Electrolye Disorders (K+) Flashcards
What is the principle intracellular cation
K+
*potassium
What is the level for Hypokalemia who is Hypokalemia common in?
Potassium <3.5
*surgical patients GI loss
*excess diuretic
*prolonged malnutrition (alcoholics)
What are the iatrogenic causes of Hypokalemia
- Diuretics
- Failure to replace with fluids
What other minerals are low during Hypokalemia
- Magnesium
- Phosphorus
- Calcium
What are some of the signs of Hypokalemia
Heart, muscle, nerve dysfunction
1. Weakness
2. Hyporeflexia
3. Paresthesia
4. Paralysis
What are the EKG changes of Hypokalemia
- Low voltage
- Prolonged PR
- Flat/inverted T waves
- U-waves
*cardiac arrhythmia can develop and cause immediate life threat
What is the oral treatment of Hypokalemia
Treat the underlying cause
1. 40mEq potassium every 4 hours max dose
What is the IV treatment of Hypokalemia
- 10 mEq K+ in 100ml NS over 1 hour
- 20mEQ K+ in 100ml NS over 1 hour (monitor rhythm)
What is the level of hyperkalemia
K+ >5.0 mEq
What are some of the causes of hyperkalemia
Surgical patient
1. Crush injury
2. Burns
3. Renal or adrenal insufficiency
4. Excessive K+ administration
What are the EKG changes due to hyperkalemia
Cardiotoxic if K+ >6.0 (medical emergency)
1. Tall parked T waves
2. Loss of P waves
3. Shortened QT interval
4. ST depression
What is the treatment for hyperkalemia
- Kayexalate PO 25mg in sorbitol every 4 hours
- Restrict K+ intake
- Discontinue potassium-sparing diuretics
What is the treatment for hyperkalemia if the level is above 6.0mEq
- Calcium gluconate 10% solution IV 10mL over 10 minutes
- Dextrose and insulin
*shift K+ to intracellular - 10 U regular insulin + 1 amp D50 to prevent hypoglycemia
What is the treatment for hyperkalemia is the level is above>7.5mEq
- Sodium bicarbonate
- Hemodialysis
