Exam 1: Potassium Imbalances

Question 1

What is Potassium?

Answer 1

A major intracellular electrolyte

Question 2

Where is Potassium located?

Answer 2

98% of the bodys potassium is inside the cell

Question 3

Where is the remaining Potassium located?

Answer 3

2% located in ECF, and important for neuromuscular function.

Question 4

What does Potassium influence in ECF?

Answer 4

Skeletal and Cardiac Muscle Activity

Question 5

Normal Serum Potassium concentration?

Answer 5

3.5 to 5 mEq/L

Question 6

Potassium are commonly associated with?

Answer 6

Various diseases, injuries, medications, and acid-base imbalances

Question 7

How much Potassium is excreted daily?

Answer 7

80% excreted through kidneys daily

Question 8

Altername name for Potrassium Deficit?

Answer 8

Hypokalemia

Question 9

Waht is Hypokalemia?

Answer 9

When serum Potassium Levels fall bellow 3.5 mEq/L, indicating a deficit in total potassium stores

Question 10

Hypokalemia Contributing Factors

Answer 10

Diarrhea, Vomiting, Gastric Suction, Starvation, Diuretics

Question 11

Hypokalemia Signs/Symptoms

Answer 11

Fatigue, Anorexia, Muscle Weakness, Decreased Bowel Motility, Decreased BP

Question 12

Hypokalemia ECG (T)

Answer 12

Flattened T Waves

Question 13

Hypokalemia ECG (U)

Answer 13

Prominent U Waves

Question 14

Hypokalemia ECG (ST)

Answer 14

Depression

Question 15

Hypokalemia ECG (PR)

Answer 15

Prolonged PR interveral

Question 16

Hyperkalemia range?

Answer 16

> 5.0 mEq/L

Question 17

Hyperkalemia Contributing Factors

Answer 17

Kidney Injury, Use of Potassium Conserving Diuretics, Addison Disease, Crush Injury, Burns, ACE Inhibitors

Question 18

Hyperkalemia Signs/Symptoms

Answer 18

Muscle Weakness , Tachy/Bradycardia, Flaccid Paralysis, Cramps, Abdominal Distention, Anxiety

Question 19

Hyperkalemia ECG (T)

Answer 19

Tall tented T waves

Question 20

Hyperkalemia ECG (PR)

Answer 20

Prolonged PR intervals

Question 21

Hyperkalemia ECG (QRS)

Answer 21

Prolonged QRS duration

Question 22

Hyperkalemia ECG (P)

Answer 22

Absent P Waves

Question 23

Hyperkalemia ECG (ST)

Answer 23

ST Depression

Question 24

What diuretics can induce hypokalemia?

Answer 24

Thiazides and Loop Diuretics

Question 25

Other medications that can lead to hypokalemia?

Answer 25

Corticosteroids, Sodium Penicillin ,and Amphotericin B

Question 26

Another common cause of potassium depletion?

Answer 26

GI Loss. Votmiting and Gastric Sunction frequently lead to hypokalemia.

Question 27

Potassium deficit occurs frequently with

Answer 27

diarrhea, may contain as much as 30 mEq/L

Question 28

What does Hyperaldosteronism do and lead to?

Answer 28

Increases renal potassium wasting and can lead to sever potassium depletion

Question 29

Primary Hyperaldosteronism is seen in patients with

Answer 29

adrenal adenomas

Question 30

Secondary Hyperaldosteronism occurs in patients with

Answer 30

Cirrhosis, Nephrotic Syndrome, Heart Failure, or Malignant Hypertension

Question 31

What does Magnesium depletion cause?

Answer 31

Causes renal potassium loss and must be corrected first; otherwise, urine loss of potassium will continue

Question 32

If Prolonged, Hypokalemia can lead to

Answer 32

an inability of the kidneys to concentrate urine, causing idlute urine and excessive thirst

Question 33

Potassium depletion spresses

Answer 33

the release of insulin and results in glucose intolerance

Question 34

Urinary potassium excretion exceeding 20 mEq/day with hypokalemia suggests that

Answer 34

renal potassium loss is the cause

Question 35

What is the corrected daily administration of potassium needed?

