Potassium Flashcards
Complication of hypokalemia
Fatal arrhythmia
When K>3, 10 mEq KCl changes the measured K by:
0.1
only in the case where the K>3.
What is the max speed at which K can be replaced in a peripheral IV?
10 mEq/hr *if K>3
When K 2.5-3, how many mEq of KCl does it take to move measured K 0.1?
15 mEq KCl to move K 0.1
When K 2.0-2.5, how many mEq of KCl does it take to move measured K 0.1?
20 mEq KCl to move K 0.1
What is the best way to replace K?
PO
40 mEq intervals
Take home about K
Replace K as soon as you see it dropping
What is critical hypokalemia?
Arrhythmia already there –> go straight to dialysis (for any electrolyte abnormality)
Step 1 in hyperkalemia
EKG
Peaked Ts mean
Mild to moderate Hyperkalemia
Stretched T waves mean
Moderate Hyperkalemia
EKG complication of severe hyperkalemia?
T wave stretches out, EKG eventually looks like a sine wave –> may be too late
What are the three phases of hyperkalemia correction?
- Stabilize cardiac membrane
- Temporize K (shift K into cells)
- Eliminate K
What is the action in the stabilization of the cardiac membrane in the tx of hyperK?
IV CCl
What are the actions in the temporization of serum K in the tx of hyperK?
Option 1: Give D50 –> insulin pushes K into cells
Option 2: Give NaC03-
Option 3: Beta agonists ie albuterol (less used)
What are the two routes of elimination of K?
Pee and poop
What are the actions in the temporization of K in the tx of hyperK?
Option 1: for functioning kidneys, use furosemide
Option 2: Kayexalate
What is the first step in the treatment of DKA/HHS?
Assess K+
Treat volume depletion
In the treatment of DKA/HHS, what is the next step if the K is >5.2?
Begin insulin infusion
In the treatment of DKA/HHS, what is the next step if the K is 3.3-5.2?
Begin insulin
Infuse K with volume resuscitation
In the treatment of DKA/HHS, what is the next step if the K is <3.3?
Hold insulin
Infuse K with volume resuscitation
What is initial management in a patient with hyperkalemia and evidence of ECG changes?
Calcium gluconate should be given intravenously for any evidence of ECG changes due to hyperkalemia. It prevents dysrhythmias and can reverse ECG changes.
