Fundamentals 🩺: Electrolyte Imbalances (Potassium Imbalances)

Hyperkalemia -

potassium level 5 or higher

Hyperkalemia - Signs and symptoms Remember “MURDER” (M)

Muscle cramps and weakness

Hyperkalemia - Signs and symptoms Remember “MURDER” (U)

Urinary failure

Hyperkalemia - Signs and symptoms Remember “MURDER” (R1)

Respiratory distress

Hyperkalemia - Signs and symptoms Remember “MURDER” (D)

Decreased cardiac contractility

Hyperkalemia - Signs and symptoms Remember “MURDER” (E)

EKG changes (peaked t waves)

Hyperkalemia - Signs and symptoms Remember “MURDER” (R2)

Reflexes decreased

Hyperkalemia - Causes (due to burns or tissue damage)

K+ leaves lysed cells

Hyperkalemia - Causes (due to Addisons)

Results in hypoaldosteronism leading to K+ retention

Hyperkalemia - Causes (due to excessive intake)

Potassium containing solutions, supplements, foods

Hyperkalemia - Causes (due to medications)

• ACE inhibitors (retain K+)

• potassium sparing diuretics

• NSAIDs

Hyperkalemia - Causes (due to decreased K excretion)

Kidney disease (dialysis patients)

Hyperkalemia - Treatment (if due to excessive intake)

ALWAYS MONITOR EKG

• stop potassium solutions

• restrict potassium in diet

Hyperkalemia - Treatment (if due to decreased excretion)

ALWAYS MONITOR EKG

• potassium wasting diuretics (Furosemide)

• dialysis

Functions of potassium

• balances fluid volume

• nerve transmission

• heart contractility

• muscle functioning

Hypokalemia -

Potassium level 3.5 or lower

Hypokalemia - Signs and symptoms Remember “The 6 L’s” (L1)

Lethargy and confusion

Hypokalemia - Signs and symptoms Remember “The 6 L’s” (L2)

Leg cramps

Hypokalemia - Signs and symptoms Remember “The 6 L’s” (L3)

Limp muscles

Hypokalemia - Signs and symptoms Remember “The 6 L’s” (L4)

Low, shallow respirations

Hypokalemia - Signs and symptoms Remember “The 6 L’s” (L5)

Lethal cardiac dysthymias (T wave inversion)

Hypokalemia - Signs and symptoms Remember “The 6 L’s” (L6)

Lots of urine (polyuria)

Hypokalemia - Causes (due to poor potassium intake)

• NPO

• Fasting

• Malnutrition

Hypokalemia - Causes (due to movement of K+ from ECF to ICF)

• Alkalosis

• excess insulin

Hypokalemia - Causes (due to dilution of serum potassium)

• excessive water intake

• excessive fluids without potassium

Hypokalemia - Causes (due to excess potassium loss)

• potassium wasting diuretics (Furosemide)

• vomiting, and diarrhea

• NGT suction

Hypokalemia - Treatment (due to inadequate intake or serum dilution)

• Potassium supplementation

• NEVER GIVEN IV PUSH / CAN CAUSE CARDIAC ARREST

• monitor EKG changes