hypokalemia and respiratory acidosis

[Cristy3685]

Hello. I just wanted to get your inputs on this scenario:

Hyperkalemia is frequently associated with acidosis as potassium moves out of the cell to compensate for hydrogen moving into the cell. How, then, would you explain the patients hypokalemia occurring along with respiratory acidosis? (Hint: The patient is concurrently receiving Potassium Chloride 40 mEq/L in IV fluid.

[shorty3_31]

Actually, if hydrogen is moving into the cells that would make it alkalosis because hydrogen would be leaving the blood. The pH of blood depends on two things: the amount of hydrogen ions and the amount of bicarbonate (HCO3). Most of the time you can determine the type of acid-base imbalance by the substance that is most outside its normal limits. Usually metabolic is associated with bicarb whereas respiratory is tied to hydrogen.

That being said, I'm not sure how you might be having HYPOkalemia when you're having a potassium drip. You might need to share a little more info about the patient/problem before getting a good answer.

I'm not sure I helped any with that answer...

[Daytonite, BSN, RN]

can't. respiratory acidosis is always due to an inadequate exhalation of c02. this causes the co2 levels in the blood to elevate (normal arterial co2 is 35-45 mmhg) and carbonic acid levels in the blood to increase. as well, the person often hypoventilates which results in low o2 levels.

this patient's respiratory acidosis does not explain their hypokalemia. the only way respiratory acidosis and hypokalemia could be related is if the patient had some medical condition in addition to the respiratory acidosis that had hypokalemia as one of its features or complications. so, some other pathophysiology is going on. 40 meq of kcl is commonly added to a liter of iv fluids and is done for potassium replacement purposes.

table of commonly used iv solutions.doc