Hyperkalemia Article

Question 1

Extracellular K level

Answer 1

4.0 - 4.5 mEq/L

Question 2

Total body K is regulated by

Answer 2

the kidneys

Question 3

Increasing the extracellular K concerntration results in

Question 4

Early effects of hyperkalemia

Answer 4

increase myocyte excitability by shifting the resting membrane potential to a less negative value and thus closer to threshold

Question 5

When moderate hyperkalemia occurs

Answer 5

myocyte depression occurs

Question 6

At what mV dose calcium channels open

Answer 6

-40 to -45 mV during phase 0

Question 7

The phase 2 plateau is cause by what

Answer 7

the movement of K out of the cell and Ca into the cell. temporarily off setting eachother, hence the plateau

Question 8

During phase 3 what happens

Answer 8

the Ca channels close and the K channels continue to release K out of the cell. Hence the doward slope of the the curve to a more negative state.

Question 9

Signs seen on an EKG of hyperkalemia

Answer 9

ST segment depression

Peaked T waves

shortening of the QT interval

Question 10

Earliest sign of hyperkalemia on the EKG

Answer 10

Peaked T waves

Question 11

Peaked T waves

Answer 11

K greater then 5.5 mEq/L

Only shows on 22% EKGs

Question 12

K greater then 6.5 mEq/L

Answer 12

widening QRS complex and prolonged PR interval

Question 13

8-9 mEq/L

Answer 13

SA node may stimulate the ventricles without atrial activity

Question 14

10 mEq/L

Answer 14

SA node conduction no longer occurs

Junctional pacer takes over causeing accelerated junctional rhythm

Question 15

> 10 mEq/L

Answer 15

widening of the QRS to become a sine wave and blends with the T wave.

U FUCKED Vfib and Asystole

Question 16

3 Ways to Treat Hyperkalemia

Answer 16

Membrane stabilization

Promote k influx into the Cell

Promote K Removal from the body

Question 17

Initial Tx for hyperkalemia

Answer 17

Ca infusion to antagonize the effects of hyperkalemia at the cellular level

Changes the resting membrane potential to less negative decreasing the excitability of the cell

Question 18

Ca effect can be seen how quickly

Answer 18

1-3 min

Question 19

Ca effects las how long

Answer 19

30-60 min

Question 20

which is the prefered calcium of choice IV gluconate or chloride

Answer 20

gluconate

10% solution given 10ml

or

100 mg

Question 21

calcium chloride is how many times stonger then calcuim gluconate

Answer 21

3X

Question 22

Typically how do you promote K influx into the cell

Answer 22

D50 and Insulin

effects are seen within 10 - 20 min

Decreases the K by 0.6 - 1 mEq/L

Question 23

The quickest K removal is done how

Answer 23

dialysis

not the most fesible though

Question 24

Other ways to get K out of the Body

Answer 24

Ion exchange resin with sorbitol via the gut, orally or rectally

decreases the K by 1 mEq/L in 24 hours