Wk 3 Potassium Imbalances Flashcards
Potassium it the major __ cation
Intracellular
Sodium in the major __ cation
Extracellular
What is the main function of potassium?
Regulates cell excitability and electrical status
What is an example of excess potassium intake?
IV fluids with 40 units of KCl and renal insufficiency
What is 3 examples that cause potassium to shift out of the cell and sodium into the cell, causing hyperkalemia?
Acidosis
Tissue catabolism
Intense exercise
What is oliguria?
Low urine output
What are two examples of failure to eliminate potassium?
Renal disease
Adrenal insufficiency
What is adrenal insufficiency called?
Addison’s disease
What medication classes can cause potassium to leave the body?
Loop and thiazide diuretics
What is an example of a loop diuretic?
furosemide
What type of diureitc is hydrochlorothiazide?
thiazide diuretic
3 nonpharmacological reasons a patient may have excess potassium loss?
GI - vomiting or diarrhea
Kidney - dialysis
Diaphoresis
What are three reasons that potassium might shift into the cell causing hypokalemia?
Increased insulin release
Insulin therapy
Alkalosis
What are two examples of low potassium intake?
Starvation or a low potassium diet
No K+ in IVF if NPO
EKG changes, fatigue, irritability, muscle weakness, are characteristic of what potassium imbalance?
Hyperkalemia AND hypokalemia
What are three other characteristics of hyperkalemia?
Loss of muscle tone
Paresthesia
Confusion
What would increase potassium excretion in a patient that is hyperkalemic?
Loop/thiazide diuretics
Dialysis
Patiromer (Veltessa) or sodium polystyrene sulfonate (Kayexalate)
How long does it take Patiromer (Veltessa) or sodium polystyrene sulfonate (Kayexalate) to work?
Hours to days
A patient who has very high serum potassium may be a candidate for emergency __.
dialysis
If a patient is hyperkalemic and is also acidotic, what would you give them?
sodium bicarbonate
What else will force potassium back into the cell for a patient with hyperkalemia?
Insulin and dextrose
For a patient with hypokalemia, do we have to wait as long to increase their intake of potassium, like we would with sodium?
No
You should not exceed __ meq/hr of potassium
10
When can you exceed potassium restrictions?
In ICU setting and if patient has a CVAD (central venous access device)
Infiltration of potassium can cause…
necrosis
What would you do for a patient with hypokalemia?
Increase med intake
Increase PO intake
IV KCl
Hypokalemia precipitates __
digitoxicity
What are fruits that are high in potassium?
Apricot Avocado banana cantaloupe dried fruits grapefruit juice honeydew oranges and OJ prunes raisins
What are vegetables that are good sources of potassium?
Black beans Butternut squash Broccoli Carrots Greens (not kale) Mushrooms Potatoes spinach tomatoes veggie juice
What are other foods that are good sources of potassium?
bran or bran products chocolate granola milk nutritional supplements nuts/seeds pb salt substitutes salt free broth yogurt
