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Potassium Pathophysiology - Coggle Diagram
Potassium Pathophysiology
Ins
Oral
IV
Almost never possible to cause issues alone
Outs
K Excretion requires
CCD Flow
Low Extracellular volume/low GFR
Aldosterone
Less angiotensin 2
Adrenal not responsive to angiotensin 2
Decreased aldo due to CCD
Receptor defect
sick Cells
K sparing diuretics
Shifts
Cell Lysis: High water causes cells to lyse and release water
Inhibition of Na-K-ATPase
Lack Insulin
Block beta-adrenergics
Conditions
Hypokalemia
Serious Effects
Arrhythmias
Muscle weakness or paralysis
ECG
Flattened T wave and U wave development
Causes
Ins
Decreased body K content - Decreased intake
Shifts
Cell Anabolism
Insulin
B2 stimulation
Metabolic alkalosis
Outs
GI Tract
Severe Diarrhea
Kidneys
Too High Concentration of potassium in urine due to hihg aldo or bicarb in urine
Excess HCO3 in urine increases urine K
High Flow due to high ECFV or high salt diet, loop or thaizide diuretics
Common
Diarrhea
Vomiting
Diuretics
Treatments
Reduce Losses
Replacement: Deficits and ongoing losses
Hyperkalemia
Cardiac
Risk of brady or tachyarrhythmias
Progression is unpredictable and any EKG change is an emergency
ECG
Peaked T waves and Widened QRS
Management
ECG Changes
Provide calcium to stabilize membranes
Shift K into Cells
Insulin
Salbutamol
Bicarb
Outs
Gut: Ion Exchange Resins
Kout = Flow x [K-]
Increase flow
Diuretics
Expand ECFV (salt)
Increase K in urine
Aldosterone
Dialysis
Causes
Shift from ICF to ECF (cell death, insulin deficiency )
Decrease renal excretion (low tubular flow, low aldo or low response)
