potassium

normal K level

3.5-5.0

most abundant cation in the ICF

K

potassium is mostly regulated by the

kidney

function of K

conduction of nerve impulses and muscle contraction

hypokalemia level

< 3.5

signs of symptoms of hypokalemia

cramps, muscle weakness, cardiac arrythmias, polyuria, ECG changes

what can cause hypokalemia

GI loss

decreased K intake from diet

alkalosis

increased entry to the cells

medications

which meds can lead to hypokalemia

diuretics

ampho B

insulin

ECG changes assoc with hypokalemia

flat T waves

U waves

when replacing K with K supplements, every 10 meq of K will increase serum K by ___

0.1 meq/L

what are the oral K supplements: (all start with Potassium)

potassium chloride

potassium citrate

potassium bicarb

potassium gluconate

what is the most common oral K supplement

potassium chloride

oral KCl is available as

ER capsule, ER tablet, liquid and powder

pts who have hypokalemia and need to crush meds or have a NG tube can take which dosage form of oral K supplements?

powder and liquid

oral KCl max dose at one time

60 meq

separate doses of oral KCl by ___

4+ hours

IV K supplement options

potassium chloride

potassium acetate

potassium phosphate

what is the most common IV K supplement

potassium chloride

pts on IV K supplements need to have monitoring for…

vein irritation

thrombophlebitis

when pts on IV K supplements who end up having vein irritation or thrombophlebitis, what needs to happen to their dose?

dilute the IV or slow the infusion

what is the max rate and conc for IV K supplements in a peripheral line

10 meq/hr

10 meq/ 100 ml

what is the max rate and conc for IV K supplements in a central line

40 meq/hr

20-40 meq/100ml

what is the max conc for IV K supplements in a large volume bag

60 meq/ bag

when treating hypokalemia, if Cl levels are high, what IV K supplement should be chosen?

K acetate or K phosphate

when treating hypokalemia, if phosphate levels are low, what IV K supplement should be chosen?

potassium phosphate

IV K supplements are considered high risk so need ot monitor

EKG

mild to moderate hypokalemia (3.0-3.4) should be treated with?

oral K supplements (usuallY)

severe hypokalemia <3.0 should be treated with?

either oral or IV K supplements

hyperkalemia level

> 5

T/F: hyperkalemia is more at risk of cardio issues than hypokalemia

T

symptoms of hyperkalemia

muscle weakness

hypotension

decrease pH

parathesis

EKG changes

cardiac arrythmias

which symptoms do both hypokalemia and hyperkalemia share

muscle weakness

EKG changes

cardiac arrythmias

what could cause hyperkalemia?

increased K intake

decreased K excretion

increased K release from cells

EKG assoc with hyperkalemia

peaked T wave

short QT

wide QRS

Tx options for hyperkalemia short term/ symptom relief

calcium gluconate

sodium bicarb

reg insulin ± dextrose

albuterol

calcium gluconate is used to treat

hyperkalemia

calcium gluconate tx for hyperkalemia:

MOA: ______

duration: _____

onset: ______

monitor: _____

membrane potential stabilization

short

short

EKG and Ca levels

sodium bicarb tx for hyperkalemia:

MOA: ______

duration: _____

onset: ______

monitor: _____

redistribution of K into the vasculature

short

short

Na load

regular insulin ± dextrose tx for hyperkalemia:

MOA: ______

duration: _____

onset: ______

monitor: _____

redistribution

short

short

glucose

albuterol tx for hyperkalemia:

MOA: ______

duration: _____

onset: ______

monitor: _____

redistribution

short

short

tachycardia and tremors

long term tx options of hyperkalemia

loop diuretic + saline

sodium polystyrene sulfonate (kayexalate)

patiromer (veltassa)

sodium zirconium cyclosilicate (lokelma)

dialysis

loop diuretic + saline tx for hyperkalemia:

MOA: ______

duration: _____

onset: ______

monitor: _____

excretion

long

long

dehydration

sodium polystryene sulfonate (kayexalate) tx for hyperkalemia:

MOA: ______

don’t give for: ____

excretion

emergencies (can cause bowel necrosis)

patriomer (veltassa) tx for hyperkalemia:

MOA: ______

monitor: _____

excretion

GI ADE

dialysis tx for hyperkalemia:

MOA: ______

onset: _____

removal

immediatley