FLUID AND ELECTROLYTE

IMBALANCE

DEFINITON

Insulin (e.g. intravenous injection of 10-15 units of regular insulin

along with 50 ml of 50% dextrose to prevent hypoglycemia) will lead
to a shift of potassium ions into cells

Salbutamol (albuterol, Ventolin), a 2-selective catecholamine, is

administered by nebulizer (e.g. 1020 mg). This drug also lowers
blood levels of K+ by promoting its movement into cells

CAUSES OF HYPERKALEMIA
Ineffective elimination- Renal insufficiency
Medication that interferes with urinary excretion. amiloride
ACE inhibitors and angiotensin receptor blockers
Potassium-sparing diuretics (e.g spironolactone)
NSAIDs such as ibuprofen, naproxen, or celecoxib
Mineralocorticoid deficiency or resistance, such as: Addison's disease
Aldosterone deficiency
Some forms of congenital adrenal hyperplasia
Massive blood transfusion or massive hemolysis
Shifts/transport out of cells caused by acidosis, low insulin levels, betablocker therapy, digoxin overdose, or the paralyzing agent
succinylcholine
Acute Digoxin toxicity may cause hyperkalaemia
Excessive intake Excessive intake with potassium salt-substitute,
potassium-containing dietary supplements, or potassium chloride (KCl)

SIGNS AND SYMPTOMS

Malaise
palpitations
muscle weakness
mild hyperventilation may indicate a compensatory
response to metabolic acidosis which is one of the possible
causes of hyperkalemia.

TREATMENT

Insulin

(e.g. intravenous injection of 10-15 units

of regular insulin along with 50 ml of 50%
dextrose to prevent hypoglycemia) will lead to a
shift of potassium ions into cells

Salbutamol

(albuterol, Ventolin), a 2-selective

catecholamine, is administered by nebulizer (e.g.
1020 mg). This drug also lowers blood levels of
K+ by promoting its movement into cells

Calcium

(calcium chloride or calcium gluconate)

HYPOKALEMIA
DEFINITION
The condition in which the concentration
ofpotassium(K+) in the blood is low

CAUSES

Inadequate potassium intake

Gastrointestinal or skin loss

Diarrhea, vomiting or excessive perspiration.

Urinary loss

medications likeloop diuretics, thiazide diuretics,

cancer drug, cisplatin, can also cause long-term
hypokalemia.

diabetic ketoacidosis

high aldosterone levels can cause hypertension and

excessive urinary losses of potassium-renal artery stenosis
and tumors

Cushing's syndrome

SIGNS AND SYMPTOMS

muscle

weakness, myalgia, tremor, and muscle

cramps
flaccid

paralysis and hyporeflexia

Respiratory

depression from severe impairment of

skeletal muscle function

electrocardiographic

(ECG) findings associated

with hypokalemia include flattened or inverted T
waves, a U wave, ST depression, and a wide PR
interval