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Potassium, KMetabolism 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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