Electrolytes

Question 1

Potassium supplements are available as?

Answer 1

Potassium chloride and Potassium Phosphate

Question 2

What is potassium supplements used for?

Answer 2

hypokalemia

Question 3

What are the adverse effects of potassium supplements

Answer 3

nausea, vomiting, diarrhea

Question 4

Before administering potassium supplements what should we give first to the patient?

Answer 4

food and lots of water!

Question 5

How is it administer?

Answer 5

IV

It can cause local irritation and pain

Question 6

If the patient experiences pain what do we do?

Answer 6

Stop and check for infiltration, if everything looks good continue but more slowly

Question 7

Can we kill someone with potassium supplements?

Answer 7

YES

Question 8

When administering potassium chloride why would we watch out for serum K levels?

Answer 8

If someone is dehydrated and kidneys are not working well, they are at a high risk for developing hyperkalemia

Question 9

How would you monitor for signs and symptoms of hyperkalemia?

Answer 9

Using a EKG

Question 10

When you administer KCl through IV peripheral line, how much?

Answer 10

10 meq diluted in 100 ml NS over 1 hr

Question 11

When you administer KCl through IV central line, how much?

Answer 11

20 meq diluted in 50 or 100 NS over 1 hr

Question 12

What should not be available in patient care units?

Answer 12

potassium chloride vials

Question 13

If a patient comes in with hyperkalemia what is the first action?

Answer 13

administer calcium IV to protect the heart!

Question 14

Name the two treatment approaches for hyperkalemia

Answer 14

Shift the potassium back into the cells
or
Increase excretion of potassium

Question 15

Name the three ways you can shift potassium back in to the cells?

Answer 15

Sodium bicarbonate injection
Albuterol continuous injection
Regular insulin + dextrose 50% injection

Question 16

Someone with metabolic acidosis and hyperkalemia, what medication would you give them?

Answer 16

Sodium Bicarbonate

Question 17

What are the adverse effects of sodium bicarbonate?

Answer 17

Vasculature
Hypokalemia
Metabolic alkalosis

Question 18

Albuterol is used for what?

Answer 18

causes bronchodilation

Question 19

It is used for what patients?

Answer 19

Asthma patients

Question 20

Albuterol is considered what type of medication?

Answer 20

Beta 2 agonist

Question 21

What does albuterol activate?

Answer 21

adenylate cyclase to stimulate production of cAMP

Question 22

What is cAMP used for?

Answer 22

Na-K ATPas pump to move K intracellularly

Question 23

What is the adverse effect of albuterol?

Answer 23

Tachycardia

Question 24

What does regular insulin do to glucose?

Answer 24

uptakes glucose

Question 25

Regular insulin is used for what?

Answer 25

Diabetes | Hyperkalemia

Question 26

What would you monitor on a patient who is on regular insulin?

Answer 26

drop of blood sugar

Question 27

What is the relationship between potassium and insulin?

Answer 27

Na-K ATPase pumps (in the cell membrane) requires insulin + glucose as an energy source because the pumps use ATP hydrolysis as its energy source

Question 28

What is the Na-K ATPase responsible for?

Answer 28

Exchanges Na for K (3:2) Maintains intracellular and extracellular K levels

Question 29

Name the three ways you can increase excretion of potassium?

Answer 29

Diuresis with furosemide (kidney) Hemodialysis (fake kidney) Kayexalate (gut)

Question 30

What is kayexalate?

Answer 30

It is resin that exchanges Na for K in the gut

Question 31

How can we administer kayexalate?

Answer 31

Oral or rectal

Question 32

Would you use kayexalate in cases of emergency?

Answer 32

No

Question 33

What is the major concern for the kayexalate medication?

Answer 33

intestinal necrosis and serious GI adverse effects

Question 34

So we have to monitor for what when patients are on kayexalate?

Answer 34

poop explosions

Question 35

What is Magnesium hydroxide and citrate used for?

Answer 35

Constipation

Question 36

What is the role of magnesium on the body?

Answer 36

- Activates intracellular enzymes - Binds to mRNA to the ribosome - Regulates skeletal muscle contractility and blood coagulation

Question 37

Magnesium sulfate is used for what?

Answer 37

Preeclampsia and eclampsia Migraines Status asthmaticus Hypomagnesemia

Question 38

What are the precautions for magnesium sulfate

Answer 38

Renal dysfunction | Monitor cardiac and neuromuscular status

Question 39

What route would you administer magnesium sulfate?

Answer 39

IV

Question 40

Magnesium oxide is used how?

Answer 40

oral replacement

Question 41

What are the adverse effects of magnesium oxide

Answer 41

large doses cause diarrhea.