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Flashcards in Fluid and Electrolytes Deck (70)
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61

Potassium supplements

62

Hypokalemia treatment

Moderate

Severe

  • Moderate hypokalemia (2.5-3.5) without EKG change
    • Usually replace orally at dose of 40-120 mEq/day
  • <2.5 and or EKG change
    • Initiate IV replacement 
      • 1 mEq fall in serum K from 4-3 is a 200 mEq deficit
      • Serum K <3.0
        • Total body deficit increases by 200-400 mEq for each 1 mEq reduction in serum concentration 

63

Recommended K dosage/infusion rate guideline

64

Hyperkalemia causes

  • Increased K intake
    • Excessive intake
    • Blood transfusion
    • Rapid excessive IV admin
  • Decreased K elimination
    • Renal failure
    • Medications (ACEs, Bactrim, spironolactone, NSAIDs)
    • Addisons disease decrease cortisol production
  • K release from cells
    • Tissue breakdown (surgery, trauma, hemolysis, rhabdomyolysis)
    • Metabolic acidosis
  • Pseudo-hyperkalemia
    • Hemolyzed blood samples

65

Treatment of Hyperkalemia

66

Mg disorders (__-__)

Normal maintenance?

1.4-1.8

280-350 mg/day

67

Empiric treatment of Hypomagnesemia

68

Hypomagnesemia treatment

  • Diarrhea may be dose-limiting with oral therapy
  • Replace more cautiously in those with renal dysfunction
  • Hypokalemia must be corrected concomitantly
  • Generally takes 3-5 days to restore levels because up to 50% of a dose is excreted in urine, monitor renal function, adjust replacement if needed

69

Hypermagnesemia treatment

  • IV calsium gluconate- temporarily reverses neuromuscular and cardiavascular effects
    • Indicated if [Mg] > 5.0 mEq/L with symptoms or if >8 without
    • 1-2 grams repeat if needed
  • 0.9% NaCl + furosemide (good renal function) or hemodialysis (renal failure)
  • D/C all Mg containing medications (MOM, Maalox) 

70

Summary

Electrolyte disorders need to be?

Understanding the ___ of electrolyte disturbances is?

Knowledge of appropriate electrolyte strategies based on?

Including?

  • Identified and treated rapidly
  • cause of electrolyte disturbances is important to ensure continued insult is not occurring
  • Based on pts serum electrolyte levels
    • Including rate of adminitration based on IV access