F&E (Exam 3) Potassium

Question 1

Potassium Imbalances

Answer 1

Hypokalemia = K < 3.5

Hyperkalemia = K > 5.0

Question 2

Potassium

Answer 2

-Intracellular cation

-Helps regulate cell excitability and electrical status (Muscle and heart contraction and function)

-Helps control intracellular osmolarity

Question 3

Main source of potassium

Answer 3

Diet

Question 4

Main source of potassium loss

Answer 4

Kidneys (Peeing Out)

Question 5

Hypokalemia: Causes

Answer 5

Renal or GI losses

Diuresis

Acid base disorder (K in extracellular space goes into intracellular space)

-Not from dietary intake

Question 6

Hypokalemia: Signs and Symptoms

Answer 6

-Cardiac rhythm disturbances

-Muscle weakness and leg cramps

-Decreased bowel motility: constipation. N

Question 7

Hypokalemia: Treatment

Answer 7

Potassium chloride (KCl)

Question 8

KCl: Indications

Answer 8

-Treat/prevent K depletions when dietary measures prove inadequate

Question 9

KCL: Nursing Implicaitons

Answer 9

-Oral or Liquids

-DILUTE with water/juice which decreases GI distress

-Large pills may be a challenge for some patients

-May cause GO ulcers and bleeding

Question 10

Giving Potassium via IV

Answer 10

-ALWAYS diluted

-NEVER IV PUSH

Question 11

What do we watch when we give potassium?

Answer 11

Urine output

(Don’t give to people with renal problems)

Question 12

KCL: IV

Answer 12

-Must be diluted and administered slowly

-Give only to clients with documneted urine output

-May cause phlebitis/pain

-Ive solutions should not contain more than 40 meq/L of k and should not exceed 10-20 mEq/hr

Question 13

KCL: Contraindications

Answer 13

-Renal failure (K levels already high because kidneys cant excrete the K)

-Nurse should always question an order to give KCL to a patient on dialysis

-Patient should be on telemetry

Question 14

Serious ADR with Undiluted Potassium

Answer 14

-Ventricular fibrillation can be precipitated by administration of undiluted IV KCL

-NEVER PUSH IV POTASSIUM

-Has to be done over an hour or more

Question 15

Hyperkalemia: Causes

Answer 15

-Decrease K output (Renal failure or not peeing)

-Burns, crush injuries, sepsis (massive cell injury) (K lives inside cell which burst and inter blood stream)

Question 16

Drugs that cause high level of K

Answer 16

-ACE, ARB’s and NSAIDS

Question 17

Hyperkalemia: S/S

Answer 17

-Cardiac rhythm disturbances

-Muscle weakness, cramps

-Abdominal cramping and vomiting

Question 18

Hyperkalemia: Treatment

Answer 18

sodium polystyrene sulfonate

Oral suspension, oral and rectal poweder, oral and recatl suspension, rectal edemia

Question 19

Sodium polystyrene sulfonate: Class

Answer 19

Cation exchange resins

Question 20

Sodium Polystyrene Sulfonate: MOA

Answer 20

Binds to potassium in the digestive tract replacing potassium ions for sodium ions. Potential to drop K by 0.5-1.0 meq/L in 4-6 H

Question 21

Sodium polystreyene sulfonate: Precaution

Answer 21

-Use only in patients with normal bowel function

Question 22

Sodium polystyrene sulfonate: Adverse reactions

Answer 22

-Constipation, diarrhea, N/V, hypokalemia

-Serious: Intestinal obstruction and intestinal necrosis

(MAKES PEOPLE POOP)

Question 23

D50/Insulin for hyperkalemia

Answer 23

-Lytic Cocktail (To reduce potassium level)

-Combo shifts potassium into the cell temporally

-Usually give 10 units of regular insulin and 1 ampule of D50 (50% dextrose)