Potassium and magnesium

Question 1

K+ location

Answer 1

very intracellular with only 2% being shown in blood

Question 2

K+ movement

Answer 2

Level is maintained with Na-K pump in kidneys
-Forced into cells by insulin
-Aldosterone lowers K by trading for Na

Question 3

K+ 3.0-3.5

Answer 3

Mild decrease, asymptomatic

Question 4

K+ 2.5-3.0

Answer 4

Moderate decrease, muscle cramps, weakness, myalgiaK

Question 5

K+ <2.5

Answer 5

severe decrease, arrhythmias, cramping
Need Ca2+ fast to regulate heart contraction

Question 6

hypokalemia causes

Answer 6

Dietary issues, renal loss (diuretic), intracellular shift from insulin, metabolic alkalosis or B2A agonist, diuretics

Question 7

Hypokalemia treatment

Answer 7

need to use KCL since low Cl- is often associated with low K+ and any phosphates will lower Cl- further
need 100-400 mmol for every 1mmol/L K+ is low

Question 8

Potassium phophate

Answer 8

only for use with hypophosphatemia and chloride levels are high

Question 9

Sodium bicarbonate

Answer 9

for use in metabolic acidosis to help correct hyperkalemia

Question 10

Potassium chloride

Answer 10

The most common but causes lots of GI upset
IV dose only 10mEq/L or in central line. All other IV medication should be in saline not D5W to prevent intracellular shift

Question 11

K+ 5.1-5.9

Answer 11

asymptomatic

Question 12

K+ 6.0-7.0

Answer 12

Cardiac arrhythmias and palpitations

Question 13

Hyperkalemia causes

Answer 13

Over correction, metabolic acidosis pulling K+ from cells, renal failure, drugs

Question 13

K+ >7

Answer 13

arrhythmias, ECG issues, ascending paralysis, respiratory failure.

Question 14

Mild hyperkalemia treatment

Answer 14

Dietary changes, low dose furosemide to excrete K

Question 15

Severe hyperkalemia treatment

Answer 15

Calcium, insulin, sodium bicarbonate to correct acidosis, sodium polystyrene sultanate (exchange Na+ for K+), hemodialysis for emergency

Question 16

Mg <0.7

Answer 16

palpitations/arrhythmias, QRS widening, twitching, chvostek and trousseau signs

Question 17

hypomagesium cause

Answer 17

dietary changes, reduce absorption from PPI, fluid loss, diuretics

Question 18

hypomagnesmia treatmetn

Answer 18

oral dosing with fibre and watch for diarrhea or IV magnesium sulphate if serious

Question 19

Mg >2

Answer 19

starts to be symptomatic, lethargy, confusion, muscle weakness

Question 20

hyper magnesia treatment

Answer 20

reduce intake (laxatives/ antacids), furosemide, calcium for heart Sx, forced diuresis (1/2 saline and furosemide)