Potassiun 💗 - Exam 5 Flashcards
Potassium is a Major electrolyte in — fluid
Intracellular
Potassium Maintains what 2 things?
Heart and muscle contraction
Potassium is regulated by what
Kidneys and aldosterone
Increased K+ in the cell what happens to H?
Moves out of the cell
Increased H+ in the cell what happens to K+?
K+ moves out of the cell
What is our main source of K+ ?
Diet
Low potassium causes what toxicity?
Digoxin toxicity
Using diuretics with digoxin is an increased risk for what
Hypokalemia
Lab value ranges for K
3.5-5.0
Water retention causing hemodilution
Corticosteroids
Increased secretion of aldosterone is a sign of what syndrome?
Cushings
Aldosterone excretes what through what
Potassium through the kidneys
If you have higher levels of aldosterone what happens to potassium
Causes more potassium excretion
Hypokalemia causes GI loss - what are some examples
Vomiting, diarrhea, prolonged NG suction
Hypokalemia causes excessive what
Diaphoresis
In hypokalemia what is located inside the cell
H and K
In alkalosis, there is less what in the blood
H+
When there is less H+ in the blood this causes what?
H to shift out of cells and K to shift into cells
Excess insulin moves what into cell
K
A patient has severe hypokalemia <2.5
What in cardiovascular conditions should we watch for
- torsades de pointes **
- irregular apical HR
- lethal dysrhythmias
- bradycardia **
What are 6 ways we can lose potassium?
- Diuretics
- Corticosteroids
- Cushings ~ increased secretion of aldosterone
- GI loss
- Excessive Diaphoresis
- Kidney disease
A patient has severe hypokalemia <2.5 what neuromuscular signs would we watch for?
- confusion, lethargy
- muscle weakness ***
- diminished DTRs
A patient has severe hypokalemia <2.5 what GI symptoms would we watch for?
Constipation
In a patient with hypokalemia you are doing a GI assessment and the bowel sounds are absent what might the patient have?
Paralytic ileus
Portion of bowel not moving and can lead to small bowel obstruction
Paralytic ileus
This interval means heart is taking longer to electronically charge for the next heartbeat
Long QT interval
A patient had a syncope episode what might have been the reason why?
Long QT interval
What other electrolyte level should we check with hypokalemia ?
Magnesium
Why should we check magnesium level with hypokalemia?
Mg+ exacerbates K+ losses so we must correct Mg+ first to correct K+
Irregular QRS complexes appearing to wrap around the EKG baseline
Torsades de Pointes
T wave inversion
ST depression
Prominent U wave
Hypokalemia
Peaked T waves
P wave flattening
PR prolongation
Wide QRS complex
Hyperkalemia
What two things do we monitor in a patient with hypokalemia ?
Cardiac and respiratory status
What can we administer to help with hypokalemia?
Supplements orally or IV
What is big with administering potassium?
Give it slowly! Can be lethal when given to fast
If a patient with hypokalemia is taking a diuretic- what do we need to do?
May need to stop the diuretics
What drug is a potassium sparing diuretic
Spironolactone
If you are giving potassium to a patient what must you give with it everytime!
Food
How is Iv potassium given
It’s diluted and administered using an infusion pump
In Hyperkalemia H and K are located where
Inside the cell
In acidosis there is more H in where? What syndrome is this related to?
More H in blood : Hyperkalemia
I’m acidosis there is more H+ in blood this causes H+ to shift into where?
What condition is this?
Into the cells : Hyperkalemia
In acidosis, there is more H+ in the blood this causes H+ to shift into the cells and K+ shifts where?
What condition is this related to?
K+ shifts out of the cells
Hyperkalemia
A patients potassium level is >6.5 what condition is this?
Severe Hyperkalemia
A patients potassium is >8.5 what condition is this?
Lethal Hyperkalemia
In a patient with Hyperkalemia, what in the cardiovascular area do we watch out for?
- low BP
- dysrhthmias ** - vfib and cardiac standstill
In a patient with Hyperkalemia what in the GI area do we watch out for?
Increased motility ~ hyperactive bowels
Diarrhea ***
A patient with Hyperkalemia has muscle weakness this can result in
Paralysis and respiratory arrest
Peaked narrow T wave
St segment depressed
Prolonged PR interval
Hyperkalemia EKG reading
In mild Hyperkalemia what interventions does the nurse need to be apart of
- Monitor cardiac rhythm changes
- Restrict K+ in diet
- Diuretics
- Kayexalate
- Stop any medication causing an increase in K
- Dialysis
In a patient with severe >6.5 Hyperkalemia what IV med can we give ?
Calcium gluconate 10% IV
What does Ca+ Gluconate protect the heart from
Myocardial irritability
How long do we give Ca Gluconate ?
3-5 minutes
What must we monitor in a patient when we are giving Ca Gluconate?
Place patient on monitor for dysthymias
Monitor BP and HR
Hypertonic glucose and insulin move …
Excess K into the cells
NaHCO3 does what with K
K shifts into the cell and raises pH
