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Flashcards in Potassium. Deck (15):
1

What is a normal potassium?

3.5 - 5.5

2

What are common causes of hyperkalaemia?

renal failure
spironolactone
K supplements
hypovolaemia
addisons

3

How does hyperkalaemia present?

palpiataions and renal failure symptoms

4

How do we Dx hyperkalaemia?

ECG
repeat sample (cuffed) or ABG/VBG.

5

What do we see on ECG for hyperkalaemia?

wide QRS
tall tented T waves
P wave flattening
prolonged PR interval

in extreme cases get a sine wave pattern in VF.

6

How do we treat a potassium of 5.5-6.5?

give calcium resonium and wait for K to come back down with fixing cause.

7

How do we treat a potassium of over 6.5 or a rise of over 2 in 24 hours or ECG changes?

(if not in DKA)

calcium gluconate (unless high Ca already) to stabilise the myocardium (10% in 10ml over 10 mins)

5-10mg salbutamol (2 x 5)

10 units of insulin (actrapid or novorapid - in 50ml 50% or 100ml 20% dextrose over 30 mins)

recheck after 1 hour, repeat until Ok.

consultant can give sodium bicarbonate and dialysis if needed.

8

What does calcium resonium do?

stabilises cardic muscle.

9

What common things cause hypokalaemia?

loop and thiazide diuretics
salbutamol
DKA insulin infusion
Conns/Cushings
vom and D
MI
refeeding syndrome (remeber this in bowel surgery)
hypomagnesaemia (keeps in K in extracellular space)

10

What do we see on ECG for hypokalaemia?

prolonged PR
flat/inverted T waves
U wave (after T)

11

How do we treat hypokalaemia of 3-3.5?

2 sando K a day (oral)

12

How do we treat hypokalaemia of 2.5-3?

3 sando K a day

13

When would we use IV replacement of K?

If really low
non-compliance
TI issues causing poor absorption.

14

How do we give IV potassium?

can give 20-40mmols in 500mls Na 0.9 or glucose.

Cant exceed more than 10mmols per hours (generally give over 6-8 hours.

15

Why don't we give potassium too quickly?

is irritant and can extravasate or cause phlebitis.