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Potassium, K


Metabolism
aldosterone increases the excretion of potassium
magnesium is needed for absorption

Functions
acid-base balance
Electrical activity of nerve and muscle cells
Water balance - potassium is pumped into cells
Kidney and adrenal function
lowers blood sugar

Requirements
RDA - 5 g qd
Normal serum levels are 3.5 - 5.5 mEq/l

Sources
avocado

Interactions
thiazide and loop diuretics deplete potassium
potassium sparing diuretics and ACE inhibitors may cause buildup
caffeine - increases excretion of potassium

Therapeutics
Cardiac
hypertension, arrythmia - used in nerve impulse conduction
postural hypotension - needed for adrenal function
atherosclerosis
Oncology
cancer

Hypokalemia
Etiology
renal loss most common (usually due to diuretics)
insufficient dietary intake
Signs
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


Hyperkalemia
Etiology
usually renal disease (cannot excrete)
burns - cellular destruction releases K into extracellular space
crushing injuries - cellular breakage releases K from cells
adrenal insufficiency
respiratory or metabolic acidosis
Signs
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.
Rx
diuretics if kidney function is adequate
hypertonic IV glucose with insulin
calcium IV if cardiac action is depressed
sodium bicarbonate if acidotic

Toxicity
high doses - nausea, vomiting and diarrhea with ulcers


 

 

 

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