SPARK NOTES ELECTROLYTES - Since potassium is normally...

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Since potassium is normally found inside the cell, anytime you have tissue damage (cellular contents spill out) then serum K+ (potassium levels in the blood) will rise Mg and K+ can only be excreted by the kidneys so if urine output is decreased you have to monitor these levels closely and decrease any dietary intake (including antacids, etc.) they contain them Na+ levels are a good indicator of hydration. A high Na+ means dehydration, or fluid volume deficit, and low sodium means fluid overload, or fluid volume excess. Mg and Phos are inversely proportional. If one goes up, the other goes down. Therefore hypermagnesiemia is the same as hypophosphatemia. In Respiratory Acidosis/Alkalosis...the lungs are the problem and can only be fixed by the kidneys In Metablolic Acidosis/Alkalosis...the kidneys are the problem and can only be fixed by the lungs The lungs only have one compound to fix an acid base imbalance and that is CO2, which is an acid, and it will either be excreted (hyperventilation) to correct metabolic acidosis or retained (hypoventilation) to fix metabolic alkalosis. The effects are immediate. The kidneys can excrete HCO3(base) or H+(acid) to correct respiratory problems but this usually takes at least three days to become effective. Hypokalemia Refers to a potassium deficit in ECF Serum potassium less than 3.5 mEq/L 2.5 or less is very dangerous Hyperkalemia Refers to an excess of potassium in ECF Serum potassium greater than 5 mEq/L Occurs less than hypokalemia, but can be much more dangerous Patho When extracellular potassium levels fall potassium moves from the cell creating an intracellular potassium deficient Sodium and hydrogen ions are then retained by the cells to maintain isotonic fluids Patho Risk Factors “Your body is trying to DITCH potassium” D rugs (laxatives, diuretics, corticosteroids) I nadequate consumption of Potassium (NPO, anorexia) T oo much water intake (dilutes the potassium) C ushing’s Syndrome (High secretion of Aldosterone) H eavy Fluid Loss (NG suction, vomiting, diarrhea, wound drainage, Risk Factors Remember the phrase “The Body CARED too much about Potassium.” C ellular Movement of Potassium from Intracellular to extracellular (burns, tissue damages, acidosis) A drenal Insufficiency with Addison’s
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sweating) Other causes: when the potassium moves from the extracellular to the intracellular with alkalosis or hyperinsulinism (this is where too much insulin in the blood and the patient will have symptoms of hypoglycemia) Disease R enal Failure E xcessive Potassium intake D rugs (potassium-sparing drugs like aldactone (spiroaldactone), Triamterene, ACE inhibitors, NSAIDS Since potassium is normally found inside the cell, anytime you have tissue damage (cellular contents spill out) then serum K+ (potassium levels in the blood) will rise Decreased potassium excretion Obliquric renal failure Potassium-sparing diuretics Hypoaldoesteronism High potassium intake (esp in the presence of renal insufficiency
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