The nurse caring for a patient post colon resection is assessing the patient on the first postoperative day. The nasogastric tube (NG) remains patent and continues at low intermittent wall suction
The IV is patent and infusing at 125 mL per hour. The patient reports pain at the incision site rated at a three on a zero-to-ten rating scale. During your initial shift assessment, the patient complains of cramps in her legs and a tingling sensation in her feet. Your assessment indicates decreased deep tendon reflexes (DTRs). You suspect the patient has hypokalemia. What other signs or symptoms would you expect this patient to exhibit?
A) Increased bowel motility
B) Dilute urine
C) Increased muscle strength
D) Excessive thirst
Ans: B
Feedback: Manifestations of hypokalemia include fatigue, anorexia, nausea, vomiting, muscle weakness, leg cramps, decreased bowel motility, paresthesias (numbness and tingling), and dysrhythmias. If prolonged, hypokalemia can lead to an inability of the kidneys to concentrate urine, causing dilute urine (resulting in polyuria, nocturia) and excessive thirst. Potassium depletion suppresses the release of insulin and results in glucose intolerance. Decreased muscle strength and DTRs can be found on physical assessment. Options A and D are incorrect because at this point post-op bowel motility cannot be accurately assessed and a patient with an IV running at 125 mL per hour should not exhibit signs of thirst. You would expect decreased, not increased, muscle strength with hypokalemia.
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