SIGNS AND SYMPTOMS OF HYPOKALEMIA

Slides:



Advertisements
Similar presentations
Updated March 2006: D. Tucker, RPh, BCPS
Advertisements

ELECTROLYTES.
Objectives Review causes and clinical manifestations of severe electrolyte disturbances Outline emergent management of electrolyte disturbances Recognize.
Other Cardiac Conditions and the ECG
Fluid and Electrolyte Management Presented by :sajede sadeghzade.
Refeeding Syndrome Management Issues Stella Hahn Pulmonary/Critical Care Fellow 2013.
Hypokalemia & Hyperkalemia
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Chapter 42 Agents Affecting the Volume and Ion Content of Body Fluids.
Disorders of Potassium metabolism Dr. Hammed Al shakhatreh Consultant Nephrologist.
Chapter4(2) Potassium Disorders 1.Normal potassium metabolism: (1) Balance of potassium intake and excretion: K + intake : mmol/day from vegetable.
3.)What are the adverse medical implications of this condition.
Professor of Anesthesia and Intensive care
Hypokalemia 55 y/o male CC: chronic diarrhea Farmer in La Trinidad, Benguet Noted progressive weakness for the past weeks Blood Test Na140 meq/L Cl110.
Electrocardiography Arrhythmias Review
Disorders of potassium balance Zhao Chenghai Pathophysiology.
Cardiovascular System Block Cardiac Arrhythmias (Physiology)
Arrythmia Interpretation (cont’d) Rates of automaticity – Too fast (tachycardia) – Too slow (bradycardia) – Too irritable (Premature) – Absent (block)
Hyperkalemia. Objectives Definition Brief review of potassium regulation processes Causes Clinical Manifestations Therapy Proposals for standardized management.
Electrocardiogram Primer (EKG-ECG)
Fast & Easy ECGs, 2nd E – A Self-Paced Learning Program
Measured by pH pH is a mathematical value representing the negative logarithm of the hydrogen ion (H + ) concentration. More H + = more acidic = lower.
EKG’s & Electrolytes Steven W. Harris MHS, PA-C Lock Haven University.
Chapter 17 Interpreting the Electrocardiogram
♣Que ,Francesca ♣ Lin, Yun Hsing ♣Reyes, Elaine
Lecture Objectives Describe sinus arrhythmias Describe the main pathophysiological causes of cardiac arrhythmias Explain the mechanism of cardiac block.
ECG, EKG, Electrocardiogram  The ECG is easy to understand  The abnormalities happen for a reason.
Hyperkalemia Tutorial
Chapter 12 – Miscellaneous Conditions  Artifact  Digitalis Effect  Pericarditis  Early Repolarization  Low Voltage  Hypo- and Hypercalcemia  Hyperkalemia.
Fluid and Electrolyte Imbalance Lecture 2 11/26/20151.
Arrhythmias. Cardiac dysrhythmia Cardiac dysrhythmia (arrhytmia) Abnormal electrical activity in the heart.
Disorders of potassium Dr Muhammad Rizwan ul Haque Assisstant Professor of Nephrology Shaikh Zayed Postgraduate Medical institute Lahore.
Electrocardiography – Abnormalities (Arrhythmias) 7
Aging & the Endocrine System Content for this module provided by The John A. Hartford Foundation, Institute for Geriatric Nursing, Online Gerontological.
HYPOKALEMIA mmol/L) ) Potassium Only 2% is found outside the cells and of this only 0.4% of your K+ is found in the plasma. Thus as you can see.
* QUINIDINE  Quinidine has pronounced cardiac anti muscarinic effects. It is absorbed orally. It undergoes extensive metabolism by the hepatic cytochrome.
In the name of GOD carnitine transporter deficiency
Electrolyte Emergencies
Kalemia Cindy Chung, Annel Garcia, Keaton Hambrecht, Carly Hoisington, Kirk Jones, Tiffany Le, Amy McCready, Jessica Medrala, Raquel Robayo-Krause, Jomay.
Arrhythmias ED SHO TEACHING C Brown, August 2015.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 25 Disorders of Cardiac Conduction and Rhythm.
DISORDERS OF POTASSIUM BALANCE
Learning Objectives Dietary sources Daily Requirements Metabolism
Cardiac Function in Disease Robert A. Augustyniak, PhD
Electrocardiography A recording of the electrical activity of the heart over time Gold standard for diagnosis of cardiac arrhythmias Helps detect electrolyte.
MLAB 2401: Clinical Chemistry Keri Brophy-Martinez
Electrical Properties of the Heart
Objective 12 Electrocardiograms
Sinus Rhythms: Dysrhythmia Recognition & Management
RHYTHM ANALYSIS DAN MUSE, MD.
CKD answers.
β-adrenergic antagonists
Electrocardiography (ECG) EKG
Potassium Homeostasis Ch4
Resident Survival Skills
Cardiovascular System Block Cardiac Arrhythmias (Physiology)
Stephanie Sutton RN, CNRN
Treatment of Congestive Heart Failure
©2012 Lippincott Williams & Wilkins. All rights reserved.
Arrhythmia Arrhythmia.
Hypokalemia 55 y/o male CC: chronic diarrhea
ECG Lecture Scott Ewing, D.O. March 23, 2006.
Electrocardiography – Normal 6
Sinus Rhythms: Dysrhythmia Recognition & Management
Antiarrhythmic drugs [,æntiə'riðmik] 抗心律失常药
Potassium Disorders.
Electrocardiograms Depolarization-cell's membrane becomes positive. Action potential generated. (Na+ and Ca+ into cell) Repolarization-cell's membrane.
Arrhythmias Simple-dysfunction cause abnormalities in impulse formation and conduction in the myocardium. However, in clinic it present as a complex family.
Electrolyte/metabolic disturbance
Presentation transcript:

