aldosterone increases the excretion of potassium
magnesium is needed for absorption
Electrical activity of nerve and muscle cells
Water balance - potassium is pumped into cells
Kidney and adrenal function
lowers blood sugar
RDA - 5 g qd
Normal serum levels are 3.5 - 5.5 mEq/l
thiazide and loop diuretics deplete potassium
potassium sparing diuretics and ACE inhibitors may cause buildup
caffeine - increases excretion of potassium
hypertension, arrythmia - used in nerve impulse conduction
postural hypotension - needed for adrenal function
renal loss most common (usually due to diuretics)
insufficient dietary intake
muscle weakness, muscle pain, cramping, fatigue
hypotension, shallow respiration
nerve conduction abnormalities - arrythmias - PVCs particularly
anorexia advancing to nausea, vomiting
apathy, drowsiness leading to coma
mental confusion, irritability
paralytic ileus, abdominal bloating
ECG changes - peaked P, flat T, depressed ST, elevated U waves
usually renal disease (cannot excrete)
burns - cellular destruction releases K into extracellular space
crushing injuries - cellular breakage releases K from cells
respiratory or metabolic acidosis
Hyperkalemia results in prolonged depolarization of the cell membrane,
which causes weakness which may progress to flaccid paralysis
and hypoventilation if the respiratory muscles are involved.
The most serious effect of hyperkalemia is cardiac toxicity.
Early EKG changes include increased T-wave amplitude, or peaked T waves.
More severe degrees of hyperkalemia result in a prolonged PR interval and
QRS duration, atrioventricular conduction delay, and loss of P waves.
Progressive widening of the QRS complex and merging with the T wave
produces a sinewave pattern.
The terminal event is usually ventricular fibrillation or asystole.
diuretics if kidney function is adequate
hypertonic IV glucose with insulin
calcium IV if cardiac action is depressed
sodium bicarbonate if acidotic
high doses - nausea, vomiting and diarrhea with ulcers
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