CV 6

Question 1

Potassium is a primary ______cation

Answer 1

intracellular

Question 2

what do insulin and catecholamines do?

Answer 2

promote shift of k into cells

Question 3

primary route of K+ elimination?

Answer 3

Kidneys

Question 4

3 physiological functions of K+

Answer 4

protein and glycogen synthesis
cell metabolism and growth
determination of the resting membrane potential across cell membranes

Question 5

Normal K+ range

Answer 5

3.5-5 mmol/L

Question 6

Hypokalaemia

Answer 6

low potassium

Question 7

hyperkalaemia

Answer 7

high potassium

Question 8

Hypokalemia classification

Answer 8

mild = 3-3.5
moderate = 2.5-3
severe = <2.5

Question 9

estimation of K+ deficit

Answer 9

0.3mmol/L on average for every 100mol

Question 10

Hypokalemia decreased intake causes

Answer 10

starvation, clay ingestion

Question 11

redistribution into cells hypokalemia cause

Answer 11

metabolic alkalosis
- vomiting etc
Hormonal
- insulin, b2agonsits
Anabolic state
- body building

Question 12

Increased net loss hypokalemia non renal causes

Answer 12

GI losses - vomiting, diarrhea, draining fistures, plasma volime contraction
Integumentary loss - sweat

Question 13

increased net loss hypokalemia renal causes

Answer 13

increased distal flow and increased secretion of K+

Question 14

Transcellular K+ shift - hypokalemia - drugs

Answer 14

B2 adrenergic agnoists
Bronchodilators
epinephrine
decongestants
theophyline
insulin overdose
caffeine

Question 15

Increased renal K+ loss - hypokalemia - drugs

Answer 15

diuretics
thiazides
chlorthalidone
furosemide
mineralcorticocoids
high dose gluccorticoids
high dose abx
drugs associated w/ mg depletion

Question 16

excess potassium in the stool - hypokalemia - drugs

Answer 16

sodium polystyrene sulfonate

Question 17

hypokalemia preventative therapy

Answer 17

20-40mmol/day

Question 18

hypokalemia - 2.5-3.5 treatment in an asymptomatic pt

Answer 18

40-200mmol/day in divided doses
check serum K+ levels daily

Question 19

K+ less than 2.5 OR K+ 2.5-3.5 WITH symptoms - name the symptoms

Answer 19

cardiac arrhythmias
conduction disturbances
respiratory muscle weakness
paralysis

Question 20

K+ less than 2.5 OR K+ 2.5-3.5 WITH symptoms - treatment - IV intermittent

Answer 20

general nursing units:
20mmol/50mL centrally or 20mmol/250mL peripherally administered over 1 hour

Critical/special care areas: 40 mmol/100mL centrally over 1 hour. ECG monitored required for rates above 20 mmol/hr.

Question 21

K+ less than 2.5 OR K+ 2.5-3.5 WITH symptoms - treatment - IV infusion

Answer 21

Peripheral line: usual 20-40mmol/L (max 80 mmol/L) infused at max rate of 10mmol/hour)

Central Line: usual 20-40mmol/L (max 120mol/L) infused at max rate of 20 mmol/hour)

Question 22

most common Potassium preparation

Answer 22

KCl

Question 23

Preferred route

Answer 23

oral, IV if life threatening

Question 24

appropriate rate of administration

Answer 24

divide it up and give it 3-4 times daily

Question 25

pseudohyperkalemia define

Answer 25

• artifact produced during the in vitro measurement of serum K+
• produced due to the release of K+ in the process of drawing blood or from lysis of cells in blood prior to assay
• diagnosed if serum k+>plasma k+ by >0.3 mmol/L

Question 26

Pseudohyperkalemia common causes

Answer 26

related to collection and storage of specimen
- difficulty in collecting sample
- pt clenched fist when sample was taken
- sample was shaken
- contaminated, cooled, deterioration

Related to pre-existing conditions
- thrombocytosis
- severe leukocytosis
- hereditary and acquired red cell disorders

Question 27

Hyperkalemia Treatment, antagonizers

Answer 27

CaCl, 1g (10ml) IV direct over 2-5mins
CaGlu, 1g (10ml) IV in D5W 50mL infused over 15 mins

Question 28

Hyperkalemia Treatment Shifters

Answer 28

1. Insulin 50% Glucose, dextrose 50%: 25g (50mL) IV direct over 5 mins followed by insulin regular 10U IV direct
2. Salbutamol 0.5mg IV 20mg via neb