Potassium Flashcards
What is the major cation in ICF?
Potassium
What is the role of potassium in the body
Cell metabolism, nerve impulse transmission, cardiac/lung/muscle function, and acid-base balance
What is hypokalemia?
Blood potassium level less than 3.5 mEq/L
Name 3 causes of actual potassium deficits
Overuse of diuretics, GI losses(vomiting, diarrhea), and Cushing syndrome.
What are causes of relative potassium deficit?
Alkalosis, hyperinsulinism, water intoxication
What vital sign changes occur in hypokalemia?
Decreased BP, thready weak pulse, orthostatic hypotension
What ECG changes are seen in hypokalemia?
Flattened T wave, U wave, ST depression, prolonged PR interval
What GI symptoms occur in hypokalemia?
Nausea, vomiting, constipation, hypoactive bowel sounds
What is a dangerous respiratory effect of hypokalemia?
Shallow breathing and respiratory failure
How is potassium never to be administered?
Never via IV bolus or IM/SQ injection or IV push
What is the maximum IV potassium infusion rate?
10 mEq/L
What are potassium-rich foods?
Bananas, oranges, avocados, dried fruits, dairy, meat, whole grains
What serious cardiac complication can result from hypokalemia?
Cardiac arrest
What is hyperkalemia
Blood potassium level greater than 5.0 mEq/L
Name 3 causes of actual potassium excess
Kidney failure, adrenal insufficiency, overconsumption of potassium
Name 2 causes of relative potassium excess
Acidosis, tissue damage
What vital sign changes occur in hyperkalemia?
Slow, irregular pulse, hypotension
What ECG changes are seen in hyperkalemia?
Peaked T waves, widened QRS, flat P waves
What are neuromuscular signs of hyperkalemia?
Restlessness, weakness, flaccid paralysis
What GI finding occur in hyperkalemia
Diarrhea, hyperactive bowel sounds
What labs are increased in hyperkalemia with kidney failure?
BUN, creatinine, potassium
What medicine protects the heart in severe hyperkalemia?
IV calcium gluconate
What are potassium-restricted diet reccomendations?
Avoid citrus fruits, legumes, whole grains; choose refined grains, apples, grapes, cabbage
What other medication shifts potassium intracellularly besides insulin?
Beta-2 agonists (albuterol)
What chronic med is used for hyperkalemia?
Patiromer
What serious complication can result from hyperkalemia?
Cardia arrest
What interproffesional consults may be needed for hyperkalemia?
Nephrology, cardiology, and nutritional services
What patient teaching is essential for clients on potassium sparing diuretics?
Avoid salt substitutes and potassium-rich foods
Nursing interventions for hypokalemia?
Administer potassium replacement, monitor cardiac rhythm, assess respirations, encourage potassium-rich foods, and implement fall precautions
Nursing interventions for hyperkalemia?
Stop potassium intake, administer diuretics, give insulin with dextrose, monitor ECG, and prepare for dialysis if severe
What potassium imbalance is linked to diabetes ketoacidosis?
Hyperkalemia
What respiratory complication is associated with hypokalemia?
Respiratory muscle weakness leading to shallow breathing
What is an early neuromuscular sign of hyperkalemia?
Paresthesia
What intervention is essential before administering IV potassium?
Ensure adequate urine output
What ECG change is a hallmarks of hyperkalemia?
Peaked T waves
What IV solution is commonly used with insulin to treat hyperkalemia?
Dextrose 50% (D50W)
What potassium shift issues in alkalosis?
Potassium shifts into cells
What dietary habit may contribute to hyperkalemia in older adults? `
Use of salt substitutes high in potassium
What potassium imbalance is common with loop diuretics?
Hypokalemia
What is the first priority for hyperkalemia with ECG changes?
Administer calcium gluconate to stabilize cardiac membranes
What fluid should you avoid giving rapidly to a client with hypokalemia?
Potassium chloride IV bolus
Why is potassium critical for cardiac function?
It regulates myocardial cell excitability and contractility
What is an alternative medication to insulin for shifting potassium intracellularly?
Albuterol (beta-2 agonist)
What is a dietary teaching point for hyperkalemia prevention?
Choose low-potassium fruits and vegetables
What is the most common cause of hyperkalemia in hospitalized patients?
Acute or chronic kidney failure
What potassium imbalance is linked to digitalis toxicity?
Hypokalemia
What is a potassium-lowering resin used for chronic hyperkalemia
Patiromer
What nursing intervention is crucial when administering Patiromer?
Administer with food and separate from other oral medications by at least 3 hours
What potassium imbalance can cause paralytic ileus?
Hypokalemia
What electrolyte imbalance should you monitor for when giving insulin and glucose for hyperkalemia?
Hypokalemia
What common ECG finding is associated with hypokalemia?
Presence of U waves
What respiratory finding may indicate hypokalemia
Shallow respirations
