potassium
- Created by: Rebecca 291991
- Created on: 11-01-14 10:42
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- Potassium
- Hypokalaemia
- symptoms
- dyshythmia, constipation, fatigue, muscle wasting, muscle weakness, spasms, paralysis
- causes
- low potassium in diet, malnutrition or starvation
- gastrointestinal loss, diarrhoea, excessive sweating, vomiting, pancreatic fistulae, GI adenoma
- urinary loss, diuretics such as thiazides, or cisplatin
- diabetic ketoacidosis from polyuria, and loss of K from tubules
- hypomagnesaemia, magnesium required for K processing
- alkalosis causes a shift of K from plasma and IF into cells, rising HCO3 causes excretion of K
- renal stenosis and tumours of adrenal glands due to high aldosterone and high BP leading to excessive urinary loss of K
- defects in renal salt transporters eg Gitelman's
- difference between spurious and physiological causes
- spurious
- when sample has been left for a long time and in warm conditions
- in acute leukaemia where potassium moves into leukaemia cells
- spurious
- treatment of diuretic associated hypokalaemia
- switch to a potassium sparing diuretic
- symptoms
- Hyperkalaemia
- causes
- spurious
- inappropriate blood collection technique due to increased venous pressure and leakage of fluid into EC space, fist clenching leads to release of K into circulation, antiseptic can cause haemolysis, EDTA contamination, incorrect order of draw, IV drip contamination, delayed specimen to lab leads to K leakage into EC fluid, low temps give rise to a slowing of the Na-K ATPase/ red blood cell pump so K moves into the cells, too high centrifugation leads to haemolysis
- physiological
- ineffective elimination
- Renal insufficiency, ACE inhibitors, angiotensin receptor blockers, Potassium-sparing diuretics e.g. amiloride/ spironolactone), NSAIDs, immuno-suppressants, cyclosporin, Addison's disease, Aldosterone deficiency, congenital adrenal hyperplasia, familial hypertension with hyperkalaemia
- excessive release from cells
- muscle wasting, burns, blood transusion or hemolysis, acidosis, low insulin, beta-blockers, digoxin
- excessive intake
- dietary supplements, KCl
- familial pseudohyperkalaemia
- dominant inherited red cell trait
- ineffective elimination
- spurious
- symptoms
- Sickness, heart palpitations, muscle weakness, hyperventilation, cardiac arrhythmias or heart failure
- treatment of diuretic associated hyperkalaemia
- IV saline accompanied by a loop diuretic (eg, furosemide). Discontinue potassium-sparing diuretics, ACE inhibitors, angiotensin-receptor blockers and other drugs that inhibit renal K excretion.
- causes
- Hypokalaemia
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