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BCPS Potassium Disorders 2013

Terms in this set (26)

Normal potassium levels
3.5 - 5 (primarily intracellular ion)
What can cause potassium to shift into cells
beta adrenergic stimulation
insulin
hypothermia
alkalosis
Causes of hypokalemia
GI losses
mineralcorticoid excess
diuretic use
increased shift into cells
What electrolyte disturbance occurs with hypokalemia frequently
hypomagnesemia
Symptoms of hypokalemia
Occur < 3 mEq/L
muscle weakness
ECG - flat T or elevated U
Dig toxicity even with normal dig level
rhabdo - dec blood flow to sk muscle
Estimated potassium deficit in hypokalemia
200 - 400 mEq for every 1 mEq/L reduction in K+
Guidelines for K+ replacement
if no ECG change - us po formulation
replacement guided by levels check every 2-4 hrs if K+ <3
60 mEq/L iv should be via central line
max infusion rate 40meq/hr
rates > 10 - 20mEq/hr should be on monitor
When should KCL, K-acetate, K bicarbonate be used
KCL - metabolic alkalosis
K acetate (po) K bicarbonate (iv) for metabolic acidosis
What should K+ not be mixed with for infusion
Dextrose. (insulin release would shift K+ into cells)
Dose of replacement K+ for level 3 - 3.5
60 - 80 mEq/ day check K+ daily
Dose of replacement K+ for level 2.5 - 3
120 mEq/Day of IV 60 - 80 mEq
Dose of replacement K+ for level 2 - 2.5
IV KCl 10 - 20 meq/ hr
Dose of replacement K+ for level < 2
IV KCl 20 - 40 meq/hr (need ecg monitor)
Causes of Hyperkalemia
acidosis
Beta adrenergic blockade
Dig overdose
rewarming from hypothermia
succinylcholine
when is urgent treatement needed for hyperkalemia
plasma K+ > 6.5
severe muscle weakness
ECG changes
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