Question

Patient with an NG tube is complaining of muscle weakness and leg cramps. Pt has PVCs noted on the cardiac monitor. Lab results show sodium of 142, potassium of 2.9, chloride 101, magnesium 1.9, calcium 9.3. What is going on with this patient? What are interventions for this patient?

Answer 1

Patient with an NG tube is complaining of muscle weakness and leg cramps. Pt has PVCs noted on the cardiac monitor. Lab results show sodium of 142, potassium of 2.9, chloride 101, magnesium 1.9, calcium 9.3. What is going on with this patient? What are interventions for this patient?

Answer: Patient is on lower potassium levels

Normal serum potassium levels: 3.5-5.5 meq/L or mmol/L

Symptoms of hypokalemia include weakness, myalgia, constipation, and
rhabdomyolysis. Patients can develop Premature Atrial Complexes, Premature Ventricular Contractions, Sinus bradycardia, Premature
Arterial Tachycardia, Junctional tachycardia, AV Block, Ventricular tachycardia, and Ventricular Fibrillation.

This patient could be diagnosed as PCVs induced arrhythmia or Cardiomyopathy or? MI

Hypokalemia can be treated as :

The treatment of hypokalemia has four facets, as follows:

• Reduction of potassium losses

• Replenishment of potassium stores

• Evaluation for potential toxicities

• Determination of the cause to prevent future episodes, if possible

Sympathomimetics, insulin, methylxanthines, and dobutamine drive extracellular potassium into cells by stimulating Na+,K+-ATPase. Diuretics increase renal potassium loss by inhibiting sodium reabsorption in the loop of Henle and in the distal nephron. Amphotericin B is well known for its capability of disrupting the function of the collecting duct, causing nephrogenic diabetes insipidus, renal potassium loss, and distal renal tubular acidosis. Nonreabsorbable anions such as some penicillins and aminoglycosides can cause hypokalemia via obligatory potassium loss into urine.

Replacement potassium via parenteral route should be reserved for patients with severe hypokalemia presenting with electrocardiographic abnormalities.

Total amount of daily K+ replacement should be less than 240-400 meq/ day

Parenteral K+ replacement should be given in the form of dextrose free vehicles.