K disorderss

Question 1

3 causes of hypokalemia

Answer 1

1. decreased intake
2. shift into cells
3. excess loss
   - renal or GI

Question 2

main cause of K into cells (2)

Answer 2

1. insulin into cels

2. B2 agon

Question 3

main causes of renal K loss

Answer 3

1. diuretics
   - high aldo (RAAS) and high flow to CCD
2. renal tubular disease
3. ecess glucocort.
4. Mg def

Question 4

3 interactions between aldo and K

Answer 4

1. aldo stim leads to instertion of eNaC
2. Na reabsorbed faster than Cl
3. K out due to elect. greadtient

Question 5

3 reasons for hypokalemia in diuretics

Answer 5

1. high aldo
   - diuretics cause low ECF
   - increases renin
2. increased flow to collection duct
3. combo increases urine K loss

Question 6

7 clinical signs of low K

Answer 6

1. weakness
2. arrthymias
3. low deep tendon reflexes
4. paralytic ileus
5. polyuria and dipsia
6. N/V

Question 7

mgmt of low K

Answer 7

acute
- oral (preferred) or IV (if severe) Kcl
chronic
- high K foods
- K sparing diuretics

Question 8

3 causes of hyperkalemia

Answer 8

1. increased intake
2. shift out of cells
3. failure of renal excretion

Question 9

3 causes of hyperkalemia

Answer 9

1. increased intake
2. shift out of cells
3. failure of renal excretion

Question 10

3 reasons K comes out of cells

Answer 10

1. (acidosis) insulin def. - DKA, hyperglycemia
2. muscle necrosis- rhabdo
3. hemolysis - GI bleeds
4. rapid admin of B-blocker

Question 11

2 reasons for low K excretion

Answer 11

1. low flow to CCD - low gfr, low ECFV
2. low aldo
   - adrenal disease
   - ACEi, ARB
   - k-sparing diuretics

Question 12

signs of hyperkalemia

Answer 12

1. muscle weakness
   - low reflexes
   - resp failure
2. ECG chnages
3. arrythmias
   K>7 is life threatening

Question 13

2 ways diabtes and hyperkalemia are related

Answer 13

1. insulin def.

2. reduced Kidney excretion

Question 14

***4 princinples to manage hyperkalemia

Answer 14

1. stabilize myocardium
2. shift K into cells
3. excrete K
4. dyalise

Question 15

how to stabilize the myocardium

Answer 15

• give calcium gluconate

- helps antagonize the membrane action of hyper kalemia

Question 16

how to shift K into cells

Answer 16

IV insulin or B2 agon

Question 17

3 ways to help excrete K

Answer 17

1. renal
   - IV saline and the furosomide
2. GI
   - laxative
   NOT in post-op ileus
3. dialysis