Potassium Levels

[LPN trying for RN]

Hi everyone,

I have a question about Potassium for my homework that I just don't know the answer to and I've looked on the internet and can not find the answer. Any help would be much appreciated.

Why would a doctor give a pediatric client a potassium IV drip if his potassium level is already increased?

Background info is that this pediatric client is in DKA, vomiting and had blood glucose of 501 last night.

[DolceVita, ADN, BSN, RN]

Just spit ballin' here...

When you say "increased" do you mean abnormally high? i'll assume yes. Where did that child's "excess" potassium come from? Within the cells. So once treatment is started (e.g. insulin and rehydration) where will that excess K+ go? Back into the cells. Meanwhile your patient will have been diuresing like crazy (losing potassium). So, the elevated potassium will reverse itself fairly quickly and the child will be hypokalemic.

It is a quick and dirty explanation -- I am a bit time limited right now. If you want a better one google "emedicine DKA". You should sign up for the site, it is very useful. Also, any decent med/surg book covers this in detail.

Hope that helps.

[JROregon, ASN, BSN, RN]

Dolce Vita has it right. After getting that insulin, those cells will be taking up potassium pretty quickly and the patient will be low again. Look what happens to potassium as a person goes into DKA.

[VickyRN, MSN, DNP, RN]

For this precise reason, my facility requires q hourly chem7's (including serum K+) for a child with DKA until the child no longer has any ketones.

Just as quickly as the serum K+ climbs in response to acidosis, the serum K+ will drop as the glucose levels are brought down with insulin and IV fluids and the child is no longer acidotic.

[nurseprnRN, BSN, RN]

when you have a patient with a really high serum glucose, the orders for insulin and potassium are always written together for that reason-- the insulin that drives the glucose into the cells (intracellular) takes potassium with it. the resulting low serum (extracellular) potassium makes for increased cardiac irritability and risk for pvcs and vt/vf (look this up, it's critical and has many other applications in nursing). so the potassium is prophylactic for that.:redbeathe

[LPN trying for RN]

thanks guys you all are very helpful....i'm just learning about this and really didn't understand it until you all explained it!!

[JROregon, ASN, BSN, RN]

You know, until I picked up a patient that was in DKA, I could not understand where stuff was shifting and why. Once I saw the insulin in action and watched the potassium levels, it sunk right in. Have fun with the learning!