SIGNS AND SYMPTOMS OF HYPOKALEMIA

SYMPTOMS Seldom occur unless the plasma K+ conc is <3mmol/L Fatigue, myalgia, and muscular weakness of the lower extremities Palpitations; constipation; nausea or vomiting; abdominal cramping; polyuria, nocturia, or polydipsia; psychosis, delirium, or hallucinations; depression Severe hypokalemia may lead to progressive weakness, hypoventilation and eventually complete paralysis Hypokalemic periodic paralysis Patients are often asymptomatic, particularly with mild hypokalemia. Symptoms are often due to the underlying cause of the hypokalemia rather than the hypokalemia itself. Hypokalemia should be suggested by a constellation of symptoms that involve the GI, renal, musculoskeletal, cardiac, and nervous systems. The clinical manifestations of K depletion vary between individual and severity depends on degree of hypokalemia. Fatigue, myalgia, and muscular weakness of the lower extremities – common complaints; due to a lower (more negative) resting membrane potential. Hypoventilation due to respi muscle involvement. states can potentially result in hypokalemia due to a K shift into cells. This may occur following rapid cell growth seen in px with pernicious anemia treated with Vit B12 or with neutropenia after tx with granulocyte-macrophage colony stimulating factor

SIGNS Signs of ileus Hypotension Ventricular arrhythmias Cardiac arrest Bradycardia or tachycardia Premature atrial or ventricular beats Hypoventilation, respiratory distress Respiratory failure Lethargy or other mental status changes Decreased muscle strength, fasciculations, or tetany Decreased tendon reflexes Cushingoid appearance (eg, edema) http://emedicine.medscape.com/article/767448-overview Potassium affects the way neuromuscular cells discharge energy (depolarize) and then regenerate (repolarize) that energy to be able to fire again. When potassium levels are low, the cells cannot repolarize and are unable to fire repeatedly, as is needed for the function of muscles and nerves.

ADVERSE MEDICAL IMPLICATIONS OF THIS CONDITION

Hypokalemia Impaired muscle metabolism and blunted hyperemic response to exercise associated with profound K+ depletion increase the risk of rhabdomyolysis Smooth muscle function may also be affected and manifest as paralytic ileus ECG changes: Early changes: T wave flattening or inversion, prominent U wave, ST segment depression, prolonged QU interval Severe K+ depletion: prolonged PR interval, decreased voltage and widening of QRS complex, and an increased risk of ventricular arrythmias (px with Myocardial Ischemia or left ventricular hypertrophy) Predispose to digitalis toxicity Associated with acid-base disturbances related to the underlying disorder Intracellular acidification and an increase in net acid excretion or new HCO3- production: consequence of enhanced proximal HCO3- reabsorption, increased renal ammoniagenesis, and increased distal H + secretion → generation of metabolic alkalosis Glucose intolerance attributed to either impaired insulin secretion or peripheral insulin resistance. ECG changes are due to delayed ventricular repolarization and do not correlate well with plasma K conc. Since the heart is also a muscle, there can be some changes in the electrocardiogram(EKG or ECG) that are associated with hypokalemia, especially in the repolarization section of the EKG tracing. Palpitations (irregular heartbeats) may be perceived by the patient. In severe cases, hypokalemia can lead to dangerous disturbances in heart rhythm (arrhythmias).

Hypokalemic periodic paralysis: rare condition characterized by recurrent episodic weakness or paralysis. Since K is the major ICF cation, anabolic