Electrolyte imbalance: Potassium

Potassium

3.5-5 mEq/L

Function:

major intracellular ion; influences muscle activity & pH regulation

Hypokalemia

Values:

           <3.5, Moderate: 2.5-3; severe <2.5

Causes:

·              Loss of GI secretions

·              Excessive renal excretion of K

·              Movement of K in cells (DKA)

·              Diuretics

Signs and symptoms:

·              Skeletal muscle weakness

·              ↓ smooth muscle function

·             ↓DTR’s

·             ↓ BP, EKG changes, possible cardiac arrest

·             N/V, paralytic ileus, diarrhea

·             Metabolic alkalosis

·             Mental depression and confusion

Treatment:

1.            Potassium supplements:

·          Oral replacement through high K diet

·         IV supplementation

    No more than 10 mEq/hr; for child 2-4   mEq/kg/24hr

No more than 4 mEq/hr

2.           Hypertonic glucose solution

3.           Monitor:

·            I&O

·            Bowel sounds

·            VS, cardiac rythm

·            Muscle strength

·            Digoxin level if necessary

Hyperkalemia

Values:

            >5.3

Causes:

·             Excessive Potassium intake especially in patients

     with Renal failure

·              Tissue trauma

·             Acidosis

·             Catabolic state

Signs and symptoms:

·              ECG Changes

·              Tall, tented T-waves

·              Cardiac arrhythmias

·              Muscle weakness

·              Paralysis,

·              Paresthesia of tongue, face, hands and feet

·              N&V

·             Cramping

·             Diarrhea

·             Metabolic acidosis

Treatment:

1.            10% Calcium gluconate

2.            Sodium Bicaronate

3.            50% glucose solution

4.            Kayexalate PO or PR

5.            Stop K supplements and avoid K in foods, fluids, salt substitutes