PHRM 825: Fluids and Electrolytes - Electrolytes - K+

Question 1

Goal for potassium blood level

Answer 1

3.5-5 mEq/L

Question 2

Potassium is primarily an _______ cation

Answer 2

intracellular

Question 3

Potassium is responsible for cell ______

Answer 3

metabolism

Question 4

Potassium is responsible for ____ and ____ synthesis

Answer 4

glycogen and protein

Question 5

Potassium determines the resting potential across cell membranes in _____ and _______ tissue

Answer 5

cardiac and non-cardiac

Question 6

Hypo- and hyperkalemia are associated with potentially fatal _______

Answer 6

cardiac arrhythmias

Question 7

_____ depletion impairs K+ reabsorption across tubules

Answer 7

Magnesium

Question 8

_____ is a cofactor for Na/K ATPase

Answer 8

Magnesium

Question 9

Causes of hypokalemia

Answer 9

• Diuretic loss (potassium wasting)
• Beta-agonist medications
• NG drainage
• Metabolic alkalosis
• Diarrhea
• Magnesium depletion

Question 10

Hypokalemia definition

Answer 10

Low potassium

Question 11

Clinical presentation of hypokalemia

Answer 11

• Nonspecific and highly variable
• Weakness
• Nausea/vomiting
• Changes in cardiac function/arrhythmias
• Cramping
• Impaired muscle contraction (muscle weakness)
• Cardiac patients may be at higher risk

Question 12

Goals of hypokalemia therapy

Answer 12

• Prevent and treat serious complications, cardiac arrhythmias
• Normalize serum potassium concentration
• Identify and correct underlying causes
• Avoid overcorrection/hyperkalemia

Question 13

Treatment of hypokalemia (3.5-4 mEq/L)

Answer 13

• No therapy recommended

- ICU goal is often >4 mEq/L, may warrant treatment

Question 14

Treatment of hypokalemia (3-3.4 mEq/L)

Answer 14

• Treatment debatable

- PO potassium for pts with cardiac conditions

Question 15

Treatment of hypokalemia (< 3 mEq/L)

Answer 15

• Always treat
• PO route is preferred in asymptomatic patients
• IV for symptomatic pts or pts who cannot take PO
• Should attempt to correct Mg+2 deficit if present

Question 16

_____ mEq of K+ will increase serum levels by _____ mEq/L

Answer 16

10; 0.1

Question 17

Potassium levels in severe hypokalemia

Answer 17

<2.5 or 3 mEq/L

Question 18

IV potassium criteria

Answer 18

• Severe case of hypokalemia
• Symptomatic
• Unable to tolerate PO

Question 19

Signs/symptoms of hypokalemia

Answer 19

ECG changes and muscle spasms

Question 20

______ mEq of K+ is diluted in 100 mL of D5W for treatment

Answer 20

10-20

Question 21

K+ infusion rate without cardiac monitoring

Answer 21

10 mEq/hr

Question 22

K+ infusion rate with continuous cardiac monitoring

Answer 22

20 mEq/hr

Question 23

_______ mEq/hr if EMERGENT with SEVERE hypokalemia

Answer 23

40-60; VERY RARE

Question 24

Blood level during hyperkalemia

Answer 24

> 5.5 mEq/L

Question 25

Mild hyperkalemia blood level

Answer 25

5.5-6 mEq/L

Question 26

Moderate hyperkalemia blood level

Answer 26

6.1-6.9 mEq/L

Question 27

Severe hyperkalemia blood level

Answer 27

7 mEq/L

Question 28

Clinical presentation of hyperkalemia

Answer 28

Cardiac arrhythmias (peaked T wave, Slow action potential, VF or asystole > 9mEq/L)

Question 29

Goal of therapy for hyperkalemia

Answer 29

• Antagonize adverse cardiac effects
• Reverse any symptoms
• Return the serum K+ concentration to normal level
• Correct underlying cause(s)

Question 30

Goal of therapy for severe hyperkalemia

Answer 30

• Antagonize membrane actions (stabilize heart)
• Decrease extracellular potassium
• Remove K+ from body