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IM2 > Potassium (Regular, Hypo, & Hyperkalemia) > Flashcards

Potassium (Regular, Hypo, & Hyperkalemia) Flashcards

1
Q

what is the normal range for K+

A

3.5-5.0

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2
Q

what is K+ king of

A

king of hearts

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3
Q

K+ is a major electrolyte in which fluid

A

Intracellular fluid

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4
Q

what does K+ maintain (2)

A

heart & muscle contraction

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5
Q

what regulates K+ (2)

A

regulate by kidneys & aldosterone

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6
Q

Increased K+ in the cell means H+ does what

A

moves out of the cell

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7
Q

Increased H+ in the cell means K+ does what

A

moves out of the cell

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8
Q

what is a main source of K+

A

diet

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9
Q

what causes hypokalemia (8)

A

potassium loss
corticosteriods
increased secretion of aldosterone
GI loss
Excessive diaphoresis
Kidney disease
Inadequate K+ intake
Alkalosis, Metabolic

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10
Q

what med can cause K+ loss (1)

A

Diuretics

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11
Q

what medication should we be careful using with diuretics

A

digoxin

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12
Q

when the K+ is low is digoxin toxic

A

yes

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13
Q

when we use diuretics with digoxin what are we are at an increased risk for

A

hypokalemia

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14
Q

corticosteroids causes water retention which cause what dilution

A

hemodilution

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15
Q

increased secretion of aldosterone causes what disease

A

Cushing’s

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16
Q

aldosterone is K+ excretion through

A

kidneys

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17
Q

if there are higher levels of aldosterone more K+ is what

A

excreted

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18
Q

What can cause K+ to be lost through the GI system (3)

A

Vomiting
Diarrhea
NG suction

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19
Q

what can excess insulin do to K+

A

moves K+ into the cell

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20
Q

what is the severe level of hypokalemia

A

2.5 or less

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21
Q

what will the pt’s cardiovascular system look like if they have hypokalemia (4)

A

torsades de pointes
irreg. apical HR
lethal dysrhytmisas
bradycardia

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22
Q

what does tosades look like/what will it look like on an EKG

A

a long QT interval

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23
Q

what does a long QT interval mean for the heart (what is the heart doing)

A

heart takes longer to electrically charge for the next heartbeat

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24
Q

what does torsades de pointes mean in english

A

twisting of the points

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25
Q

what do torsades de pointes look like in hypokalemia

A

irreg. QRS complexes appearing to wrap around the EKG baseline

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26
Q

what does an EKG look like for a pt with hypokalemia

A

increased amplitude & width of P wave, T wave flattening and inversion, prominent U waves and apparent long QT intervals due to merging of the T & U wave

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27
Q

how does an EKG look like in a pt with hyperkalemia

A

Peaked T waves
P wave flattening
PR prolongation
Wide QRS complex

28
Q

how will a hypokalemic pt’s neuromuscular function present (4)

A

confusion
lethargy
muscle weakness
diminished DTRs

29
Q

how will a hypokalemic pt’s GI function present to us

A

Constipation

30
Q

what should we think is happening in the GI system if there are absent bowel sounds in a hypokalemic

A

think paralytic ileus

31
Q

what is a paralytic ileus

A

portion of bowel not moving & can lead to small bowel obstruction

32
Q

what other electrolyte should we check with hypokalemia

A

Mg+

33
Q

What if the Mg+ level is low in a hyperkalemic pt

A

if Mg+ is low it enhances K+ loss, correct Mg+ loss first then fix K+

34
Q

what interventions do we do for hypokalemic pt’s (4)

A

monitor cardiac & respiratory status
admin K+ supplements orally or via IV
If pt on diuretic, may need to stop it
K+ rich foods to replace K+

35
Q

Should we admin K+ fast or slow

A

slow because it’s lethal if given too fast

36
Q

what diuretic should we give to a pt that will spare K+ from being excreted

A

Spironolactone

37
Q

if we give K+ orally what should we always give it with

A

food

38
Q

K+ is never admined in which routes (3)

A

IV push, IM, or SubQ

39
Q

IV K+ is always what

A

diluted

40
Q

What can cause hyperkalemia (6)

A

excess K+ intake
decreased K+ excretion
adrenal insufficiency
kidney disease- #1 cause
traumatic burns
acidosis, metabolic

41
Q

what is the number 1 cause of hyperkalemia

A

kidney disease

42
Q

what drugs can cause hyperkalemia (3)

A

K+ sparing diuretics (sprionolactone)
Ace inhibitors
NSAIDS (decrease renal perfusion)

43
Q

what adrenal insufficient disease can cause hyperkalemia

A

addison’s

44
Q

why does addison’s cause hyperkalemia

A

addison’s had low aldosterone which causes retention of K+

45
Q

why does kidney disease cause hyperkaleima

A

there is a decrease in urine output and increase in K+

46
Q

how can acidosis cause hyperkalemia

A

because H+ levels are elevated in blood, K+ moves out as H+ moves into the cell

47
Q

what is the severe level of a patient in hyperkalemia

A

greater than or equal to 6.5

48
Q

what is the lethal level of a pt w/ hyperkalemia

A

greater than or equal to 8.5

49
Q

how will a pt’s cardiovascular system look with hyperkalemia (4)

A

low bp
dysrhythmias
V fib
Cardiac standstill

50
Q

how will a pt’s GI system sound like with hyperkalemia

A

hyperactive bowels

51
Q

what do the hyperactive bowels indicate in a pt with hyperkalemia (2)

A

diarrhea & increased motility

52
Q

what weakness can result in paralysis & respiratory arrest

A

muscle weakness

53
Q

how will an EKG look in a pt with hyperkalemia (3)

A

peaked narrow T wave, ST segment depressed, prolonged PR interval

54
Q

what interventions will we do for a pt with hyperkalemia (6)

A

monitor cardiac rhythm changes
restrict K+ in diet
Diuretics
Cation exchange resins
Stop meds causing increase in K+
Dialysis

55
Q

what cation exchange resin do we give to a pt w/ hyperkalemia

A

sodium polystyrene sulfate (Kayexalate)

56
Q

what happens to a pt’s bowels when we give Kayexalate

A

explosive diarrhea

57
Q

what emergency medical treatments (meds) do we give to a pt w/ severe hyperkalemia (3)

A

Ca+ Gluconate 10% IV
Hypertonic glucose & insulin
NaHC03

58
Q

What does Ca+ Gluconate protect the heart from

A

myocardial irritability

59
Q

what does Ca+ Gluconate not lower

A

does not lower K+

60
Q

how long must Ca+ Gluconate be given

A

given over 3-5 mins

61
Q

what should we monitor when giving Ca+ gluconate (3)

A

HR & BP
Dysrhythmias

62
Q

where does insulin move K+

A

into the cells

63
Q

where does hypertonic glucose & insulin move excess K+

A

into the cells

64
Q

where does NaHCO3 (sodium bicarb) shift K+

A

into the cell

65
Q

when NaHCO3 shifts K+ into the cell what is also raised

A

pH

IM2 (17 decks)

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