Potassium abnormalities

Question 1

6 causes of potassium to shift into the cells

Answer 1

Alkalosis

Beta Agonist

Calcium channel defects

Drugs

Hypothermia

Insulin

Question 2

Antifungal known for causing hypokalemia

Answer 2

Amphotericin B

Question 3

Potassium level below which EKG changes occur

Answer 3

< 3.0

Question 4

3 EKG changes associated with hypokalemia

Answer 4

ST depression

T wave decreased

U waves

Question 5

4 cardiac arrhythmias associated with hypokalemia

Answer 5

AV block

Bradycardia

Torsades (hypomagnesemia required)

V-tach/fib

Question 6

Electrolyte that has to be replaced with K if low

Answer 6

Magnesium

Question 7

Max rate of replacement of potassium

Answer 7

20 mEq/hr normally

Life threatening can increase to 40 mEq/hr

Question 8

3 common ICU drugs that will cause hyperkalemia

Answer 8

Beta blockers

Digitalis

Succinylcholine

Question 9

Average potassium level for which EKG changes are noted in hyperkalemia

Answer 9

5. 5 for acute

6. 5 for chronic

Question 10

5 EKG findings in patients with hyperkalemia

Answer 10

Loss of P wave

Peaked T wave

PR interval long

QRS widened

Sine wave (late)

Question 11

Dose of calcium to stabilize cardiac membrane in hyperkalemia

Answer 11

500 to 1000 mg IV over 2-3 minutes

Chloride preferred

Question 12

Dose of insulin for treatment of hyperkalemia

Answer 12

10 units regular insulin given IV

Can add a dose of D50 as needed based off glucose levels or if glucose unknown

Question 13

Drugs used for hyperkalemia

Answer 13

C Big K LD

Calcium chloride

Bicarb

Insulin with Glucose

Kayexelate or Lokelma

Loop diuretic and replace volume

Dialysis

Question 14

Medication that can be given in hyperkalemia if life-threatening levels and dialysis not available and medical therapy has failed

Answer 14

Sodium Polystyrene sulfonate (Kayexelate)