Flashcards in Potassium. Deck (15):
What is a normal potassium?
3.5 - 5.5
What are common causes of hyperkalaemia?
How does hyperkalaemia present?
palpiataions and renal failure symptoms
How do we Dx hyperkalaemia?
repeat sample (cuffed) or ABG/VBG.
What do we see on ECG for hyperkalaemia?
tall tented T waves
P wave flattening
prolonged PR interval
in extreme cases get a sine wave pattern in VF.
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.
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.
What does calcium resonium do?
stabilises cardic muscle.
What common things cause hypokalaemia?
loop and thiazide diuretics
DKA insulin infusion
vom and D
refeeding syndrome (remeber this in bowel surgery)
hypomagnesaemia (keeps in K in extracellular space)
What do we see on ECG for hypokalaemia?
flat/inverted T waves
U wave (after T)
How do we treat hypokalaemia of 3-3.5?
2 sando K a day (oral)
How do we treat hypokalaemia of 2.5-3?
3 sando K a day
When would we use IV replacement of K?
If really low
TI issues causing poor absorption.
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.