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Potassium (Regular, Hypo, & Hyperkalemia) Flashcards

1
Q

what is the normal range for K+

A

3.5-5.0

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2
Q

what is K+ king of

A

king of hearts

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3
Q

K+ is a major electrolyte in which fluid

A

Intracellular fluid

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4
Q

what does K+ maintain (2)

A

heart & muscle contraction

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5
Q

what regulates K+ (2)

A

regulate by kidneys & aldosterone

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6
Q

Increased K+ in the cell means H+ does what

A

moves out of the cell

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7
Q

Increased H+ in the cell means K+ does what

A

moves out of the cell

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8
Q

what is a main source of K+

A

diet

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9
Q

what causes hypokalemia (8)

A

potassium loss
corticosteriods
increased secretion of aldosterone
GI loss
Excessive diaphoresis
Kidney disease
Inadequate K+ intake
Alkalosis, Metabolic

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10
Q

what med can cause K+ loss (1)

A

Diuretics

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11
Q

what medication should we be careful using with diuretics

A

digoxin

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12
Q

when the K+ is low is digoxin toxic

A

yes

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13
Q

when we use diuretics with digoxin what are we are at an increased risk for

A

hypokalemia

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14
Q

corticosteroids causes water retention which cause what dilution

A

hemodilution

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15
Q

increased secretion of aldosterone causes what disease

A

Cushing’s

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16
Q

aldosterone is K+ excretion through

A

kidneys

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17
Q

if there are higher levels of aldosterone more K+ is what

A

excreted

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18
Q

What can cause K+ to be lost through the GI system (3)

A

Vomiting
Diarrhea
NG suction

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19
Q

what can excess insulin do to K+

A

moves K+ into the cell

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20
Q

what is the severe level of hypokalemia

A

2.5 or less

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21
Q

what will the pt’s cardiovascular system look like if they have hypokalemia (4)

A

torsades de pointes
irreg. apical HR
lethal dysrhytmisas
bradycardia

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22
Q

what does tosades look like/what will it look like on an EKG

A

a long QT interval

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23
Q

what does a long QT interval mean for the heart (what is the heart doing)

A

heart takes longer to electrically charge for the next heartbeat

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24
Q

what does torsades de pointes mean in english

A

twisting of the points

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25
what do torsades de pointes look like in hypokalemia
irreg. QRS complexes appearing to wrap around the EKG baseline
26
what does an EKG look like for a pt with hypokalemia
increased amplitude & width of P wave, T wave flattening and inversion, prominent U waves and apparent long QT intervals due to merging of the T & U wave
27
how does an EKG look like in a pt with hyperkalemia
Peaked T waves P wave flattening PR prolongation Wide QRS complex
28
how will a hypokalemic pt's neuromuscular function present (4)
confusion lethargy muscle weakness diminished DTRs
29
how will a hypokalemic pt's GI function present to us
Constipation
30
what should we think is happening in the GI system if there are absent bowel sounds in a hypokalemic
think paralytic ileus
31
what is a paralytic ileus
portion of bowel not moving & can lead to small bowel obstruction
32
what other electrolyte should we check with hypokalemia
Mg+
33
What if the Mg+ level is low in a hyperkalemic pt
if Mg+ is low it enhances K+ loss, correct Mg+ loss first then fix K+
34
what interventions do we do for hypokalemic pt's (4)
monitor cardiac & respiratory status admin K+ supplements orally or via IV If pt on diuretic, may need to stop it K+ rich foods to replace K+
35
Should we admin K+ fast or slow
slow because it's lethal if given too fast
36
what diuretic should we give to a pt that will spare K+ from being excreted
Spironolactone
37
if we give K+ orally what should we always give it with
food
38
K+ is never admined in which routes (3)
IV push, IM, or SubQ
39
IV K+ is always what
diluted
40
What can cause hyperkalemia (6)
excess K+ intake decreased K+ excretion adrenal insufficiency kidney disease- #1 cause traumatic burns acidosis, metabolic
41
what is the number 1 cause of hyperkalemia
kidney disease
42
what drugs can cause hyperkalemia (3)
K+ sparing diuretics (sprionolactone) Ace inhibitors NSAIDS (decrease renal perfusion)
43
what adrenal insufficient disease can cause hyperkalemia
addison's
44
why does addison's cause hyperkalemia
addison's had low aldosterone which causes retention of K+
45
why does kidney disease cause hyperkaleima
there is a decrease in urine output and increase in K+
46
how can acidosis cause hyperkalemia
because H+ levels are elevated in blood, K+ moves out as H+ moves into the cell
47
what is the severe level of a patient in hyperkalemia
greater than or equal to 6.5
48
what is the lethal level of a pt w/ hyperkalemia
greater than or equal to 8.5
49
how will a pt's cardiovascular system look with hyperkalemia (4)
low bp dysrhythmias V fib Cardiac standstill
50
how will a pt's GI system sound like with hyperkalemia
hyperactive bowels
51
what do the hyperactive bowels indicate in a pt with hyperkalemia (2)
diarrhea & increased motility
52
what weakness can result in paralysis & respiratory arrest
muscle weakness
53
how will an EKG look in a pt with hyperkalemia (3)
peaked narrow T wave, ST segment depressed, prolonged PR interval
54
what interventions will we do for a pt with hyperkalemia (6)
monitor cardiac rhythm changes restrict K+ in diet Diuretics Cation exchange resins Stop meds causing increase in K+ Dialysis
55
what cation exchange resin do we give to a pt w/ hyperkalemia
sodium polystyrene sulfate (Kayexalate)
56
what happens to a pt's bowels when we give Kayexalate
explosive diarrhea
57
what emergency medical treatments (meds) do we give to a pt w/ severe hyperkalemia (3)
Ca+ Gluconate 10% IV Hypertonic glucose & insulin NaHC03
58
What does Ca+ Gluconate protect the heart from
myocardial irritability
59
what does Ca+ Gluconate not lower
does not lower K+
60
how long must Ca+ Gluconate be given
given over 3-5 mins
61
what should we monitor when giving Ca+ gluconate (3)
HR & BP Dysrhythmias
62
where does insulin move K+
into the cells
63
where does hypertonic glucose & insulin move excess K+
into the cells
64
where does NaHCO3 (sodium bicarb) shift K+
into the cell
65
when NaHCO3 shifts K+ into the cell what is also raised
pH

IM2 (17 decks)

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