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17 Introduction to Potassium

17 Introduction to Potassium

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Published by Joel Topf

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Published by: Joel Topf on Oct 26, 2009
Copyright:Attribution Non-commercial

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11/13/2012

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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    
+    
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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