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9 Cards in this Set
- Front
- Back
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______kalemia causes acidosis.
______kalemia causes alkalosis. What % of K+ is IC? Why is a change in K+ clinically important? insulin and B2 agonists cause K+ to move _____. |
hyper - acid
hypo - alka 98% makes transmembrane potential, cardiac/neuro/muscular effects; small changes cause large effects intracellularly |
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Case #1: 45 y/o m, c/o fatigue, N/V/D x 3 d, abd distension, constipation. Skin, mucus membranes dry, orthostatic hypotension.
Labs: Na 135, K 2.8, Cl 88, Urine K <20 EKG: ST-T changes, T inversion, U waves Cause? other causes? |
diarrhea - GI loss of K, vomiting, diarrhea
other causes: diuretics |
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How does Bartter's affect K+?
4 things to evaluate for hypokalemia? Neuromuscular effects of hypokalemia? Cardiac effects? |
affects JGA - produces renin
Hx BP acid-base status urine electrolytes - Cl, K neuromuscular - ileus, cramps, rhabdomyolysis, respiratory paralysis cardiac - ventricular arrhythmias |
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EKG changes with hypokalemia?
Tx? Which route is preferred? what else should you correct? If pt has arrhythmias, what should you do? |
flat, inverted T waves, U waves
aggressive, preferably oral tx, correct Mg++ also give IV K+ |
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5 causes of hyperkalemia?
Explain how renal failure effects K+. decreased aldosterone action causes ____kalemia. |
loss of cell integrity - rhabdo, hemolysis
hyperosmolarity - hyperglycemia insulin deficiency beta blockade acidosis (increased Cl) renal failure --> decreased urine flow rate, so less K+ excreted hyperkalemia |
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4 causes of RTA type 4?
3 drugs that impair aldosterone production? 2 drugs that inhibit K secretion? Cyclosporine causes ____ RTA. Why does constipation cause hyperkalemia? |
DM, sickle cell, obstruction, renal transplant
ACEI's, NSAID's, heparin K sparing diuretics, Bactrim Cyclosporine - Type 4 normally K is secreted in feces |
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EKG changes in hyperkalemia?
Other effects? Goal of tx for hyperkalemia? Give ___ IV. |
peaked T waves, flattened P waves, widened QRS
ventricular arrhythmias, conduction defects tingling, paresthesia, skeletal muscle paralysis shift K+ to normal places, antagonize cardiac effects - use IV Ca, insulin, glucose |
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Other tx options?
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cation exchange resin - Kayexalate
dialysis NaHCO3 with furosemide, diet restriction |
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Case: 22 y/o m, coma post car accident.
Na 135, K 7.8, Cl 100, HCO3 15, UA brown, detectable myoglobin EKG: no P waves, peaked T, wide QRs. cause? initial steps? |
rhabdomyolysis from trauma --> ARF
cardiac stabilization give CaCl, Ca gluconate then insulin, glucose, Kayexalate, albuterol, IVF |
