Potassium Flashcards
What does potassium do for the body??
It pumps the heart
Contracts the muscles
Potassium is regulated by what
Kidney and aldosterone
What is the acid base balance for potassium
Increased K+ in the cell = H+ moves out
Increased H+ in the cell = K+ moves out
Where do we mainly get Potassium from
Our diet
What are the causes of HYPOkalemia?
Diuretics
Corticosteroids
Cushings
GI loss
Excessive Diaphoresis
Kidney disease
Metabolic Alkalosis
Not enough K+ intake
Why does diuretics cause HYPOkalemia?
When pt takes a diuretic they pee a lot. Which means they lose electrolytes. Which means they can lose K+ in the process, if they take a diuretic with low K+ it increases the risk of digoxin toxicity
What does corticosteroids do to the body?
Increases aldosterone, the hormone that causes water retention which can lead to hemodilution
What is Cushings disease?
When you have hyperaldosteronism
Higher Aldosterone causes more k+ to be excreted through the kidneys
What GI loss can cause HYPOkalemia?
Vomiting
Diarrhea
Prolonged NG suction
What is metabolic alkalosis and why does it cause HYPOkalemia?
In alkalosis there’s less H+ in blood which causes H+ to shift out of cells and K+ to shift into the cells
Not in taking enough K+ causes K+ to do what?
K+ moves from ECF to ICF
Or
Excess insulin causes K+ to move into the cell
What are the S/S of a pt with HYPOkalemia?
Torsades de pointes
Bradycardic
Muscle weakness
Constipated
Diminished DTRs
Lethargy (confused)
Lethal dysrhythmias
If bowel sounds are absent, think of paralytic ileus = portion of bowel not moving which can lead to small bowel obstruction
Should the nurse check Mg+ levels first before correcting K+? Why or why not?
Yes bc when Mg+ is low it causes K+ loss due to K+ not being absorbed properly without Mg+
What is torsades de pointes?
It’s an irregular QRS complex appearing to wrap around the EKG baseline
It’s a long QT interval which means the heart is taking much longer to electrically charge for the next heartbeat
What should the nurse do when the pt is HYPOkalemic?
Monitor their cardiac and respiratory status
Administer K+ supplements orally or IV SLOWLY
Stop the pt on any diuretics esp Spironolactone
Have them eat K+ rich foods
K+ is never administered how? Why?
Never administer K+ IV push, IM, SubQ can cause death
IV K+ is always diluted and administered using a pump
What are the causes of HYPERkalemia?
Excess K+ intake
Addisons
Decreased K+ excretion
Kidney Disease
Metabolic Acidosis
Traumatic burns
What can cause a decreased K+ excretion ?
Spironalactones
ACE inhibitors
NSAIDs (decrease renal perfusion)
What type of Adrenal insufficiency causes HYPERkalemia?
Addisons = low aldosterone (hypoaldosteronism) which means K+ retention
Hypoaldosteronism causes what?
Causes large amount of sodium excretion and K+ retention
Why does Metabolic Acidosis cause HYPERkalemia?
I gotta ask about this
What are S/S of HYPERkalemia?
Low BP
Dysthymia
Hyperactive Bowels Sounds
Muscle Weakness = can result in paralysis and Cardiac arrest
What are MILD treatments for HYPERkalemia?
Monitor Cardiac Rhythm changes
Restrict K+ diet
Dialysis
Stop medications that increase K+
Kayexalate?
What are SEVERE HYPERkalemia interventions?
Severe HYPERkalemia: greater than 6.5
Ca+ Gluconate 10% IV
Given over 3-5 minutes
Monitor for Dysrhythmias, BP, HR
Hypertonic glucose + insulin
NaHCO3
What does Hypertonic Glucose and insulin do to treat HYPERkalemia?
Shifts excess K+ into the cell
How does NaHCO3 treat HYPERkalemia?
K+ shifts into the cell and raises pH
What will a pts EKG look like for HYPERkalemia??
Peaked narrow T wave
ST segment depressed
Prolonged PR interval
What does insulin help K+ do?
Helps out K+ in the cells
