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Fluid and Electrolytes > Potassium > Flashcards

Potassium Flashcards

1
Q

What does potassium do for the body??

A

It pumps the heart
Contracts the muscles

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2
Q

Potassium is regulated by what

A

Kidney and aldosterone

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3
Q

What is the acid base balance for potassium

A

Increased K+ in the cell = H+ moves out
Increased H+ in the cell = K+ moves out

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4
Q

Where do we mainly get Potassium from

A

Our diet

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5
Q

What are the causes of HYPOkalemia?

A

Diuretics
Corticosteroids
Cushings
GI loss
Excessive Diaphoresis
Kidney disease
Metabolic Alkalosis
Not enough K+ intake

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6
Q

Why does diuretics cause HYPOkalemia?

A

When pt takes a diuretic they pee a lot. Which means they lose electrolytes. Which means they can lose K+ in the process, if they take a diuretic with low K+ it increases the risk of digoxin toxicity

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7
Q

What does corticosteroids do to the body?

A

Increases aldosterone, the hormone that causes water retention which can lead to hemodilution

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8
Q

What is Cushings disease?

A

When you have hyperaldosteronism
Higher Aldosterone causes more k+ to be excreted through the kidneys

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9
Q

What GI loss can cause HYPOkalemia?

A

Vomiting
Diarrhea
Prolonged NG suction

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10
Q

What is metabolic alkalosis and why does it cause HYPOkalemia?

A

In alkalosis there’s less H+ in blood which causes H+ to shift out of cells and K+ to shift into the cells

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11
Q

Not in taking enough K+ causes K+ to do what?

A

K+ moves from ECF to ICF
Or
Excess insulin causes K+ to move into the cell

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12
Q

What are the S/S of a pt with HYPOkalemia?

A

Torsades de pointes
Bradycardic
Muscle weakness
Constipated
Diminished DTRs
Lethargy (confused)
Lethal dysrhythmias
If bowel sounds are absent, think of paralytic ileus = portion of bowel not moving which can lead to small bowel obstruction

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13
Q

Should the nurse check Mg+ levels first before correcting K+? Why or why not?

A

Yes bc when Mg+ is low it causes K+ loss due to K+ not being absorbed properly without Mg+

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14
Q

What is torsades de pointes?

A

It’s an irregular QRS complex appearing to wrap around the EKG baseline
It’s a long QT interval which means the heart is taking much longer to electrically charge for the next heartbeat

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15
Q

What should the nurse do when the pt is HYPOkalemic?

A

Monitor their cardiac and respiratory status
Administer K+ supplements orally or IV SLOWLY
Stop the pt on any diuretics esp Spironolactone
Have them eat K+ rich foods

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16
Q

K+ is never administered how? Why?

A

Never administer K+ IV push, IM, SubQ can cause death
IV K+ is always diluted and administered using a pump

17
Q

What are the causes of HYPERkalemia?

A

Excess K+ intake
Addisons
Decreased K+ excretion
Kidney Disease
Metabolic Acidosis
Traumatic burns

18
Q

What can cause a decreased K+ excretion ?

A

Spironalactones
ACE inhibitors
NSAIDs (decrease renal perfusion)

19
Q

What type of Adrenal insufficiency causes HYPERkalemia?

A

Addisons = low aldosterone (hypoaldosteronism) which means K+ retention

20
Q

Hypoaldosteronism causes what?

A

Causes large amount of sodium excretion and K+ retention

21
Q

Why does Metabolic Acidosis cause HYPERkalemia?

A

I gotta ask about this

22
Q

What are S/S of HYPERkalemia?

A

Low BP
Dysthymia
Hyperactive Bowels Sounds
Muscle Weakness = can result in paralysis and Cardiac arrest

23
Q

What are MILD treatments for HYPERkalemia?

A

Monitor Cardiac Rhythm changes
Restrict K+ diet
Dialysis
Stop medications that increase K+
Kayexalate?

24
Q

What are SEVERE HYPERkalemia interventions?

A

Severe HYPERkalemia: greater than 6.5
Ca+ Gluconate 10% IV
Given over 3-5 minutes
Monitor for Dysrhythmias, BP, HR
Hypertonic glucose + insulin
NaHCO3

25
Q

What does Hypertonic Glucose and insulin do to treat HYPERkalemia?

A

Shifts excess K+ into the cell

26
Q

How does NaHCO3 treat HYPERkalemia?

A

K+ shifts into the cell and raises pH

27
Q

What will a pts EKG look like for HYPERkalemia??

A

Peaked narrow T wave
ST segment depressed
Prolonged PR interval

28
Q

What does insulin help K+ do?

A

Helps out K+ in the cells

Fluid and Electrolytes (5 decks)

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