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Dr deopujari
Miss Munira
Urinary potassium is for the most part secretory potassium. Distal potassium secretion is regulated by the amount of sodium in the the distal and collecting tubules, and the aldosterone activity. Serum potassium in itself is an important factor in the regulation of aldosterone activity.
98 %
2%
98 %
2%
Causes Hyperkalemia
Clinical features.
138
True Hyperkalemia Excess K+ intake Decreased excretion Redistribution Acidosis Diabetes. Adrenal Ins. Periodic P. Renal failure Oliguria Hypoaldo. Nsaids Ace inhibitors
2%
98 %
Hyperkalemia
Calcium chloride: 0.2 mL /kg/dose of 10% sol IV over 5 min; not to exceed 5 mL (stop infusion if bradycardia develops) Calcium gluconate: 100 mg/kg (1 mL/kg) of 10% sol IV over 5 min; not to exceed 10 mL (stop infusion if bradycardia develops) Soda bi carb ( with acidosis ) 2 ml / kg 25 % dextrose with .1 units /kg insulin . over 30 minutes (1 U regular insulin/5 g glucose ) Beta agonists
Onset of action
1-3 min.
5-20 min.
1-2 ml/Kg IV
1-2 hours
0.1 U/Kg of - insulin & 0.520-30 min. 1.0 g/Kg of glucose 4 i:micro g/Kg IV over 15-20 minutes5 - 10 30 min. mg via inhalation
2 hours
Salbutamol
4-6 hours
Hypokalemia
Causes..
Distribution Decreased
Hypertension
Normal B.P.
Acidosis Renin
Alkalosis
88
I . V . Kesol should be considered for Significant arrhythmia Sever muscle weakness Severe hypokalemia (< 2.5.0 mEq. / L). Digoxin toxicity Hepatic encephalopathy Maximum concentrations of KCl used in peripheral veins generally should not exceed 4 meq. /100 cc due to the damaging effects on the veins , at a rate of 1 mEq/kg per hour.
3 months female weighing 2.3 kg with persistent diarrhea . If serum [K+ ] level does not Serum potassium 2.3 not rising in appreciably rise byand 48 hours, spite of good magnesium concomitant Potassium replacement. depletion should be suspected Cause ?
Potassium should be administered slowly, preferably Orally, at a dosage of 4 to 6 mEq/kg per day.
Human milk contains small amounts of K+ , about (12.8 mEq) per liter, whereas cow's milk contains almost three times.
SERUM K
7.4
ALKA
LOSIS LOW K
ACIDOSIS CAUSES
HYPERKALEMIA
H I O N S
THANKS