tailieunhanh - Fluids and Electrolytes Demystified - part 6

Bất kể nguyên nhân của hạ kali máu, bổ sung kali thường được cung cấp để giảm bớt các triệu chứng và biến chứng. Phạt cảnh cáo được thực hiện với chất bổ sung kali để tránh dư thừa. Nếu hạ kali máu là do nhiễm kiềm, thận trọng đặc biệt được thực hiện với chất bổ sung bởi vì sự điều chỉnh của nhiễm kiềm sẽ gây ra kali | CHAPTER 6 Potassium Imbalances 105 T C Table 6-3 Foods with High Content of Potassium Apricots raw Apricot nectar Bananas raw Cantaulopes Dates dried Oranges Orange juice Raisins Carrots Potatoes Tomatoes Milk Salt substitutes Lite salt salt-free Mrs. Dash Morton Nature s Seasons Regardless of the cause of the hypokalemia potassium supplements usually are provided to diminish the symptoms and complications. Caution is taken with potassium supplements to avoid excess. If hypokalemia is caused by alkalosis particular caution is taken with supplements because the correction of alkalosis will cause potassium to shift back out of the cells and supplements could result in a potassium excess. Case Application Mr. Lawrence Key age 62 was admitted 5 days ago after a car accident with massive injuries to his extremities and trunk. Vital signs are blood pressure BP 100 60 mm Hg pulse P 118 beats minute and respiration R 32 breaths minute. He is lethargic his skin is cool to the touch and his mucous membranes are dry. His laboratory a results today revealed Na 137 mEq L K mEq L CO2 20 mEq L blood urea nitrogen BUN 40 mg dL and creatinine mg dL. His urine output has been 20 mL h except when a diuretic Lasix was administered. The nurse considers the following when analyzing Mr. Key s risk for potassium imbalance Mr. Key s age places him at risk because of decreased renal function accompanying aging. The massive trauma resulted several conditions that increase potassium concentration 106 Fluids and Electrolytes Demystified Cell injury caused the release of potassium from cells. Circulatory compromise . decreased level of consciousness low BP tachycardia cool skin and dry mucous membranes indicate possible shock decreases renal perfusion and excretion of K resulting in hyperkalemia. K level is elevated indicating hyperkalemia. CO2 is low indicating low bicarbonate and possible acidosis pulling potassium out of the cells and driving H ions into the cells. BUN and .