric fluid contains acid and electrolytes, including potassium. Removing it would cause a loss.
Analyze Option C (Addison's disease): Recall the function of aldosterone (which is deficient in Addison's). Aldosterone helps excrete potassium. Less aldosterone means more potassium is retained (hyperkalemia).
Analyze Option D (Potassium-retaining diuretic): The name itself tells you its function. It 'retains' or 'spares' potassium, leading to higher levels (hyperkalemia).

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 149-151

E6 Medicine Harrison 22e Part 1 p. 395-397