Answer 35

40 to 80 mEq/day

Question 36

Diet for one with hypokalemia?

Answer 36

Diet containing sufficient potassium should be provided. Average is 50 to 100 mEq/day. Foods include fruits and vegetables, legums, whole grains, milk

Question 37

IV route is mandatory for patients with severe hypokalemia, a range of

Answer 37

< 2 mEq/L

Question 38

What signals warrant assessing teh serum potassiun concentration?

Answer 38

Fatigue, anoxeria, muscle weakness, decreased bowel motility, paraesthesias and dysrhythmias

Question 39

Prevention for Hypokalemia

Answer 39

Encouraging patient to each foods rich in potassium.

Question 40

How much Potassium is lost per liter of urine output?

Answer 40

40 mEq

Question 41

Why should you be careful with Potassium and Urine Output?

Answer 41

Potassium is primarily excreted by the kidneys. Potassium administration can cause the serum potassium to rise dangerously.

Question 42

Whats the Hyperkalemia range?

Answer 42

> 5 mEq/L

Question 43

Hyperkalemia seldom occurs with

Answer 43

normal renal function

Question 44

In older adults, there is an increased risk of hyperkalemia due to

Answer 44

decreases in renin and aldosterone as well as an increased number of comorbid cardiac conditions.

Question 45

Hyperkalemia (Like Hypokalemia) is often caused by

Answer 45

iatrogenic (treatment-induced) causes.

Question 46

Hyperkalemia is more dangerous because

Answer 46

cardiac arrest is more frequently associated with high serum potassium levels

Question 47

Major causes of hyperkalemia are

Answer 47

decreased renal excretion of potassium, rapid administration of potassium, and movement of potassium from the ICF compartment to the ECF compartment

Question 48

Hyperkalemia is comonly seen in patients with

Answer 48

untreated kidney injury

Question 49

Patients with Hypoaldosteronism or Addison disease are at risk for hyperkalemia because

Answer 49

deficient adrenal hormones lead to sodium loss and potassium retention

Question 50

Common Medications to cause Hyperkalemia?

Answer 50

KCl, Heparin, Ace Inhibitors, NSAIDS, Beta Blockers, Cyclosporine, Tacrolimus

Question 51

In acidosis, potassium moves

Answer 51

out of the cells and into the ECF.

Question 52

Elevated ECF Potassium level should be anticipated when

Answer 52

extensive tissue trauma has occured, as in burns, crushing injuries, or severe infections. Similarly, it can occur after chemotherapy

Question 53

Most important consequence of hyperkalemia is its

Answer 53

effect on the myocardium.

Question 54

At what level of potassium are cardiac effects present?

Answer 54

When the level is 8 mEq/L or greater. This may lead to ventricular dysrhythmias and cardiac arrest.

Question 55

Hyperkalemia; what should be obtained immediately?

Answer 55

An ECG

Question 56

What should be done ijf serum potassium levels are dangerously elevated?

Answer 56

May be necessary to administer IV calcium gluconate. It antagonizes the action of hyperkalemia on the heart

Question 57

Loop Diuretics; Hyperkalemia

Answer 57

They increase excretion of water by inhibiting sodium, potassium, and chloride reabsorption in the ascending loop of Henle and distal renal tube

Question 58

Hyperkalemia; Beta-2 Agonists

Answer 58

Highly effective in decreasing potassium, but cause tachycardia and chest discomfort

Question 59

How do Beta-2 Agonists work

Answer 59

Move potassium into the cells and may be used in the absence of ischemic cardiac disease

Question 60

Nursing Management for Hyperkalemia

Answer 60

Monitor for I/O, observe for signs of muscle weakness and dysrhythmias. Apical Pulse should be taken

Question 61

What foods should be avoided in hyperkalemia

Answer 61

Vegetables, Fruits, Legumes, Whole-Grain breads, Lean Meat, Milk, Eggs