K objectives

Question 1

What is the cause of hypokalemia

Answer 1

1. decrease intake of K
2. increase K movement into cells
3. Drugs: diuretics and ampho B
4. K loss thru urine, feces or sweat

Question 2

what causes hyperkalemia

Answer 2

1. K sparing diuretics
2. unresponsive to aldosterone (MOA of K sparers)
3. metabolic acidosis moving K into ECF
4. beta blockers
5. succinylcholine
6. IV AA’s

Question 3

what drugs most commonly cause hypokalemia?

Answer 3

loop and thiazide diuretics

Question 4

how do beta blockers cause hyperkalemia

Answer 4

decrease beta 2 receptor K reuptake

Question 5

how does lysine, arginine and aminocaproic acid cause hyperkalemia

Answer 5

release K from cells to ECF

Question 6

how does succinylcholine cause hyperkalemia

Answer 6

depolarize cell membranes

Question 7

how does digoxin toxicity cause hyperkalemia

Answer 7

decrease NaK/ATPase activity

Question 8

what are the signs and symptoms of hyperkalemia?

Answer 8

1. usually asymptomatic
2. palpitations
3. skipped heart beat
4. ECG change = loss of P wave

Question 9

what are the signs and symptoms of severe hyperkalemia?

Answer 9

muscle weakness

ecg changes : merged QRS and T wave

Question 10

how is hyperkalemia treated?

Answer 10

1. calcium
2. insulin and glucose
3. sodium bicarb (if metabolic acidosis causes it)
4. loop or thiazide
5. cation exchange resin

Question 11

if a pt. has ECG changes with hyperkalemia, what treatment is recommended?

Answer 11

calcium gluconate