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Flashcards in Hyperkalemia Article Deck (24)
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1
Q

Extracellular K level

A

4.0 - 4.5 mEq/L

2
Q

Total body K is regulated by

A

the kidneys

3
Q

Increasing the extracellular K concerntration results in

A
4
Q

Early effects of hyperkalemia

A

increase myocyte excitability by shifting the resting membrane potential to a less negative value and thus closer to threshold

5
Q

When moderate hyperkalemia occurs

A

myocyte depression occurs

6
Q

At what mV dose calcium channels open

A

-40 to -45 mV during phase 0

7
Q

The phase 2 plateau is cause by what

A

the movement of K out of the cell and Ca into the cell. temporarily off setting eachother, hence the plateau

8
Q

During phase 3 what happens

A

the Ca channels close and the K channels continue to release K out of the cell. Hence the doward slope of the the curve to a more negative state.

9
Q

Signs seen on an EKG of hyperkalemia

A

ST segment depression

Peaked T waves

shortening of the QT interval

10
Q

Earliest sign of hyperkalemia on the EKG

A

Peaked T waves

11
Q

Peaked T waves

A

K greater then 5.5 mEq/L

Only shows on 22% EKGs

12
Q

K greater then 6.5 mEq/L

A

widening QRS complex and prolonged PR interval

13
Q

8-9 mEq/L

A

SA node may stimulate the ventricles without atrial activity

14
Q

10 mEq/L

A

SA node conduction no longer occurs

Junctional pacer takes over causeing accelerated junctional rhythm

15
Q

> 10 mEq/L

A

widening of the QRS to become a sine wave and blends with the T wave.

U FUCKED Vfib and Asystole

16
Q

3 Ways to Treat Hyperkalemia

A

Membrane stabilization

Promote k influx into the Cell

Promote K Removal from the body

17
Q

Initial Tx for hyperkalemia

A

Ca infusion to antagonize the effects of hyperkalemia at the cellular level

Changes the resting membrane potential to less negative decreasing the excitability of the cell

18
Q

Ca effect can be seen how quickly

A

1-3 min

19
Q

Ca effects las how long

A

30-60 min

20
Q

which is the prefered calcium of choice IV gluconate or chloride

A

gluconate

10% solution given 10ml

or

100 mg

21
Q

calcium chloride is how many times stonger then calcuim gluconate

A

3X

22
Q

Typically how do you promote K influx into the cell

A

D50 and Insulin

effects are seen within 10 - 20 min

Decreases the K by 0.6 - 1 mEq/L

23
Q

The quickest K removal is done how

A

dialysis

not the most fesible though

24
Q

Other ways to get K out of the Body

A

Ion exchange resin with sorbitol via the gut, orally or rectally

decreases the K by 1 mEq/L in 24 hours