Potassium

Question 1

What is the daily requirement for potassium?

Answer 1

2 mEq/kg/day

Question 2

Example of cause for hypokalemia

Answer 2

Caused by diarrhea and results in constipation (decrease motility)

Question 3

What causes hypokalemia?

Answer 3

<3.5 mEq/L

1. Poor intake (Anorexia nervosa)
2. Loss
   - GI/Vomiting/Diarrhea
   - Renal (RTA or excessive aldosterone)
   - Furosemide

Question 4

What 3 EKG findings do you see with HYPOkalemia?

Answer 4

1. Flattening T wave
2. ST depression
3. PVCs
   * if extreme U waves appears before the T wave

Question 5

How do you emergently treat hypokalemia?

Answer 5

Give KCL at 0.5-1 mEq/L per kg over 1 hour.

*always do EKG monitoring when replacing K

Question 6

What are the symptoms of hypokalemia?

Answer 6

Muscle weakness 
Muscle pain
Paralysis
Constipation/ileus
Polyuria

Question 7

What causes hyperkalemia?

Answer 7

> 5 mEq/kg

1. Excess intake
2. Can’t excrete (renal failure, hypoaldosteronism
3. Redistribution (in an acidotic state, H+ into the cell, K+ out)
4. Cell breakdown (pseudohyperkalemia

Question 8

What 3 EKG findings do you see with HYPERkalemia?

Answer 8

1. Peaked T waves
2. No P waves (at HIGH levels >10)
3. Widened QRS complex (at HIGH levels)
   * Associated with elctromechanical dissociation (EMD) which gives you muffled heart sounds

*idiopathic BB and Vtach have similar widened QRS but do NOT have muffled heart sounds.

Question 9

How to treat hyperkalemia emergently?

Answer 9

Mild

• Glucose/Insulin
• Sodium Bicarb
• Inhaled albuterol
• IV lasix
• Oral polystyrene resin

Severe (>10, symptomatic)

• IV calcium chloride
• Dialysis

Question 10

Alkalosis and Potassium

Answer 10

1. Alkalosis–> high pH –> little H+ in the ECF
2. The Hs move out of the cell –> H moves from ICF to ECF
3. To replace “H cats” that left, the “K cats” move into the cell
4. During alkalosis, K heads in the house–> get lowered measured K levels

Question 11

Acidosis and Potassium

Answer 11

1. Acidosis–> low pH –> lots of H+ in the ECF
2. Too many H+s in the ECFs just chilling
3. They begin to “squat” where they don’t belong and move into the ICF
4. Because only one positive ion allowed inside, K+ gets kicked out of the cell, there fore you have increased K in the ECF