Cl & K Flashcards
Cl normal range
95-108
K normal ranges
3.5-5.3
K imbalances lead to
Cardiac Arrest
K is important for
fluid regulation
conduction of nerve impulses
smooth muscle & heart contractions
↑ serum K stimulates
Aldosterone: causes excretion of K and retention of Na until K levels return to normal
_________ promotes cellular K uptake by shifting _________ and K into cells.
insulin
glucose
Hyperkalemia (<5.5) is caused by
*Oral K supplements: too much intake
*Medications: K sparing diuretics, ACE inhibitors, NSAIDS
*↓ renal function – potassium retention/decreased excretion
*Metabolic acidosis (Burns, DKA) – exchanges hydrogen ions for K ions in the ICF
*Addison’s disease (reduced secretion of cortisol & aldosterone – promotes K retention and Na/water excretion
Signs and Symptoms of hyperkalemia
*Abdominal cramping, N/V, diarrhea
*EKG changes - ectopic beats, progresses to peaked T wave
*Bradycardia
*Muscle weakness, lethargy, fatigue, hypotension
*Oliguria
treatment for hyperkalemia
*Medications: Administer calcium gluconate
*Polystyrene sulfonate (Kayexalate)
*Insulin and D50
*Monitor EKG; place on telemetry
*Dialysis (extreme cases)
causes of Hypokalemia (<3.5)
*Malnutrition
*Vomiting, diarrhea
*K-wasting diuretic: furosemide, hydrochlorothiazide
*Metabolic Alkalosis
*Steroid use/Cushing syndrome - increased secretion of cortisol and aldosterone
Hypokalemia Signs and Symptoms
Early signs: fatigue, weakness, leg cramps
*Cardiac dysrhythmias
*increased HR
hypokalemia treatment
*IV KCL: 10 mEq is usually administered in 100ml over 1 hour (never give KCL as an IV push/bolus = DEATH!)
*Monitor EKG - EKG changes for hypokalemia: Flat or inverted T wave & a depressed ST segment
*Monitor for dig toxicity: ↓ K enhances the action of digoxin.
*Oral K replacement or food rich in K: bananas, raisins, prunes, dry fruits, squash, potatoes, nuts & orange juice
