Lecture 2 - Potassium

Question 1

Normal potassium range

Answer 1

3.5-5 mEq/L

Question 2

potassium 3.5-5 mEq/L

• primary ___ cation
• responsible for cell ___
• ___ and ___ synthesis
• determines ___ across cell membranes
• hypo/hyperkalemia are associated with potentially fatal cardiac ___

Answer 2

• intracellular
• metabolism
• glycogen and protein
• resting potential
• arrhythmias

Question 3

factors affecting K

___ pump
- insulin
- glucagon
- catecholamines
- aldosterone

Kidneys
Arterial pH/___ status

Answer 3

• Na/K ATPase pump
• acid-base

Question 4

Hypokalemia causes

• ___ loss (potassium wasting)
• ___ agonist medications (like albuterol)
• NG drainage
• metabolic ___
• diarrhea
• ___ depletion

Answer 4

• diuretic
• beta
• alkalosis
• Mg

Question 5

How does Mg depletion affect K?

Mg is a cofactor for ___
- no Mg = no exchange of K
- impairs K ___ across tubules

Answer 5

Na/K ATPase
reabsorption

Question 6

Clinical presentation of hypokalemia

higly variable
- weakness (impaired muscle ___)
- N/V
- changes in ___ function/arrhythmias
- cramping

Answer 6

• contraction
• cardiac

cardiac pts may be at higher risk

Question 7

Hypokalemia treatment

3.5-4 mEq/L
- no therapy generally recommended
- goal level in ICU is greater than or equal to ___ mEq/L

3-3.4 mEq/L
- treatment is debatable

< 3 mEq/L
- always treat
- ___ route is preferred in asymptomatic pts
- ___ route for symptomatic pts

should attempt to correct ___ deficit

Answer 7

• 4
• PO
• IV
• Mg

Question 8

Intraveous K

criteria
- severe cases of hypokalemia ( < ___ mEq/L)
- exhibiting Sx of ___ changes or ___ spasms
- Unable to tolerate ___

warnings/precautions
- ___ and pain at infusion site
- higher risk of leading to ___ /overcorrection
- ___ or ___ arrest if given too quickly

Answer 8

• 2.5-3
• ECG, muscle
• PO
• thrombophylebitis
• hyperkalemia
• arrhythmia, cardiac

Question 9

IV K administration

• generally each ___ mEq is diluted in 100 mL of D5W
• infusion rate without cardiac monitoring: ___ mEq/hr
• with continuous cardiac monitoring: ___ mEq/hr
• ___ mEq/hr is emergent with severe hypokalemia (as seen in cardiac arrest)

Answer 9

• 10-20
• 10
• 2-
• 40-60

Question 10

hyperkalemia

K greater than or equal to ___ mEq/L
mild: ___ mEq/L
moderate: ___ mEq/L
severe: ___ mEq/L

Answer 10

• 5.5
• 5.5-6
• 6.1-6.9
• > or = 7

Question 11

clinical presentation of hyperkalemia

cardiac arrhythmias
- peaked ___ wave seen in ___ mEq/L
- slows ___
- VF or ___ seen in > ___ mEq/L

Answer 11

• T, 5.5-6
• AP
• asystole, 9

Question 12

Severe hyperkalemia treatment

1. antagonize the membrane actions to prevent ___
2. decrease ___ K concentractions
3. remove K from body

3. if you can push it back into the cell, pee it out

Answer 12

• arrhythmia
• extracellular

C A BIG K DROP

Question 13

C - A BIG - K DROP

1. antagonize membrane actions
   - ___
2. decrease extracellular K concentrations
   - ___
   - ___
   - ___
3. remove K from the body
   - ___ / ___
   - ___ (furosemide)
   - Renal unit for dialysis Of Patient

Answer 13

• Calcium
• Albuterol
• Bicarb
• Insulin + Glucose
• Kayexalate/LoKelma
• Diuretics

Question 14

hyperkalemia treatment examples

1. calcium ___
2. regular insulin ( ____ route) + D ___W
3. Furosemide, ___ or Lokelma, hemodialysis

Answer 14

• chloride
• IV push, D50W
• Kayexalate

Question 15

Chronic hyperkalemia treatment option: ___
- MOA: binds K in ___ and ___ its absorption
- dose: 8.4 gm Po once daily oral susp
- onset/duration: serum K will start to decrease in __ hrs after dose and continue to decline in __ hrs
- ADEs: hypo___, constipation, diarrhea, nausea, abdominal discomfort, flatulence

Answer 15

Patiromer (Valtassa)
* GI tract, decreases
* 7, 48
* hypomagnesemia

poop it out