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467
S. Faubel and J. Topf17 Introduction to Potassium
17
17 Introduction to Potassium
468
The Fluid, Electrolyte and Acid-Base Companion
Potassium is the final electrolyte which will be covered in this book. Someof the major differences between sodium and potassium are outlined below:
Introduction
Potassium…the final frontier.
K
+
Na
+
Cl
–
HCO
3 –
BUNglucoseCr
K
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
Potassium is the ________ intracellular cation while sodium is theprimary ___________ cation.Disturbances in _______ concentration result in altered electrical ac-tivity which can affect the __________, muscles and nerves.primaryextracellularpotassiumheart
Medical Latin:•Hypokalemia: low plasma potassium, K
+
< 3.5 mEq/L.•Eukalemia: normal plasma potassium, 3.5 < K
+
< 5.0 mEq/L.•Hyperkalemia: increased plasma potassium, K
+
> 5.0 mEq/L.• Kaluresis: loss of potassium in the urine.
Sodium
•Primary extracellular cation.•Alterations in sodium concentra-tion affect the osmotic movementof water in and out of cells. Mostclinical symptoms are related tocerebral edema or dehydration.
Potassium
•Primary intracellular cation.•Alterations in potassium concen-tration result in electrical signalsthat interrupt normal cardiacrhythm, muscle activity and nerveconduction.
469
S. Faubel and J. Topf17 Introduction to Potassium
ATPAMP3 Na
+
2 K
+
K
+
K
+
K
+
K
+
Introduction
The vast majority of the total body potassium isintracellular.
When thinking about potassium physiology, two facts should always beconsidered:•99% of total body potassium is in cells.•
Small
changes in plasma potassium can have dramatic clinicalconsequences.Tight control over both the intracellular and extracellular potassium poolsis necessary because the movement of only 1% of the intracellular potas-sium to the extracellular compartment can stop the heart.
Total body water for a70 kg man is 42 liters.14 liters isextracellular28 liters isintracellularTotal extracellularpotassium is(14 L
×
4 mEq/L).
56 mEq
Total intracellularpotassium is(28 L
×
140 mEq/L).
3,920 mEq
The two central aspects of potassium physiology which must al-ways be considered are:•The vast majority of potassium is ___________.•Small changes in the extracellular _________ concentra-tion can have dramatic clinical consequences.Movement of only ____ percent of the intracellular potassiumpool to the extracellular compartment can stop the _______.aaaintracellularpotassiumoneheart
intracellular compartmentK
+
=140 mEq/Lextracellular compartmentK
+
= 4 mEq/L
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