Hypo and Hyperkalemia Flashcards
for every 100 mEq of potassium added, how much will serum K+ go up
- by 1
the key site of renal potassium excretion regulation occurs at the
how
- cortical collecting duct
- aldosterone
- reabsorb Na through ENaC
- creates negative membrane potential
- secrete K+ through ROMK
for every H+ secreted, what gets generated
- HCO3
what happens in the beta intercalated cell
- HCO3 secreted
- Cl- reabsorbed
what happens with K in inorganic metabolic acidosis
and why
and this causes
- H+ goes in cell
- Cl- can’t go in
- K+ shifts out of cell to fill the space
- hyperkalemia
what happens in organic acid metabolic acidosis
- both H+ and organic acid enter the cell
a collecting duct that is more electropositive would do what to K+
- not allow it to enter
- would stay in blood
what would decreased flow and sodium delivery to the CCD do to K+
- would make it stay in the blood
MOA of amiloride
- blocks ENaC
- potassium not excreted into urine
pH of blood with amiloride
- acidic
- H+ will stay in the blood
what is the first thing you do in a patient with hyperkalemia
- exclude a lab error
what would cause a lab error in hyperkalemia
- hemolysis
- excess tourniquet time
- severe leukocytosis/thrombocytosis
in hyperkalemia, after you have excluded lab error, what do you consider
- redistribution
what can cause redistribution problems in hyperkalemia
- tissue injury
- insulin deficiency
- mineral metabolic acidosis
- hyperosmolarity
- digoxin
- hyperkalemia periodic paralysis
TIM HDH
if the patient is hyperkalemic, doesn’t have a redistribution injury, and has decreased renal excretion, what do you consider next
- renal failure GFR <20
- decreased urine flow
- hyperkalemic distal RTA
