Skip to content
View in the app

A better way to browse. Learn more.
allnurses

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
Discussion

DKA and potassium

I searched through this site, my textbook and asked my teachers and I haven't found consistency or a concise answer. I understand that DKA effects potassium for a few reasons: during acidemia (sp?) hydrogen ions move into cells and potassium moves into the ECF, kidneys excrete glucose when levels are high excreting potassium with it and once insulin is administered potassium moves into cells. I also understand that potassium is withheld until levels are low or normal and that levels are monitored due to the potential risk of cardiac arrhythmias.

What I can't seem to get an answer to is which of these comes first. Hypokalemia or hyperkalemia? Does it depend on the pt? The severity of DKA? Any and all help is needed. It's on my first med surg test this week.

  • Quote

    • Featured Replies

    The hypokalemia comes when the patient gets treated with insulin, driving the glucose and K+ into the cells. The kidneys can't (and won't) move so much out through urine with the excess glucose to make for hypokalemia.

  • Quote
    • Experts

    There can be a brief period of hypoglycemia in the early stages of an elevated blood sugar (polyuria)....but by the time "ketoacidosis" sets in the Serum potassium is elevated but the cellular potassium is depleted (all that shifting that goes on)

    doc.gif Diabetic ketoacidosis

  • Quote
    • Author

    So pretty much what we would observe clinically is hyperkalemia because the osmotic duiresis does not move serum potassium significantly?

  • Quote

    pH and K+ are inversely correlated. In DKA pH level drops therefore K+ level increases in ECF. Hyperkalemia will occur first. Then when the patient gets treated, the insulin drives back the K+ into the cells along with glucose causing Hypokalemia.

  • Quote
    • Author

    Right! I totally knew that but for some reason forgot to apply it to DKA.

    Thanks everyone!

  • Quote

    • Join the conversation

    You can post now and register later. If you have an account, sign in now to post with your account.

    Guest
    Add a Comment
    Go to topic listing

    Currently Reading 0

    • No registered users viewing this page.

    Account

    Navigation

    Search

    Search

    Configure browser push notifications
    Chrome (Android)
    1. Tap the lock icon next to the address bar.
    2. Tap Permissions → Notifications.
    3. Adjust your preference.
    Chrome (Desktop)
    1. Click the padlock icon in the address bar.
    2. Select Site settings.
    3. Find Notifications and adjust your preference.