Flashcards in Fluid and Electrolytes Deck (70)
Loading flashcards...
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
- Usually replace orally at dose of 40-120 mEq/day
- 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
- Excessive intake
- Blood transfusion
- Rapid excessive IV admin
- Renal failure
- Medications (ACEs, Bactrim, spironolactone, NSAIDs)
- Addisons disease decrease cortisol production
- Tissue breakdown (surgery, trauma, hemolysis, rhabdomyolysis)
- Metabolic acidosis
- 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)
- Indicated if [Mg] > 5.0 mEq/L with symptoms or if >8 without
- 1-2 grams repeat if needed
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
- Including rate of adminitration based on IV access